As if confronting the coronavirus in your third trimester wasn’t alarming enough, surviving your fourth trimester with a brand-new baby, isolated at home with no outside support, with the specter of a deadly virus outside your door, could easily push anyone over the edge. According to recent research on the psychological impact of quarantine, the mental health implications of the coronavirus crisis are vast and long-lasting.
From confusion and anger to symptoms of post-traumatic stress disorder, our response to the multitude of stressors during quarantine is individual but shared at the same time. And that’s without a newborn factored in.
Moms trapped at home with infants during this phase in our history have an unprecedented set of emotional hurdles ahead of them. Our goal at EmmaWell is to ensure that these moms feel confident, resilient, connected, informed, and strong enough to handle any stressors thrown their way in the wake of the coronavirus outbreak.
Hilary Waller, EmmaWell’s Clinical Director of Mental Health and a psychotherapist at The Postpartum Stress Center, shared her advice for handling the tense position of bringing a baby into our current health crisis. She knows exactly what postpartum moms in the era of the coronavirus are struggling with and how to help them find light at the end of a dark tunnel.
I have a hard time when my routine is slightly disrupted, and right now my life feels flipped upside down. How do I adjust to my new normal?
This situation everyone is in currently is in many ways similar to the postpartum state. The reality of being postpartum is that your life is fully interrupted. You enter into a state of emotional ups and downs, of amazing gains and profound losses, of full and complete newness and unfamiliarity.
Right now, the entire world is in this state. Everything feels unfamiliar and the coping strategies that we were used to may not be readily available, if at all. Access to luxuries and, more importantly, simple, basic needs is limited. There’s so much instability right now.
And yet, those of us who have made it through the postpartum period, whether it was a simple or an extraordinarily complicated transition, can call on that experience and remember that we’ve been through the adjustment to a new normal before. For moms going through this for the first time, know that you are connected not only to people around the world experiencing the same thing, but to other mothers who are also up late into the night feeding, rocking, and nursing themselves back to physical and emotional health. You are not alone.
So how do we do it? In my house, for example, I sit down and set out a routine each morning that fits the day. Because every day is a bit different, it helps to be flexible. I want to make sure we incorporate certain activities every day (meals, snacks, time outside, time to relax- yes, relaxing with screens is okay!) so that the day feels familiar. Over time, those familiar patterns will become a routine (similar to how infant sleep patterns become a nap routine after a few months).
I also encourage you to connect with others whose circumstances are similar. Support is cropping up all over the internet on social media and blogs to help brainstorm solutions for our common struggles: How in the world we are supposed to work from home while parenting full-time? How do we manage stressors of job loss or underemployment while parenting? How can we maintain our jobs during a time when it feels like stepping outside poses a risk?
Finally, keep in mind that prolonged isolation can cause us to feel a sense of helplessness and uncertainty about the future, which can draw us inward. Activities that create a sense of change and purpose, like cleaning out a closet or donating previously-loved home décor or clothing, can help stimulate more positive energy. Please also be sure to integrate time for each adult to engage in self-care (e.g. a shower, exercise, time to talk privately to a friend on the phone).
I have become fixated on my baby’s health and convinced that we are going to contract the coronavirus. What can I work on to overcome this crippling fear?
It can be extremely difficult to remain in the present when we are distracted by what might or could happen in the future. I always encourage moms to practice some method of grounding — exercises that turn our attention to the present when we are focused on the past or future.
Here is an exercise you can do at home as an example: Give yourself the opportunity to engage your five senses. Look around and what do you see? Perhaps you see your baby in your arms.
What do you hear? You might hear the sound of your baby crying, babbling, etc. What do you smell? You might smell the bottle that you’re feeding your baby or your partner’s cooking in the kitchen. What do you touch? Maybe you feel the weight of your baby or a pet or the warmth of the blanket on top of you. What do you taste? You might try having a snack or sucking on a piece of candy to engage your sense of taste.
Once you are better grounded in the here and now, you will be better positioned to use other strategies for managing anxiety and will start to recognize which thoughts are coming from an anxious voice inside your mind (‘We are definitely going to get the virus…it’s only a matter of time’) and which thoughts are more reasonable (‘I am engaging in social distancing, I am washing my hands, and I am following other recommendations made by those studying the spread of this disease to keep me and my baby safe’).
Eventually, you will recognize that when you worry about something in the future it increases your anxiety, and when you look to the past about how things used to be, it can trigger feelings of sadness and grief. But if you stay grounded in the here and now, then you’ll be able to just see what is happening in this moment, be present, and tackle one problem at a time. You can then shift your focus from worrying about catching a disease to enjoying each precious moment with your baby and taking precautions that will protect you both.
My anxiety is preventing me from sleeping when my baby sleeps. How can I manage my racing brain at bedtime and ensure better sleep without medication?
If you’re having trouble sleeping and getting control of your racing thoughts, you might try keeping a bedtime journal so that you can put your worries on paper and get them out of your mind. That paper can be a Post-it Note that you throw away the next morning or a running list that you keep, but the idea is to put it outside your brain so you can decide to look at it and deal with it the next day if it’s still a worry. If it’s no longer a worry, there is no need to return to it.
It’s also very important to create a healthy sleep routine. Just as we work so hard on establishing sleep rituals for our children, adults need a healthy sleep routine to help the mind and body calm down, especially when stress is high. This could mean taking a warm shower at nighttime, deciding not to look at any sort of social media or news sites during your wind-down time, having some sort of snack that feels good, drinking a cup of tea, talking with a loved one, reading a book, or watching light-hearted TV that is uninterrupted by commercials or news. Use your time before bed to really wind yourself down and help your mind settle into a relaxed state.
In households with a new baby, sleep quality is typically at rock bottom, while emotions are at their peak. Postpartum moms — over 90% of them — have scary, intrusive thoughts about their baby and themselves which can interfere with sleep. The founder of The Postpartum Stress Center, Karen Kleiman, wrote a book titled “Good Moms Have Scary Thoughts: A Healing Guide to the Secret Fears of New Mothers.” It packs in lots of easy-to-digest advice and easy-to-follow exercises perfect for a sleep-deprived mom.
In the months after giving birth, how will I know if my postpartum emotions, compounded with coronavirus concerns, are typical or out of control?
The bottom line for moms is always this: If you don’t like the way you’re feeling, talk to a professional. Therapists working in this field are trained to treat a mother suffering from mild baby blues with as much respect and care as someone with a severe perinatal mood or anxiety disorder — or pandemic-induced anxiety.
Unfortunately, there’s no magic equation for determining when symptoms warrant professional intervention. Avoid relying solely on generalized diagnostic criteria because — particularly in postpartum mothers — every day is so different. A postpartum mother could wake up feeling great, but then the baby is colicky, cranky, and spitting up all over the place, and suddenly it becomes a bad day. So much of our mood when we’re postpartum is dependent on the behavior and emotions of another person, that it can take some expertise over time to tease out what’s normal and what’s not.
My recommendation is if you don’t like how you are feeling, set up a phone call with a maternal mental health care provider or seek out reputable maternal mental health resources online for more information. Remember that in this time of very, very high stress, we all are wondering what a normal amount of anxiety looks like. There’s help out there, so take advantage of what resources you can from home. Maternal mental health professionals want to help you!
With no support network to help me in the first few months home with my baby, I am feeling depressed and scared. Where can I turn for support when I really need it?
Establish a structured routine around FaceTime or Zoom calls with supportive people. Put forth some effort to maintain these social connections, and if you feel like your symptoms of depression or anxiety are getting in the way of making that effort, ask for help from your partner or friend to set up the call for you. Watch TV with a friend virtually or have a meal with the grandparents on the phone. Get creative in the way you are integrating this technology into your life.
Remember that many mental health professionals are still working even if their physical offices are closed and can offer one-on-one support throughout this time to make you feel less alone. That’s true with or without the coronavirus. Therapy is not only important for mothers suffering from symptoms of postpartum mood or anxiety disorders, but it also is a place where moms can come to feel safe expressing how they’re feeling and what they’re experiencing. It doesn’t have to be all about symptom control — it can also be about routine and camaraderie.
Even though you can’t attend maternity classes at their brick and mortar locations, you can take advantage of online workshops and support networks. Starting this month, Main Line Family Education is offering nine virtual classes on a range of topics [including “4th Trimester Survive and Thrive,” “Newborn Basics,” and “Newborn Sleep 101,”] so you can get all the same information virtually that you would have gotten in person. The Main Line Health system has replaced in-patient tours with webinars and virtual learning sessions, some of which might be helpful for postpartum mothers.
The Postpartum Stress Center has been holding free Zoom support groups on survival tips for parents of toddlers and postpartum moms in a pandemic [check The PPSC’s Facebook page for the schedule]. The Maternal Wellness Center, another Philadelphia-area resource, is hosting a support group for expecting and new mothers every Sunday evening at 7pm via the “Teletherapy” link at the top of its site. Online workshops and peer groups have the power to create a community of moms with babies around the same age. You can connect with these moms online for the time being and build bonds that will last beyond the pandemic.
With warmth and wellness,
Your EmmaWell Team
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Disclaimer: The information provided here is for educational purposes only and is not intended as medical advice. Moreover, due to rapidly changing developments, we make no warranty or guarantee concerning the accuracy or reliability of this content. For the latest information regarding COVID-19, we refer you to the Centers for Disease Control and Prevention website (www.cdc.gov).