COVID-19: Mental health before, during and after pregnancy

If you are pregnant there is no evidence to suggest that you are any more likely to get COVID-19 than if you are not pregnant.

However, the body responds differently to viruses during pregnancy, which can occasionally cause more severe symptoms. This will be the same for the COVID-19 virus. For this reason, if you are pregnant you will be included among a group of vulnerable people identified by the government, who need to take extra care in following social distancing guidelines as a precautionary measure to help stop them from becoming unwell.

You can find out more about COVID-19 and pregnancy on the NHS website.

If you are pregnant it is strongly recommended that you get the COVID-19 vaccine to protect you and your baby, and to stop the spread of the virus. You can find out more on the NHS website.

Speak to your GP or midwife to find out more about getting the COVID-19 vaccine if you are pregnant.

During the COVID-19 pandemic, some appointments might be held over the phone or by video-call instead of in person. If you are unsure about this, please contact your midwife. If you do attend face-to-face appointments or scans, medical staff will wear personal protective equipment (PPE), such as gowns, masks, eye protection and gloves, where possible.

In your appointments, your midwife and obstetrician will let you know about any changes to your maternity care, such as how often midwives can visit you after you give birth, or the possibility that your antenatal classes will be delivered by video link.

You must not attend a routine clinic in person if you have COVID-19 symptoms. If you have COVID-19 symptoms when you go into labour or have concerns about your health or the health of your baby, call your maternity service for advice.

If you have any worries about your physical or mental health or your unborn baby, contact your GP, Early Pregnancy Unit or maternity service.

The COVID-19 pandemic has caused a lot of stressful changes in our lives. You may have experienced some of the following challenges:

• less contact with your friends and family
• fear that you or your partner may lose their job
• not having help with childcare
• loss of your normal routine
• worrying information on the news
• worry that you, your friends or family members may become unwell
• fear of losing loved ones
• spending more time with your partner if you have a difficult or abusive relationship.

If you are planning a pregnancy, are pregnant or have a baby during this difficult time, you might be worried about:

• whether you should try to conceive
• whether or not to cancel or postpone fertility treatment
• changes you have to make to plans for your pregnancy and birth

Anxiety and depression are common in pregnancy. Around one in five, or 20% of women will experience a mental health problem during pregnancy or in the year after giving birth. Talk to your GP, midwife, obstetrician or health visitor if your emotions are very hard to manage, you are feeling a lot worse, or your mood feels like it is out of control.

If you have a fear of childbirth, the COVID-19 pandemic might make you more anxious. Talk to your midwife or mental health professional about your concerns and your birth plan options.

For some people with mental health problems, stress can cause them to become unwell again, though this is not the case for everyone.

If you feel like you are experiencing the same mental health problems you experienced in the past, speak to your GP or mental health team. This is especially important if you have ever had a serious mental illness like bipolar disorder.

If you are worried that you might become unwell again, talk to your GP or mental health team. They will help you to plan so that you can stay as well as possible.

Like all healthcare services, community perinatal mental health services may still be working differently during COVID-19. This might mean having different opening hours or offering remote appointments in some cases.

If you have mental health problems or are at risk of a severe postnatal mental illness but are currently well, you should still be referred to the perinatal mental health service.

If you are already under the care of a perinatal mental health team, you will continue to see them.

Find out how to contact your mental health service urgently by checking with your care coordinator or GP, or by searching online for your local crisis contact details, so that if you experience a mental health crisis you can get the help you need as soon as possible.

If you are already with a mental health service, you can follow your crisis plan. The plan should say how to contact your perinatal or general adult mental health service during working hours, and there should be the contact details for an out-of-hours crisis helpline.

If you can’t reach the mental health service or you aren’t under the care of a mental health team, contact:

• your GP
• NHS 111
• the 24-hour crisis helpline for your local mental health trust.

If you cannot get through to any of the above services, you may need to go to your local A&E if you:

• are thinking of acting on any suicidal thoughts
• have thoughts of harming your baby or others
• have thoughts or experiences that are not usual
• don’t feel safe at home.

Liaison psychiatry teams usually work in A&E to assess people’s mental health, but due to COVID-19 some may be seeing people away from A&E.

If you need more mental health support than your perinatal mental health team can provide, you may be offered care and treatment at home where possible. The Home Treatment Team can offer intensive treatment at home with visits once or twice each day. Staff who visit will wear personal protective equipment (PPE), wherever possible.

If necessary, you can be admitted to a specialist psychiatric mother and baby unit (MBU) or a general adult psychiatric ward if you need a hospital admission. These units have had to make some changes to how they work during the COVID-19 outbreak. Arrangements for visitors have also changed. Your care team will discuss the changes with you if you need to come into hospital.

Take a look at our information on mother and baby units to find out more.

Refuge has support and resources for people experiencing domestic abuse. Note that their website has an ‘Escape/hide website’ button across the top which quickly navigates you away from their site.

Women's Aid also offers advice to people experiencing domestic abuse.

Having a baby can be an isolating experience at any time. Even if your friends, family or other people close to you can’t visit, try to stay connected through phonecalls and video, if you can.

There are many organisations offering extra support for women and families during the COVID-19 outbreak, including:

• The Royal College of Obstetricians and Gynaecologists – Information for pregnant women and their families
• Action on Postpartum Psychosis – support for women experiencing postpartum psychosis, and their partners and families. One-to-one peer support via email, private messaging on the forum and video-call. Regional postpartum psychosis café groups are taking place via video call. You can also email app@app-network.org
• Bipolar UK – call-back and email service providing coronavirus advice for pregnant women with bipolar disorder at info@bipolaruk.org and an online community offering peer support.
• Maternal OCD – resources for women with perinatal obsessive-compulsive disorder. Further support and advice through the OCD Action helpline (0845 390 6232), email support@ocdaction.org.uk and Skype/phone support groups
• The PANDAS Foundation – helpline (0808 1961 776), email support and advice for any parent with perinatal mental illness and their families. Email: info@pandasfoundation.org.uk
• Anxiety UK – helpline (03444 775 774), email, text and live chat services – support, advice and information for anxiety disorders.
• Beat Eating Disorders– helpline (0808 801 0677), online support groups and resources to help you cope with eating disorders.
• Royal College of Psychiatrists – For more information about mental health problems before, during and after birth, see our information leaflets under ‘pregnancy - before, during and after'.