Postpartum mental health visits spiked by more than 25 per cent in pandemic, research shows

Canadian Medical Association Journal

Abigail Morran was no stranger to anxiety, but for years, she had it under control.

Then the first-time mom, who lives in a town just outside Winnipeg, started to feel more anxious while going to round after round of prenatal medical appointments without her fiancé because of pandemic restrictions. After worrying non-stop about getting COVID-19, she wound up leaving her job in the third trimester of her pregnancy to go on stress leave.

But the overwhelming strain of isolation and uncertainty — on top of the usual stress of having a newborn — really ramped up once her daughter Eris was born in March, just before Manitoba started experiencing its third wave of cases.

“The high from being excited about being a mom crashed, and the numbers climbed, and it was all a snowball,” she said.

The breaking point, Morran recalled, was enduring a sleepless night several weeks after her daughter was born, then driving around solo and exhausted the next day to run errands — and worrying the whole time whether her newborn was still breathing in the backseat.

“As I was driving home, I was like, I can't do this any longer unless I get some help with it,” she said. 

Soon after she got home, Morran made an appointment with her doctor.

Her experience echoes what many Canadian parents have been saying throughout the pandemic — that anxiety, stress, and feelings of burnout are high among people with kids — but in Morran's case, she'd reached a breaking point and knew it was time to seek help.

Now, just-published Canadian research suggests the strain on new mothers in particular has translated into more postpartum individuals seeking mental health support after giving birth.

Visits up as high as 34 per cent in one month

The study, published Monday in the Canadian Medical Association Journal by a team of researchers in Toronto, found month-by-month mental health visits for postpartum people in Ontario spiked by an average of more than 25 per cent throughout much of 2020 compared to previous years.

The research team was led by Dr. Simone Vigod, chief of psychiatry at Women's College Hospital and senior adjunct scientist at the Institute for Clinical Evaluative Sciences, a health information non-profit. They looked at demographic data and mental health visits for more than 137,000 people in Ontario during the postpartum period from March through November 2020. 

Canadian Medical Association Journal

After Ontario declared a state of emergency midway through March, there were noticeable increases in demand from April onward, with the rate of postpartum people accessing care each month going up by a range between 16 to 34 per cent compared to data compiled from previous years, according to the study.

“We're talking about a massive amount of increased need,” Vigod told CBC News. 

“People going to their doctors, receiving a diagnosis, and probably requiring treatment.”

And while her team's findings focused on one province, she expects there may be similar trends in other regions where new parents had to endure months of isolation and limited postpartum support from extended family and friends.

New parents vulnerable 'at the best of times'

Dr. Tali Bogler, the chair of family medicine obstetrics at St. Michael's Hospital in Toronto, agreed the mental health strain on new mothers and families in general is likely a Canada-wide issue, and not just during the postpartum period.

Since launching a social media-based initiative called the Pandemic Pregnancy Guide with her colleagues in April 2020, she said the Instagram account has garnered more than 30,000 followers, and her team now fields questions and concerns from parents-to-be across the country. 

“The COVID-19 pandemic has had a significant impact on the perinatal population, and when I say perinatal, I mean pre-pregnancy, trying to conceive, during pregnancy, and postpartum,” she said.

Canadian Medical Association Journal

In pre-pandemic times, medical experts estimated about 1 in 5 perinatal individuals typically wound up coping with a mental health issue such as symptoms of anxiety or depression, Bogler noted, and those numbers are now thought to be significantly higher.

“This is a particularly vulnerable population at the best of times,” she said. “It's a major transition in a person's life, in a family's life.”

During the pandemic, as many regions went into lockdowns, the usual support networks for families were often disrupted, and previous surveys have suggested that lack of support took a toll on parent's mental health.

One September poll of more than 1,000 Canadian adults from the Centre for Addiction and Mental Health in Toronto, for instance, found 30 per cent of parents with children under 18 reported feeling depressed — a figure 10 per cent higher than the percentage of adults without kids who reported feeling the same.

Low income patients may face barriers

Vigod wasn't surprised her research team found a spike in mental health visits echoing those earlier kinds of surveys, though she was taken aback by the magnitude of need.

Also unexpected, she added, was that the lowest-income group in her study had the smallest increase in visit rates. 

“This raises some concern about the potential for unmet need because low income patients may have greater barriers to accessing care,” the research reads.

WATCH | Winnipeg-area mom explains what it feels like to have postpartum anxiety:

Canadian Medical Association Journal

Winnipeg-area mom describes her postpartum anxiety

CBC News

3 days ago


Winnipeg-area mom Abigail Morran says her anxiety spiked as COVID-19 cases started rising again in Manitoba not long after she gave birth to her daughter Eris in March. One day in particular, she says, was a breaking point where she knew she needed more support. 0:53

That could mean difficulty affording the at-home technology required for increasingly-common online appointments, the team wrote, or a lack of private space to meet medical professionals virtually while living in a crowded home.

The cost of mental health services themselves can also be a major barrier, Vigod noted. “Across Canada, there are limits to the accessibility of affordable psychotherapy,” she said.

Both Vigod and Bogler both stressed the growing body of data showing families under strain means there needs to be more support, including for postpartum moms.

“Health systems should focus proactively on patients from high-risk groups, monitor waiting lists for care, and explore creative solutions to expand system capacity, with special attention to postpartum patients who may be experiencing barriers to care,” Vigod and her research team advised.

Mental health issues aren't a choice, mom says

In Morran's case, her appointment led to a prescription for anti-anxiety medication — a tool she'd used years before — and some new coping strategies.

As the weather is getting warmer, she's now spending most of her time outside with Eris, usually tending the back garden at their rural home, while her partner is at work. It's calming, she said, and she's also looking forward to spending more time with family and friends in the months ahead. 

She also said it's crucial for other Canadians to understand the struggles new parents are still facing, more than a year into the pandemic — and that it's no one's fault they're coping with a massive life change during a global health crisis. 

People sometimes ask Morran why she didn't wait it out before having a child, but she said you can't expect people to put their lives on hold for this long. 

“We chose to have our baby,” she said, “but it doesn't mean we chose to have all the mental health stuff that goes with it.”

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