Evaluating stress management approaches, types of social support and postpartum mental health during the COVID-19 pandemic: a cross-sectional study based in the United States.

Abstract:

Objective: Reduced psychological well-being during the postnatal period may impair a birthing parent's ability to care for themselves and their child. We investigated stress management approaches, social support types, and the association between perceived social support and postpartum depression (PPD) and postpartum anxiety (PPA) among a cohort of postpartum individuals in the United States who gave birth during the COVID-19 pandemic.

Design: This study uses Wave 3 data from the COVID-19 and Reproductive Effects study. Qualitative data from previous data collection waves were used to define social support types. Multilinear regression models evaluated the association between perceived social support, PPD and PPA.

Setting: An online convenience sample.

Participants: Participants were approximately 12 months postpartum (mean 11.93 months, SD=2.03). Data were collected between July and September 2021.

Results: Complete data were available from 252 postpartum individuals (mean age=32.2 years). Playing with their children, watching television, connecting with others in person, engaging in social media and exercising were the five most commonly reported stress management strategies. Emotional support was the most commonly reported type of social support. Higher perceived social support was associated with lower PPD (B=-1.3, p value <0.0001, 95% CI=-1.7 to -0.8) and PPA (B=-2.3, p value <0.0001, 95% CI=-3.0 to -1.6).

Conclusion: Social support was an important way through which postpartum individuals managed stress during the COVID-19 pandemic. Playing with children, which may have been facilitated by work-from-home policies, and online interactions emerged as surprising adaptations to stress. Policymakers and healthcare systems should consider ways to increase opportunities for birthing parents to engage in these sorts of interactions (eg, extended parental leave policies and interventions to enhance perceived social support), especially during crises. Doing so may improve health outcomes for birthing parents and their children.