Postpartum Depression And Anxiety Are Huge Problems. COVID-19 Is Making Them Worse.

At some point in April, about two and a half months after giving birth to her second child, Mariejose Fichtner had a thought: If she came down with COVID-19, she could get a few weeks to herself.

“I feel so ridiculous and so embarrassed to say that,” Fichtner told HuffPost. She is a therapist who understands the vulnerability of the postpartum period and had set up a support system ahead of time — but when the coronavirus pandemic hit, that system dissolved. Fichtner was overwhelmed by what she saw as her own maternal shortcomings as she tried to care for a newborn while home-schooling a 5-year-old.

“I felt extreme guilt and disappointment and shame with myself,” said Fichtner, who has since begun treatment for postpartum depression. “I felt like I was failing so much.”

Perinatal mood issues, particularly postpartum depression (PPD) and postpartum anxiety (PPA), are common complications of childbirth even in the best of times. PPD affects up to 1 in 8 women in the United States. And some research suggests that PPA is even more common.

Because COVID-19 only hit the U.S. several months ago, it is too soon for any comprehensive research on diagnoses of PPD and PPA during the pandemic. But experts who regularly treat women with postpartum mental health issues say that they’re seeing a surge in postpartum depression and anxiety.

“We were probably at double our volume of daily calls in month three,” said Paige Bellenbaum, chief external relations officer for the Motherhood Center, a mental health clinic based in New York City. “As we moved into month five and six, our call volume has tripled. It’s not only people calling, it’s people flocking to our support groups.” She said that women are reaching out from around the country and even abroad.

The reasons for that influx make perfect sense. Postpartum mental health issues are fueled not only by the hormonal turmoil that women experience but also by the emotional and practical challenges of keeping a vulnerable new human alive while operating on very, very little sleep. Having a baby during a pandemic is harder. Even if everyone in the family is healthy, it’s harder. Even if the family’s financial situation has not been damaged by layoffs, it’s harder. It takes all of the challenges of parenting a newborn — the nerves, the stress, the at-times profound loneliness — and amplifies them.

“I’d say there’s three major things that are happening. One is that there is a potential for an increase in postpartum post-traumatic stress disorder, because many women are going in by themselves to prenatal visits ... and of course we went through that period in the beginning when women were being told they weren’t being able to bring someone into the birth room with them,” said Kate Kripke, founder of Colorado’s Postpartum Wellness Center of Boulder.

“Women are spending less time in the hospital postpartum, so that sense of initial care women get postpartum is shortened,” Kripke continued. “And then I have new mom after new mom after new mom telling me, ‘I can’t have anyone help me because of COVID.’”

She summed it up: “It’s almost like this pandemic is creating a system where we’re setting women up to develop depression and anxiety postpartum.”

The stories from moms home with new babies certainly paint a concerning picture.

For Kristen, a 38-year-old from Pennsylvania who gave birth to her second baby in early April — when COVID-19 cases were peaking locally — anxiety has been on a slow creep, starting in the delivery room. Her husband was still able to be with Kristen, who asked to use only her first name for privacy reasons, but the mood in the hospital was tense and the staff, new to their coronavirus protocols, were short with each other.

That tension increased after Kristen came home. She has been trying to balance the needs of her older child with those of her newborn ― with some help from family members, who’ve had a lot of opinions to share. They’ve made it known that they believe Kristen and her husband are overreacting to the threat of the pandemic, guilting her for not wanting to attend family gatherings. It’s difficult for Kristen to get out of the house, because it is too hot to take her kids for long walks, and going into stores feels challenging and risky.

“I’m wound tighter than I normally am. I am on edge more than I normally am,” said Kristen. She was planning to meet with her doctor the day after she spoke to HuffPost because she’d reached a point where she knew she needed some level of professional mental health support.

Kristen was quick to add that her family is “so lucky and blessed,” but said the only people who really understand this experience are other parents also in the thick of it.

“One of the number-one questions I used to get before the pandemic but much more so now is ‘What’s normal? Is this normal that I feel X, Y and Z?’” said Bellenbaum. “We are in uncharted territory right now. ... This burden, this challenge and this struggle that pregnant and postpartum women are experiencing right now is unlike anything before.”

Bellenbaum said that so much of what she is doing these days is simply giving women “permission” to experience whatever it is they are feeling without guilt and to ask for help.

“Support is non-negotiable,” echoed Kripke, who said women suffer when their postpartum experience becomes an either/or situation — as in they can take care of either their baby’s physical health and safety or their own mental wellbeing, but not both. Instead, she urges women to see this time as a “how are we going to ...” moment ― as in how can they get some level of logistical and emotional support now, even amid a pandemic.

The answers can be much more difficult for women who have no partner and no family nearby and who are struggling financially. But even small steps can help.

Kripke often asks women to list three things they need to be mentally “well enough” — perhaps a quick daily walk, a shower, enough food throughout the day — and start by prioritizing those.

It’s still challenging, all of it.

“Motherhood does take a village, as corny as that sounds,” said Fichtner, who is coping better now that she has sought out mental health support but still struggles. “We’re not meant to do this alone.”