The effect of the COVDI-19 lockdown on postpartum depression among mothers
By Hareem Bilal and Dr. Austin Mardon
The COVID-19 pandemic has severely affected the mental health of many
around the world. According to recent studies, there is a correlation between symptoms of depression and the spreading of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Postpartum and pregnant women are one of the major groups significantly affected by the pandemic. Childbirth itself is difficult due to the several adjustments in psychology, biology and the social life of the mother. Coupling these adjustments with the psycho-emotional distress brought on by the COVID 19 lock-down increases the mental health issues in postpartum females, especially the depressive
Postpartum depression (PPD) can be defined as “the depression suffered by a
mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue; postnatal depression.”2 PPD is a debilitating mental health disorder, which can manifest as mood swings, change in appetite, fear of injury, sleep disorders, sense of doubt, lack of interest in daily activities, and much more.3 The American Psychiatric Association regards peripartum (postpartum) depression as a serious but treatable medical illness, which carries a risk for the mother and the child.4 With a prevalence between 5% and 60.8% worldwide, postpartum depression in severe cases can lead to suicidal ideation, and issues, such as fear of harming the child.5 People in quarantine during the COVID-19 pandemic may experience a range of emotions, including fear, sadness, anger, irritability, guilt or confusion, which could make isolation challenging and difficult for maternal health.6 A study explored whether after quarantine measures, psycho-emotional distress was enhanced in the immediate postpartum period for women giving birth in the COVID-19 “hotspot” area in northeastern Italy. The Edinburgh Postnatal Depression Scale (EPDS) was used to test for anhedonia, anxiety and depression in the immediate postpartum period. In this non‐concurrent case–cohort study, the COVID-19 study group included women who gave birth at Policlinico Abano Terme in 2020, and the
control group included women who gave birth during the same period the previous year (2019). Compared to the control group, the COVID-19 study group presented higher EPDS scores. Approximately 30% of participants in the study group scored above 12 on the global EPDS scale, which may lead to higher risk of postpartum
depression.Significantly higher scores for depression and anhedonia in the study group were revealed upon further analysis of three EPDS sub-scales. The study concluded that pregnant women were a high-risk, vulnerable population, especially during the covid-19 lockdown and in order to minimize postpartum depression, they need to be carefully followed. In order to prevent possible deterioration of maternal psychological 6 Zanardo et al., 2020
5 Ghaedrahmati et al., 2017
4 Psychiatry.Org – What Is Peripartum Depression (Formerly Postpartum)?, n.d.
3 Ghaedrahmati et al., 2017
2 Usmani et al., 2021
1 Usmani et al., 2021
health due to COVID-19 quarantine, mental and medical health care interventions are recommended to be carried out immediately.7 Another study assessed perinatal women, and concluded that the most effective social support methods during the COVID-19 lockdown were from friends and virtual (e.g video calls). To improve mental health, regularly scheduled video calls with friends or family was highly encouraged when in-person meetings were not possible.8 For many
expectant mothers, pregnancy can be an extremely stressful time, and the addition of the COVID-19 lockdown may increase psycho-emotional distress, which in turn can also have a negative impact on the infant. The dynamic interplay between the psychological, biological and social risk factors result in PPD, which can be amplified during the COVID-19 lockdown, thus medical and mental inventions need to be carried out immediately for this vulnerable population.9
1. Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M.
(2017). Postpartum depression risk factors: A narrative review. Journal of
Education and Health Promotion, 6, 60. https://doi.org/10.4103/jehp.jehp_9_16
2. Psychiatry.org—What is Peripartum Depression (formerly Postpartum)? (n.d.).
Retrieved April 14, 2022, from
3. Usmani, S., Greca, E., Javed, S., Sharath, M., Sarfraz, Z., Sarfraz, A., Salari, S.
W., Hussaini, S. S., Mohammadi, A., Chellapuram, N., Cabrera, E., & Ferrer, G.
(2021). Risk Factors for Postpartum Depression During COVID-19 Pandemic: A
Systematic Literature Review. Journal of Primary Care & Community Health, 12,
4. Zanardo, V., Manghina, V., Giliberti, L., Vettore, M., Severino, L., & Straface, G.
(2020). Psychological impact of COVID-19 quarantine measures in northeastern
Italy on mothers in the immediate postpartum period. International Journal of
Gynecology & Obstetrics, 150(2), 184–188. https://doi.org/10.1002/ijgo.13249
5. Zhou, J., Havens, K. L., Starnes, C. P., Pickering, T. A., Brito, N. H., Hendrix, C.
L., Thomason, M. E., Vatalaro, T. C., & Smith, B. A. (2021). Changes in social
support of pregnant and postnatal mothers during the COVID-19 pandemic.
Midwifery, 103, 103162. https://doi.org/10.1016/j.midw.2021.103162
Hareem Bilal is a student in the Faculty of Science at Alberta University Canada. Austin Mardon, PhD, CM, FRSC, is an Adjunct Professor in the Faculty of Medicine and Dentistry at the University of Alberta.