Canadian Study Highlights Value of Telehealth Access for Postpartum Care

Research out of Canada shows an increase of more than 30 percent in new mothers seeking treatment for postpartum mental health issues during the coronavirus pandemic, and it highlights both the value of telehealth and a need for more virtual services.

As reported in the Canadian Medical Association Journal (CMAJ), the sharp increase in women seeking help for anxiety, depression and substance use disorders between April and November of 2020 occurred at the same time that access to in-person care was severely limited. And while the surge was largest in underserved populations, it affected all economic groups.

Postpartum mental illness affects roughly one in five new mothers, and has been the subject of several connected health programs aimed at improving access to care. The pandemic has highlighted the value of those services.

“During the COVID-19 pandemic, people have been reporting concerns about postpartum infection, and difficulty accessing the extended postpartum social support networks and key community programs that protect against mental illness, such as home visits from public health nurses, breastfeeding clinics and support groups, owing to public health measures,” the researchers, primarily from the University of Toronto, said in their study. “In Canadian surveys, about 50 percent of pregnant people reported psychological distress in spring 2020, and alcohol use increased among women, particularly among those with young children. Whether this represents an increased clinical burden of mental illness or need for care is unknown.”

The study focused on women in Ontario, whose population is about 14.6 million, but the results are representative of all of North America, if not the world. Aside from the challenges faced by underserved populations in accessing telehealth, a significant percentage of the population doesn’t seek out help for mental health or substance abuse issues because of the associated stigma.

That’s especially true of new mothers. And it may mean that the numbers reported in the study are lower than the numbers of people looking for help.

“Many social determinants of health are linked to mental health and access to mental health care, including experiences of race or gender discrimination, socioeconomic status and geographic location,” the researchers noted. “Interpersonal or family factors, community dynamics and social support are also important. Our findings suggest that the COVID-19 pandemic has had disproportionate effects on parents who have newly delivered, for whom support from extended networks is beneficial and may be limited with public health efforts to contain SARS-CoV-2.”

With telehealth use soaring as a result of the pandemic, healthcare providers should see this study as a sign that more virtual care service are needed.

“Health systems should focus proactively on patients from high-risk groups, monitor waiting lists for care, and explore creative solutions to expand system capacity, with special attention to postpartum patients who may be experiencing barriers to care,” the researchers concluded. “With the extensive use of virtual care in this population, further evidence regarding the safety and effectiveness of virtual treatment for postpartum mental illness should be sought.”