New mothers struggle with depression and anxiety magnified by the pandemic
By Dan England
When Marla Arnesen was 10 weeks pregnant, friends and family crowded into the ultrasound room to celebrate the tiny nugget growing inside her.
Arnesen was a single mom, but that in itself was a reason to cheer. She was 34 and didn’t want to get married but she wanted a child, so she went to a sperm bank. She had a pack of fellow nurses from Banner Fort Collins Medical Center who worked with her in labor and delivery, and they all celebrated her life decision and what they viewed as her brave willingness to do it alone. Her parents, Guy and Mary, embraced the decision as well and looked forward to being grandparents. It was more than an ultrasound. It was a party.
Arnesen looks back in amazement, the way someone might look at the way villagers lived in the 1300s.
“That was the last time anyone came with me to an appointment,” she says.
COVID-19 came soon after, and that meant that her life decision would not be the toughest decision she would face as an adult. She had to choose who she would let in her bubble. So many of her thoughts battled each other, a civil war inflamed by a fear of the disease that made her thrilled just to reach her first trimester.
She worried about killing her parents, in their 60s, by exposing them to the illness because she worked as a nurse, even with the safer conditions of the labor unit and not the ICU or ER. She worried about exposing her baby. She also worried about her own ability to work and raise a child without the help of that supportive community, something she was counting on when she visited the sperm bank.
Indeed, the coronavirus added a list of complications to what for many adults is already the most complex, life-changing event they will ever undergo, and it also added to the isolation, frustration, loneliness, fear, anxiety and exhaustion new parents feel after having a baby (there’s joy and happiness and love in there, too).
More than ever, it was all too much: Mothers having babies during this pandemic had a greater chance of experiencing postpartum depression and anxiety, and to much greater degrees, than the so-called “baby blues” that usually last a few days.
“I’ve personally felt like there’s been a huge increase, and anxiety even more so,” says Natalie Rochester, an OB/GYN for UCHealth. “It’s not only isolating people from family and the world in some ways, you also have this even greater new need to protect your child. The vast majority of my virtual visits are about postpartum depression and anxiety.”
Arnesen decided to let her parents, and even a few close friends, inside her bubble after her baby was born Oct. 6. Her parents isolated themselves for months before the birth, and her friends are on a case-by-case basis. Her parents now pick the baby up from daycare. They come over to allow Arnesen to sleep after a late-night shift. They hold her daughter and help with the exhausting process of caring for a baby.
“Over and over again, in 2020, I would ask myself, ‘Are you going to let this knock you down, or are you going to show some resilience?’,” she says. “But doing this alone would have been terrible for my mental health.”
One too many problems
Despite COVID-19, people have continued to have babies. Locally, there really wasn’t much of a change in the number of births. However, some nationwide studies have suggested that a number of families may have decided to delay conception due to the pandemic, reporting that there will be fewer newborns in 2021. No baby boom, though we all might have joked about it during the initial lockdown’s snowy weather.
The decision to have a baby is one fraught with complications, due to the pandemic. Mothers must face the prospect of wearing a mask during delivery, quite possibly the most taxing, painful and emotional time of their lives. New mothers are cared for by people wearing masks, face shields and coverings, so they looked like aliens doing science experiments.
Some hospitals wouldn’t allow crowds, or even another single support person, like a partner, spouse or parent. Even though that doesn’t seem to be true in Colorado currently, having a baby last year was a worrisome, cold event—nothing like it’s supposed to be.
Once the baby arrived, mothers had to decide who to let in, and many times parents out of state didn’t visit for fear of traveling during a pandemic. Friends, siblings and aunts and uncles all stayed away, for the most part, leaving mothers with a crying baby and a partner they’d already seen a bit too much.
“Having a baby is a social event,” says Jen Steir, a midwife who works and delivers babies (including Arnesen’s) at Banner Fort Collins Medical Center.
The result of all that was another pandemic, a rash of postpartum depression that Steir hadn’t seen before, at least not in that high of numbers. She typically follows up the birth with a one-week and a six-week visit. Patients don’t typically come in for the one-week follow up, as they’re too exhausted. But once the pandemic started, Steir had 80 percent of her patients come in that first week just needing to talk.
“I had to watch them more closely than I normally do,” she says.
She watched them for weariness, feelings of helplessness, desperation, loneliness, isolation or worthlessness, in addition to worry. These are common feelings mothers experience, but the intensity of them, as well as the length, increased in many mothers to the point where Steir prescribed many more anti-depressants and anti-anxiety meds than she had before.
“I prioritize mental health for sure now,” she says. “I push them to come in after one week. Moms need to know now more than ever that they aren’t alone.”
Mothers may already be struggling with the pandemic, including missing their own mothers who might normally be by their side and offering advice during their pregnancy, and a baby wrecks their coping mechanisms, such as sleep, time alone or a good meal.
“We as a country are more anxious,” Rochester says, “But I’m hearing that moms are even more so, even over care issues such as washing veggies. As a parent you have that anyway, and then you add one thing to it, such as COVID, and it’s enough to push them into a downward spiral.”
Julianne Curtis, a doula who works all over Northern Colorado, offers emotional and physical comfort to a mother before, during and after the birth. As a result of the pandemic, she’s busier than ever.
“Now, it’s almost that all control has been taken from them,” Curtis says. “They can’t even go out even if they wanted to. I’ve had to come up with creative ways to support people.”
One of those ways included a set of wireless earbuds during the birth that the parents split, so she could speak to both the mother and father. She could calm the mother while offering ways the father could help during delivery.
She’s seen the same kind of helplessness in fathers and has seen an uptick in depression among them as well. She calls her fathers “Dudelas” to empower them, but the pandemic took a lot of their power away, too.
The pandemic was political, probably more than many expected, and that created conflicts as well. “Some parents won’t respect the rules,” Curtis says. “They don’t believe in COVID or wearing masks, so I have others who have to tell them they can’t come see the baby. That causes turmoil. Sometimes I’m surprised when new parents DON’T have depression.”
A safe place
Most of the time, Curtis and Rochester met with their parents over Zoom, although that is changing, as more vaccines are distributed and the country opens up. Both struggled with virtual visits at times, but they did see some good.
“[Moms] can come in their PJs,” Curtis says. “I tell them to come as they are. I want that. It should be a safe place to feel all the feels.”
Virtual options are still a good place for mothers, and they do give them a chance to take breastfeeding, birthing and parenting classes, says Bianca Schroetlin, who coordinates prenatal education for the three Banner hospitals in Northern Colorado.
“We do miss the hands-on opportunities, but it’s still an opportunity to talk and tell other people about their experiences,” she says. “It’s very isolating right now, and this way, they don’t feel so alone. When you realize you aren’t alone and you share it with other people, it just feels good.”
More mothers seemed willing to talk about their problems, because they were more comfortable being at home, in their bathrobes, Rochester says, when their baby is down for a nap or nursing, and because many talked about their own struggles with mental health (not just the pregnant ones, either) on social media. We were all going through the same thing.
“Everyone is talking about self-care and all that,” Rochester says. “That in combination with the virtual aspect makes it more comfortable to reach out.”
Rochester says she didn’t see any kind of increase in serious postpartum, such as mothers with thoughts of harming themselves or the baby. Still, society has a long way to go to help mothers with postpartum depression, she says.
Work it out
Lisa Buxman is a midwife who runs marathons and did her first ultra, a 50K, a few months ago. She would never push her lifestyle on the parents she works with, but she has a small practice and may be drawn to those who enjoy similar activities.
“I’m not seeing the depression [in mothers],” Buxman says, “and I believe the exercise and the emphasis I place on it helps.” However, she did have to alter her practice during COVID-19. “I had to screen a lot more because of this. I couldn’t take high risk women.”
Buxman only takes two births a month, but she could do a lot more if she wanted, as many mothers are opting to have home births to dodge the restrictions of the hospital. Buxman still wears a mask during the delivery, but she doesn’t require it of her clients, and does like to have her first meeting outside, where they can take down masks and see each other’s face before the stress of the birth hits.
“The development of the relationship [with] your midwife is so important,” she says. “You miss that when you have a mask on.”
Jenna Gordon of Severance and her husband, Cody, had their baby with Buxman, even though she had her first in a hospital nearly four years ago. Gordon didn’t feel comfortable with the hospital’s restrictions, and she did have one advantage: She had her first birth as naturally as possible without painkillers, the kind of birth that many midwives are known for. The home birth went well, and Gordon preferred it in many ways.
“When Lisa and her team left, my parents had my older daughter, so it was just us and the baby,” Gordon says. “It was very relaxing.”
Gordon doesn’t have a huge network of friends, and most of her family lives in Grand Junction. The quarantine, then, wasn’t much different. But she still struggled with the isolation, as well as caring for two children, because she couldn’t get out as much, and felt more depression.
However, “that could be because of a toddler,” Gordon says and chuckles. “I have a lot more responsibility this time.
”Cody, like many fathers, tries to pitch in more now as a result. Every other Friday, he takes time off from his own business to give Gordon a morning to herself. Ironically, Gordon, an introvert, turns to isolation to help cure the isolation at home. She loves to go to an acupuncture clinic.
“I just lay there in complete silence,” she says.
Dan England is a freelance writer who lives in Greeley. To comment on this article, email firstname.lastname@example.org