By Dr Emily Emmott
Low social support is a key risk factor for developing postnatal depression (PND). From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children.
The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support.
On the 23rd March 2020, England entered its first “national lockdown” following the increasing spread of COVID-19, where the government imposed social distancing measures requiring that individuals stay at home (unless exercising, shopping for food, or seeking medical attention), closed non-essential businesses and childcare facilities/schools, and banned public gatherings of more than two people. These measures remained in full force for almost 3 months until 14th June 2020, and likely impacted the social interactions of postnatal mothers & their access to childrearing support.
How did lockdown impact maternal social networks and maternal mental health?
The of the evolutionary origins of depression is still unclear. It has been proposed that “depression is an adaptation designed to detect the opportunity costs of cooperative ventures and to subsequently bargain for increased benefits”. Under this framework, PND is argued to arise when the mother’s circumstances are such that withdrawing investment in their infant in the hope of eliciting support from others is the least bad option (Hagen, 2003). Alternatively, the Pathogen Host Defence Hypothesis (PATHOS-D) suggests that depression reflects a phenotypic suite of behavioural and physiological responses evolved to mitigate mortality risk linked to pathogens (Raison and Miller, 2013). Psychosocial stress is argued to have been predictive of wounding and subsequent infection in ancestral environments – driving selection for a pre-emptive response.
Regardless of its evolutionary origins, postnatal depressive symptoms are undoubtedly an indicator of distress. With social distancing restrictions likely severing supportive ties, we wanted to know how lockdown impacted maternal social networks and mental health.
Our findings
Using data from 162 mothers living in London with infants aged ≤6 months, we explored how communication with members of a mother’s social network related to her experience of postnatal depressive symptoms during the first lockdown in England.
Before the pandemic, it was estimated that around 23% of mothers in Europe experience PND. In our sample of London mothers experiencing lockdown, levels of depressive symptoms as assessed via the Edinburgh Postnatal Depression Scale were high: 47.5% of the participants meet a ≥11 cut-off for PND.
Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding.
While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still “takes a village” to raise children in high-income populations and mothers are struggling in its absence.
Read the paper:
Communication Across Maternal Social Networks During England's First National Lockdown and Its Association With Postnatal Depressive Symptoms is published in Frontiers in Psychology.
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