WHO defines health as a collective component of physical, mental and social well-being of an individual.¹ COVID-19 is a pandemic that has proven to be a major stressor worldwide. Apart from the medical complications of the illness, it has significant impact on the psychological and social aspects of an individual’s life. It has been found that children, older adults, pregnant women, person with chronic medical conditions, immunocompromised individuals are more vulnerable to infection.² There are psychosocial stressors during pregnancy and it could lead to adverse outcome to the baby like preterm birth.³ It is quite important to have positive mental health at this time as it ensures the person has resources to manage the ongoing stressors related to pandemic. Here we share a case report on COVID positive pregnant lady and various psycho-social stressors experienced by her during the COVID illness.

This is a case report about a 26 years old multigravida female, who acquired COVID infection during the third trimester of her pregnancy. The main psychological stressor for her was the separation from her husband and child. This practice of separating mother from her family members for COVID-19 protection has harmful impacts on maternal health.⁴ Another concern of her’s was about the stigma prevailing in her own family members and general public because of COVID-19. Shaming and blaming the affected people can be hurtful which further deteriorates their mental health.⁵ Family stressors include the interpersonal conflict with her in-laws. Interpersonal issues and depression have a dose-response relationship. More the conflict more is the probability of experiencing prenatal depression.⁶ We suggested shifting her family members to the same vicinity to reduce the stress of separation. Attempts to reduce the stigma in her sister and her neighbors were initiated through phone calls. A guide to combat the stigma due to ongoing pandemic was developed by UNICEF, WHO, IFRC. This guide could create awareness about do’s and dont’s among public during this pandemic period.⁷

Owing to fetal distress, she had to undergo an emergency caesarean section. WHO advice is that caesarean sections should only be performed when medically justified.⁸ The newborn baby was kept in close contact with her and early exclusive breastfeeding was initiated with proper respiratory hygiene. According to WHO there is no restriction for a COVID positive mother to breastfeed her baby, because only breastfeeding helps the baby to thrive and prevent infections.⁸ There is no available literature addressing the psychosocial stressors of COVID-19 patients in the post discharge period. Our patient’s primary concern was about the reaction of the extended family, neighbor-hood and living situation which were addressed through our telephone support service and it provided relief to her. We strongly feel based on our experience, that, there is a pressing need to identify COVID positive patients who are experiencing bio-psychosocial stressors and continue to provide post discharge mental health support through telephone support or tele-psychiatry services, as it builds up their morale and help them to cope with the situation much better.

We recommend telephone support or tele-psychiatry service for COVID 19 patients in need of psychosocial support, at the time of admission, during hospital stay and post discharge.