The transition to motherhood during COVID-19: The mediating role of postpartum depression in the association between self-compassion and mindful parenting among Portuguese postpartum women

Background The COVID-19 pandemic can have a significant negative impact on postpartum women's mental health and, consequently, on their parenting. Self-compassion can help mothers navigate the transition to motherhood more adaptively during this pandemic. Aims and Objectives This study aims to: 1) compare depressed and non-depressed mothers and those who experienced and did not experience a negative emotional impact of COVID-19 on mindful parenting;2) explore whether self-compassion is associated with mindful parenting and whether this association can be mediated by lower levels of postpartum depression (PPD);and 3) explore the moderating role of the perceived emotional impact of COVID-19 on these associations. Methods During December 2020, 997 Portuguese mothers of infants with an average age of 2.5 months (SD = 1.28, range:0-6) completed an online survey that included a sociodemographic and obstetric form, questions about the perceived negative emotional impact of the pandemic, the Self-Compassion Scale, the Edinburgh Postnatal Depression Scale, and the Interpersonal Mindfulness in Parenting Scale. Results Women scoring above the EPDS cut-off (38.5%) presented lower levels of self-compassion and of all mindful parenting dimensions. In addition, mothers who reported having felt that the pandemic had a negative emotional impact during pregnancy (76.6%) and postpartum (79.5%) presented lower levels of self-regulation and non-judgemental acceptance of parental functioning. A moderated mediation analysis showed that higher levels of self-compassion were associated with higher levels of mindful parenting and that this association was mediated by lower levels of PPD, particularly among mothers who experienced a negative emotional impact of the pandemic. Interpretation/Discussion COVID-19 has a negative impact on postpartum women's mental health and parenting. Self-compassion seems to help mothers feel less depressed and be more mindful in parenting. Conclusions Postpartum women should be offered the possibility of receiving mental health support, especially during the pandemic. Compassion-based interventions may be particularly important in reducing PPD and promoting mindful parenting.

Becoming a mother during COVID-19: A national study on the experiences of pregnancy and childbirth in Portugal

Background Having a baby during the COVID-19 pandemic poses a number of challenges for mothers, which can seriously compromise their mental health. Aims and Objectives This study aims to describe the birth and postpartum experiences of a national sample of Portuguese postpartum mothers. It also aims to investigate the role of the negative emotional impact of the pandemic on mothers' mental health. Methods During December 2020, 1413 Portuguese mothers (70.8% primiparous) of infants with an average age of 2.5 months (SD = 1.32, range: 0-6) completed an online survey that included a sociodemographic and obstetric form, questions about the perceived emotional impact of the pandemic, the Edinburgh Postnatal Depression Scale, and the Postpartum-Specific Anxiety Scale. Results Most mothers (75.5%) were on pregnancy leave due to an obstetrical complication (45.2%), to avoid COVID-19 infection (44.8%), or both (10%). 95.9% of mothers did a COVID test before labour, but only 1.1% tested positive. Women who did not have the delivery they desired (45.2%), who were unable to be with their baby shortly after birth (14.6%), and who did not perform skin-to-skin contact (33.4%) were significantly more anxious and depressed in the postpartum than those who had the delivery they desired, contacted with their baby after birth and performed skin-to-skin contact. Women who scored above the cut-off on EPDS (37.9%) and who reported that COVID-19 had a negative emotional impact during pregnancy (77.5%) and postpartum (80.1%) presented higher levels of postpartum anxiety and depression. Interpretation/Discussion Having a baby during COVID-19 seems to have a significant impact on postpartum mothers' mental health. In addition, a positive birth experience seems to be a key factor in women's psychological adjustment. Conclusions Despite the limitations imposed by the pandemic, it is essential to promote a positive birth experience and to ensure that women in the perinatal period can obtain psychological support whenever they need it.

Protective factors of postpartum depression and anxiety during COVID-19: A longitudinal study with postpartum mothers before and during a national lockdown

Background In the beginning of 2021, Portugal faced the most difficult phase of the pandemic, being for several weeks at the top of the world ranking of infection and mortality. The transition to motherhood can be particularly difficult in this context and lead mothers to experience high levels of depression and anxiety. Therefore, it is essential to examine the role of modifiable psychological factors than can help women better adjust to this phase, such as self-compassion and psychological flexibility. Aims and Objectives 1) examine the evolution of postpartum depression and anxiety over two distinct phases of the COVID-19 pandemic;and 2) investigate whether self-compassion and psychological flexibility can reduce the likelihood of later postpartum depression and anxiety. Methods 383 Portuguese postpartum mothers completed an online survey during a pandemic phase with few restrictions (December 2020;T1) and during the third wave of the pandemic and national lockdown (March 2021;T2). The survey included a sociodemographic and obstetric form, and questionnaires assessing postpartum depression (EPDS), postpartum anxiety (PSAS-PT), self-compassion (SCS), and psychological flexibility (CompACT). Results Postpartum anxiety and depression levels significantly increased from T1 to T2 (e.g. the number of women scoring above the EPDS cut-off increased from 35.5% to 42.8%). Higher levels of self-compassion and psychological flexibility at T1 predicted lower levels of postpartum depression and anxiety at T2. Interpretation/Discussion COVID-19 control measures, including a general lockdown, have a substantial impact on postpartum women's mental health. Self-compassion and psychological flexibility are two psychological resources that seem to protect women from developing depression and anxiety during postpartum and in a particularly challenging phase of the pandemic. Conclusions Compassion-and acceptance-based interventions can help postpartum women to better adapt to postpartum challenges and to particularly demanding periods such as a lockdown.