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MEET DR BAVI VYTHILINGUM Psychiatrist. "Coping with anxiety and psychological distress related to COVID-19 during pregnancy and post-partum."

MEET DR BAVI

Dr Bavi has been a psychiatrist since 2004 and has worked both in state and in private practice. She is currently working in Kenilworth at Akeso The Crossings. She works with all patients but her special interest is in working with women, particularly around mental health issues related to menstruation, pregnancy and post-partum, and menopause. During lockdown, she is consulting online. For further information call 087 098 0470 or email drbavipractice@gmail.com

"Dealing with Anxiety and Psychological distress related to COVID-19 during Pregnancy and Post-partum."

During this period of lockdown many women who are pregnant or have young babies worry about COVID-19. They may worry about getting the infection or the impact of the infection on their baby. Other worries include being able to have a support person during labour and whether breastfeeding is safe.

The good news is that pregnant women are at no greater risk of contracting the virus and even if a mum is COVID positive her baby is safe to be with her and to breastfeed, provided precautions like handwashing and using a mask are taken. But despite these reassurances some amount of anxiety is natural and understandable. However, it helps to talk to someone about it, so talk to friends and family whom you trust.

Sometimes though the anxiety may become excessive and these are times that you must reach out to your healthcare provider, which could be your doctor or clinic sister or midwife. If you are worrying all the time about getting the infection, having difficulty sleeping, feeling sad or angry or getting sudden episodes of panic, your anxiety may be excessive.

The Four Ways - Sharing and Managing Time; Planning and Preparation; Decreasing Anxious Thoughts; and finding ways of Calming yourself.

Sharing

  • Keep in regular touch with your gynae, GP or your clinic sister
  • Divide your day into 4 parts - Rest, Hobbies, Work and Exercise. Try to create a timetable for yourself using these 4 headings equally.
  • Try not to stay isolated and find ways of interacting with relatives and friends through phone and video calls.
  • Stay away from disturbing social media posts and TV programs and request your friends and family not to send you messages that are negative.
  • if there is a lockdown and people are stuck at home, it has been seen that in some households interpersonal conflicts might increase. In case you face violence, there is a risk to your baby or unborn child and to you. Please inform a friend or family member about the violence or threat of violence and have a safety plan ready in case you have to leave home. You can also call the GBV (gender based violence) call command at 0800 428 428
  • During social isolation, you may not be able to have the regular pregnancy related celebrations and this may disappoint you. Try to find other unique ways of making yourself feel special such as having a small function with just your immediate family and sharing pictures with others.

Preparation and Planning. One good way of managing anxiety is to be prepared for eventualities. While some things are difficult to plan for, you can have a plan ready in case you have any urgent reason to visit the hospital.

  • Keep phone numbers of ambulance services, two or three of your friends, and your immediate family members handy. Inform them that you may need their help. 
  • Send a copy of your antenatal card and share phone numbers of the hospital, clinic or your doctor with immediate friends or family in case they need to come to the hospital to be with you. If there is a curfew or lockdown, they will need to show it to the police if they are asked for proof.
  • Once the baby is born, keep the telephone numbers of the paediatrician or clinic handy. Speak to them about what needs to be done about immunisation.

Decreasing anxious thoughts. 

What can you do to minimise worry?

  • Name the core worry. This stops it from getting tangled up with too many different issues. Is it about the delivery? Is it about the baby's health? Is it about how your partner will get home after he went out to get groceries during the lockdown?
  • Sometimes, naming the worry will point out that the worry is needless
  • Try to avoid "fuelling the worry" or "adding petrol to the existing fire" by staying away from social media posts, blogs, chatrooms discussing similar topics.
  • Ask yourself - Have I looked at all the options given the current situation?
  • Assign a specific time to worry - when a worry thought arises, tell yourself you will think about it only during "the worry time"- say between 6-7pm. This helps in postponing the worry and decreasing its intensity. 
  • Create a Comfort Box or Bag for yourself - this could have a picture that makes you happy, a piece of cloth or a stone or a piece of wood to touch, something with a nice aroma, some words of a song on a piece of paper - basically anyhting that can soothe you and help you calm down.

Positive things to do

  • Talk to someone, not necessarily about the worry. Just chat.
  • Identify an activity that you enjoy and get immersed in it - reading, listening to music, solving a puzzle, going for a walk, playing with kids around you, trying a new recipe, cleaning a cupboard, trying some craft, making posters out of inspirational quotes, writing a diary/blog or singing.
  • Find ways to seek comfort - an inspirational talk, soothing music, chanting, a book of wise words, laughing and sharing jokes with your family, being silly with your children.
  • Try writing a Gratitude Journal, list all the things you are thankful for.

Relaxing and Mindfulness. Find ways to relax - yoga, meditation, deep breathing, mindfuless. You don't need any fancy equipment, and don't try hard for a perfect, undisturbed perfect time/space.

Simple relaxation exercise

  • Mindful breathing. Close your eyes, relax in a chair or on the bed. Notice your feet resting on the ground. Focus on your breathing. Observe each breath as it comes in, and goes out, and in, and out. If you notice your thoughts straying, bring them back to your breathing. If any sounds around you claim your attention (the doorbell, birds chirping, the sound of traffic), notice the sound but bring your attention back to your breathing. You can do this for 10 breaths (or for 1 minute, or 5 minutes, or 10 minutes), and then slowly open your eyes. 
  • Square breathing. Breathe in to a count of 1-2-3-4. Hold for 1-2-3-4. Breathe out for 1-2-3-4. Do this for 3-5 breaths or until you feel calmer. 
  • There are many resources online for guided meditations or mindfulness practices that you can do alone or along with your family, including ones that are suitable for children. Find the ones that you relate to and try to practise whenever you can.

Please access the SADAG Helpline 0800 21 22 23 for support and help. Women in the perinatal period, partners, families and healthcare workers can call for advice on any mental health matter.

Another useful source of information is the SA COVID-19 Hotline 0800 029 999 or 0800 111132

 

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DR LESLEY CAREW

Dr Lesley Carew is a registered Child and Adolescent Psychiatrist practising at the Netcare Christiaan Barnard Memorial Hospital in Cape Town with a satellite sessional room on Thursday afternoons at the Akeso Milnerton.

CONTACT

Tel: 021 423 8774/6
Fax: 086 641 5388
Email: admin@drlesleycarew.co.za