Global Mental Health of Urban Mothers
Global Mental Health of Urban Mothers
Mental health disorders are common during pregnancy and the postnatal period, and can have
 serious adverse effects on the well-being of woman and child. Every tenth woman has
 depressive symptoms and 5% suffer major depression during pregnancy. The consequences for
 global mental health due to the novel coronavirus disease, COVID-19, are likely to be
 significant and may have long-term impact on the global burden of disease. Pregnant women may
 be particularly vulnerable due to partial immune suppression. Besides physical vulnerability,
 the women could be at increased risk of mental health problems, such as anxiety, depression,
 and post-traumatic stress disorder (PTSD), due to social distancing leading to less support
 from the family and friends, and in some cases, partners not being allowed to be present
 during prenatal visits, labor and delivery. Furthermore, many pregnant women may feel
 insecure and worried about the effect of COVID-19 on their unborn child, if the women get
 infected during pregnancy. Today, young urban women are used to utilizing internet services
 frequently and efficiently. Therefore, providing mental health support to pregnant women via
 web-based support may be effective in ameliorating their anxiety/depression and reduce the
 risk of serious mental health disorders leading to improved maternal and perinatal outcomes.
Pregnancy is a period of transition and great change, which may make some women more
 vulnerable to mental health problems. It is known that depressive symptoms during pregnancy
 may influence birth outcomes. Perinatal mental health disorders may become more prevalent
 during a time of acute crisis, and the prevalence of maternal anxiety, distress, and
 perinatal depression can be expected to increase globally, as a result of the COVID-19
 pandemic. However, there might be cross-national differences in the risk factors and impact
 of pandemic on the prevalence of perinatal mental health disorders.

 Some pregnant women might be predisposed to posttraumatic stress disorder (PTSD) during a
 crisis situation, such as the COVID-19 pandemic. Mothers who developed PTSD in response to
 the 9/11 terrorist attacks had lower morning and evening salivary cortisol levels, compared
 to mothers who did not develop PTSD. Beyond effects on the mother alone, perinatal mental
 health issues can have long-term effects on child´s mental and physical health, as well as
 the participants behavior and cognition. Distress in pregnant women may affect the fetus and
 is known to induce epigenetic changes in the placental genes. Increased risk of
 psychopathology is observed in children exposed to maternal prenatal distress. Elevated
 maternal cortisol and epigenetic regulation of placental glucocorticoid-pathway genes are
 potential mechanisms for these observations. Women often express feelings of inadequacy in
 the new mothering role, which can furthermore negatively impact the participants mental
 health and the relationship to the infant.

 Effective treatments are needed to address high global rates of postpartum depression (PPD)
 with onset typically within 4 weeks after delivery and maternal depression up to two years
 after delivery. Programs aimed at reducing PPD could achieve the most cost-efficient results
 by focusing efforts in the critical time periods around childbirth. Web-based psychosocial
 support provided by trained public health nurses is an effective treatment method for PPD.
 Limited public health resources are challenges to the accessibility of mental health
 services, which is why the use of web-based psychosocial support could be a good alternative.
 Women perceive the risk for themselves or their infants to be above average during global
 crises, which increases the levels of uncertainty. However, face-to-face consultations during
 a pandemic are likely to increase the risk of disease transmission. Therefore, easily
 accessible eHealth support could provide fast and resource-effective care during the COVID-19
 pandemic.

 The study will generate evidence on whether web-based early intervention programs could be
 efficient in ameliorating the risk and severity of perinatal mental health disorders, and
 inform best clinical practice for women affected by the consequences of the COVID-19
 pandemic.
Inclusion Criteria:

 -  Pregnant women between 12 and 18 weeks of gestation

 -  Viable intrauterine pregnancy.

 Exclusion Criteria:

 -  History of severe psychiatric

 -  Substance abuse disorder

 -  Requiring medical treatment

 -  Presence of fetal chromosomal/structural abnormality