The effect of social restrictions, loss of social support, and loss of maternal autonomy on postpartum depression in 1 to 12-months postpartum women during the COVID-19 pandemic

Highlights

• Although several epidemiologic research already shows high prevalence of postpartum depression during the COVID-19 pandemic, the reason why it happens remains unclear.

• The results of our study revealed that COVID-19 related social restrictions, loss of social support from healthcare professionals, family, and friends, or loss of maternal autonomy significantly associated with postpartum depression.

• The findings suggest that current COVID-19 situation surrounding the perinatal women can have a detrimental effect on their mental health after delivery.

Abstract

Background

This study focused on postpartum women, who are one of the most vulnerable populations during the COVID-19 pandemic, aiming to reveal mental health consequences of social restrictions, loss of social support, and loss of autonomy.

Methods

We conducted a cross-sectional study for postpartum women in October 2020 in Japan (N = 600). The Edinburgh Postpartum Depression Scale (EPDS) was used to measure postpartum depression. The prevalence ratios were estimated by log-binomial regression models, adjusting for age, education, household income, residential area, parity, the timing of delivery, and a prior history of depression.

Results

The prevalence of postpartum depression was 28.7% (EPDS ≥9, which is frequently used in Japan), 18.6% (≥11), and 13.1% (≥13). Social restrictions, including cancellation of home visits by healthcare professionals and cancellation of infant checkups or vaccinations, loss of support during pregnancy or after delivery, including loss of opportunities to consult with healthcare professionals or friends and cancellation of parents or other family members' visits to support, and loss of autonomy about delivery or breastfeeding, were associated with postnatal depression.

Conclusions

At least 13% of women who delivered and raised babies during the COVID-19 pandemic had postpartum depressive symptoms. COVID-19 related social restrictions and loss of social support from healthcare professionals, families, and friends were significantly associated with postpartum depression. In addition, loss of maternal autonomy in delivery and breastfeeding was associated with postpartum depression. The results indicate that both formal and informal support should not be limited to preventing postpartum depression during a pandemic.