College of Human Sciences

The forgotten vulnerable

Dr Janice Moodley (Senior Lecturer, Department of Psychology, CHS) says that Covid-19 presents unique challenges for pregnant women and new mothers, not only in terms of a hyper-vigilance to ensure the safety of both mother and baby against an unknown enemy, but also in the stripping away of the social networks that women rely upon during pregnancy and birth.

The expectant arrival and birth of a child, which is usually a celebratory event enjoyed by the newborn’s parents, their family, and friends, is now eclipsed not only by Covid-19-induced decreases in healthcare access but also by social isolation, which has its own unique set of debilitating consequences on maternal and foetal health. For women, the expectancy and arrival of a baby signifies a social rite of passage that invites coming together to shower both mother and baby with gifts, to share stories, to pass on inter-generational knowledge and traditions, as well as to offer practical support, advice (wanted or not!) and comfort during a time that can present unexpected stressors and anxieties.

Covid-19 has presented unique challenges for pregnant women and new mothers, not only in terms of a hyper-vigilance to ensure the safety of both mother and baby against an unknown enemy, but also, sadly, in the stripping away of the social networks that women rely upon during pregnancy and birth. Consequently, the incidence and severity of mental health issues such as perinatal and postpartum depression and anxiety may increase, as is expected during times of unprecedented change.


No solace available to physically and emotionally fatigued mothers

Expectant mums are now (understandably) mandated to attend prenatal check-ups alone while fathers are allowed to attend the birth only; that is, if you are lucky enough to birth in a private facility. The arrival of teddies, helium balloons and flowers are starkly replaced by the surreal realisation that masked medical staff are the only solace available to physically and emotionally fatigued mothers. Stuck in a cycle of change, nurse, burp, then repeat, new mothers inevitably relegate their own recovery to the periphery as they focus on caring for their newborn. Add-on services, such as lactation consultations provided by (mostly private) facilities to assist mothers with nursing issues, have fallen away - while its impact on mother-child bonding and wellbeing are unexplored.

The lack of social interaction with one’s partner and support network during the hospital stay may exacerbate incidences of postpartum depression and anxiety. Additionally, the mental health of new mothers may became additionally taxed by traumatic birthing experiences that require extended periods of social isolation in hospital, which may result in the development of post-traumatic stress disorder (PTSD). The fear of unnecessary social interactions in the threatening face of Covid-19, combined with the realities of a fractured healthcare system that is serviced by psychiatrists in rural areas at a rate of 0,03 per 100 000 in South Africa and psychologists at a rate of 1.4 per 100 000, for example, leaves women and their babies vulnerable to very serious consequences of unmanaged mental illness.


Rising numbers of maternal and infant mortality

And while we reflect on the serious psychological effects that expectant and new mothers may be vulnerable to, we are also confronted by the harsh realities of maternal and infant mortality as expectant mothers and their babies become the forgotten casualties of a pandemic that has ravaged the poor, widening social disparities globally. Media reports of human rights contravention in public facilities have jolted South Africans to the absurdities that exist within our health-care system as mothers fear for the safety of their newborns in overcrowded maternity wards, while others labour in hallways.

This rings true of an article published in The Lancet this year that discussed this indirect consequence of the Covid-19 pandemic in low- and middle-income countries – an increase in maternal and under-five child deaths arising from Covid-19-related disruptions in already overburdened health care systems. This is a saddening reality when reflecting on the gains that have been made in decreasing maternal and infant mortality, in countries such as South Africa, in line with the United Nations Sustainable Development Goals.

It is far too early to predict the exact mental health and wellbeing impact that the pandemic will have on expectant and new mothers and their babies…for now, there is a deafening silence answering the yearning for social bonding against the cries of newborns, as mothers navigate this new apocalyptic-like normal…

References available on request.

* By Janice Moodley, PhD and Senior Lecturer, Department of Psychology, College of Human Sciences

Teaser image: Marco Verch (Creative Commons 2.0)

Publish date: 2020/08/11