Research Snapshot: Increased visits for postpartum mental illness during COVID-19 in Ontario

Increased visits for postpartum mental illness during the COVID-19 pandemic in Ontario 

What you need to know

Postpartum mental illness is a common problem that affects a mother’s ability to function, her interactions with her baby, and the well-being of families. An Ontario study calculated the rate of postpartum mental health visits to primary care doctors and psychiatrists during the first nine months of the COVID-19 pandemic and compared these against expected rates based on patterns before the pandemic. Results show that rates of postpartum mental health visits were higher than the expected rates. The increase in visits was smaller for women living in the lowest-income neighbourhoods. Rates started to increase in April 2020 among women with Chinese surnames and in June among women with South Asian surnames.

 

This Research Snapshot is based on the article, “Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study” published in CMAJ in 2021. DOI: https://doi.org/10.1503/cmaj.210151

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What is this research about?

One in five mothers has mental illness in the year after their baby is born. This is known as postpartum mental illness and affects the mother’s ability to function. It also impairs her interactions with her baby, which can affect the child’s brain and social development.

When it becomes chronic and recurrent, this type of mental illness affects the entire family, including grandparents.

There is little research on how the COVID-19 pandemic impacted women who gave birth during this time. Ontario researchers used health administrative data to compare the rates of doctor’s visits for postpartum mental illness during the pandemic with the expected rates based on patterns before the pandemic.

What did the researchers do?

For this study, the researchers calculated the expected rate of visits to primary care doctors or psychiatrists for any mental illness between March and November 2020 based on pre-pandemic data. They then compared these rates with actual visits during each month of the pandemic.

They also analyzed the findings based on mothers’ sociodemographic characteristics, including neighbourhood income and ethnic diversity, as well as South Asian or Chinese ethnicity, Canada’s two largest visible minority populations.

What did the researchers find?

Before the pandemic, about 3% of postpartum women had at least one visit for mental illness to primary care doctors and psychiatrists during any given month. The rate increased to about 4% during the pandemic. Increases in rates of visit were greater in the 90 days after the child’s birth, especially from April to July 2020.

Visits increased most significantly for anxiety, depression and substance use. This pattern continued until November 2020. In some months, visit rates for bipolar and psychotic disorders were also slightly higher.

Increases were smaller for women living in the lowest-income neighbourhoods, but level of neighbourhood ethnic diversity did not make a difference. Rates started to increase in April among women with Chinese surnames and in June among women with South Asian surnames.

Limitations of the research

This study may not have captured the actual impact of the pandemic on postpartum mental health because some new mothers don’t seek care when experiencing poor mental health and others will seek help through peer support groups and private psychotherapists. Also, the study did not capture whether a woman had more than one mental illness.

The researchers also did not measure the use of other types of services, such as visits to emergency department and hospital stays. And they only evaluated income at the neighbourhood level rather than at the individual level, and looked at only two ethnicities at the individual level.

How can you use this research?

This research may be of use to system and program planners who are looking to develop mental health programs for women in the postpartum period. It is also useful to health promoters who wish to create awareness campaigns for new mothers, especially in lower-income neighbourhood and in languages other than English.  

About the researchers

Simone N. Vigod,1,2,3,4,5 Hilary K. Brown,1,2,3,4,5,6 Anjie Huang,3,4 Kinwah Fung,3,4 Lucy C. Barker,1,2,3,4,5 Neesha Hussain-Shamsy,5 Elisabeth Wright,1,2 Cindy-Lee Dennis,7 Sophie Grigoriadis,2,8 Peter Gozdyra,3,4 Daniel Corsi,9 Mark Walker,9 Rahim Moineddin3,4,5,10

  1. Women’s College Research Institute, Toronto
  2. Women’s College Hospital; Department of Psychiatry, Toronto
  3. Temerty Faculty of Medicine, University of Toronto, Toronto
  4. ICES Central, Toronto
  5. Institute for Health Policy, Management and Evaluation, Toronto
  6. Dalla Lana School of Public Health, University of Toronto; Department of Health and Society, Toronto
  7. University of Toronto Scarborough; Lawrence S. Bloomberg Faculty of Nursing, Toronto
  8. University of Toronto; Sunnybrook Health Sciences Centre, Toronto
  9. Department of Obstetrics and Gynecology University of Ottawa, Ottawa
  10. Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario.