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Isolation and fear of sickness are common factors in postpartum depression and anxiety for new moms, and those feelings are amplified in the midst of the COVID-19 pandemic.
A Regina doula and advocate is raising concerns about maternal mental health screening for new moms.
Sara Beckel owns Lilium Health and has been working as a doula to support mothers through childbirth and the postpartum period for eight years. She has been involved with supports for postpartum mental health for six years.
“I work closely with moms in the community and oftentimes they reach out when they’re struggling if they’re needing to find resources. I happened to have a mom reach out and mention that she hadn’t been screened at her (baby’s) immunization, which was pretty important considering that she had struggled in the past,” Beckel said.
In an effort to fill a potential gap in mental health support for new moms in the city, Beckel started a free online support group on Facebook. She posted about the screening program, which prompted other moms to reach out with similar stories suggesting the regular set of postpartum mental health questions were being skipped.
The Edinburgh Postpartum Depression Screening (EPDS) tool is a 10-question survey that can help identify symptoms of postpartum depression or anxiety and start the conversation with health-care professionals to direct women to proper supports.
Saskatchewan is one of the few provinces in Canada that normally provides the screening to moms through the maternal visiting program in the first few weeks of bringing a baby home, then again during public health immunization appointments when their babies are two and six months old.
In an emailed statement, the Saskatchewan Health Authority (SHA) said maternal mental health screening with the EPDS tool is still being done regularly during the home visiting program and at public health offices during two- and six-month immunization appointments for babies.
“Referrals are sent to local mental health for support, or to HealthLine 811,” an SHA communications official said by email. “The HealthLine 811 mental health clinicians (registered social workers & registered psychiatric nurses) provide service to Maternal Wellness Program clients.
“This is an outbound call program for women at risk of or suffering from postpartum depression and/or anxiety who are referred to the program by public health nurses across the province.”
The SHA’s statement does not line up with what several moms of young babies are reporting online. Beckel has heard the screening is still being done during home visits by nurses in the first few weeks if they felt it was needed, but it seems to be getting skipped during shortened immunization appointments at public health offices.
“The immunization screen was sort of the most concrete and consistent stop point for moms so it is really, really important that we’re checking in at that time as the baby blues can occur in the first couple of weeks. But if it escalates past that, we need to be checking in beyond those first couple of weeks, so the immunization screen is pretty vital,” Beckel said.
Several moms Beckel has talked to have raised similar concerns because they recognized their own symptoms after dealing with PPD or PPA in the past, but they also know first-time moms may have a harder time reaching out to get help.
“The stigma in itself is so high to begin with and when we skip over moms during a situation like this, it’s going to make it that much harder for them to reach out because they’re already scared to leave the house, they’re already scared to call, they might feel like they don’t want to bother anybody and they should just figure it out on their own,” Beckel said.
From her perspective, Beckel understands how many health services are being impacted and it may be difficult to navigate how to offer them in these changing times. She believes health and support workers are doing their best across the province but now is not the time to back down on maternal mental health screening at a time when the risk is specifically impacted.
“We’re not able to see our parents, we’re not able to see our friends, we’re not able to have support and social support within the home,” Beckel said.
“Perinatal mental health often is involved with irrational fears or anxieties around sickness or if baby is getting enough. So when we’re in the middle of a global pandemic and we have a virus that is affecting so many, it can really increase (the likelihood) of developing a perinatal mood and anxiety disorder or just increasing the symptoms if a mom is struggling.
“So these really are the times that we need to focus on mental health and make sure we’re not eliminating the supports that we do have in this province.”
Beckel said there isn’t any reason why those screening questions couldn’t be asked over the phone if the concern is about extra time in face-to-face appointments.
Knowing that in-person support groups would be impossible is what prompted Beckel to start a free online support group including weekly video chats to check in on moms, because she knows part of the healing process is for moms to share stories and understand they’re not alone in the struggle.
