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On Confinements & Coexistence: Perspectives on the Impact of Covid-19 on the Mental Health of Women

Pandemics have a profound psychological impact. They are known to disrupt one’s sense of safety, security, certainty, control, concordance, and predictability in life events. Ever since the outbreak of Covid-19 the infection has caused a phase-shift from known ways of living. Human beings appear to have switched from a ‘growth-orientated lifestyle’ to a fear or threat-based ‘survival modes of living’. Covid’s spread has had a snowballing effecton personal and socio-occupational areas of one’s life. Human beings (irrespective of socio-politico-cultural and economic locations) appear to be re-classified into five subsets. These are i) those who are infected/reinfected and isolated, ii) those who are quarantined, iii) those who have recovered, iv) those who face an elevated risk of contracting Covid-19 (frontline workers), and v) those who have had to stay at home, in an attempt to protect themselves from contracting the infection, especially if they have a chronic illness, are immune-compromised, older adults, below 18years of age, pregnant,  and so on. In March 2021, UN Women highlighted the “disproportional effects of Covid-19 on women and girls as they are affected multi-dimensionally” due to the ongoing pandemic (UN Women, 2021). These issues are constantly projected in scientific research and the grey literature.This article puts forward some perspectives on the gendered impact of Covid-19 in women and its possible mental health challenges.

In the Indian context, women are primarily valued for their roles in life-giving (procreative) and life-maintaining (domestic) activities, as daughters, wives, mothers, grandmothers, as homemakers and caretakers. Yet, amid thepandemic, staying home and ‘house arrest’ has given rise to serious concerns for women, especially homemakers. In my routine clinical observations, women have expressed their apprehension over changes in the physical setup of their homes. Their ‘living spaces’, during the pandemic, have been converted to ‘segregated commercial spaces’ which are expected to be ‘noise-free and intrusion-free’ offices, virtual workstations, trading zones, schools and study units. Homemakers areexpected to be round-the-clock providers of extra care giving to their family. These expectations include helping their young ones who might be studying online, those who are infirm or sick, older adults, and their life partners working from home.  Additionally, access to paid domestic helpers is restricted due to lockdowns and/or safety precautions. Women are also acquiring the role of  ‘school tutors’ with as long as six hours of online home-schooling of their children. A daily monitoring of academic milestones/exams of their wards has become essential in order to ensure continued cognitive motor skill development. Invariably, vigilance over behavioural addictions has to be maintained by homemakers as children are at a greater risk of pandemic impacted lifestyle changes such as overuse/misuse of technology, gadgets, internet or gaming addictions. Schooling is being offered on smartphones/virtual platforms or applications which puts a load on the primary caregiver to supervise technology-mediated learning outcomes. Pandemic parenting covers a range of ways in which “parents are worried about each other: parents see and anticipate how the work of parenting in pandemic may take a toll on each other’s mental and emotional health; and we may find ourselves more regularly reaching out to each other with mean-end analysis, advise, sympathy, humor, or support” (Harbin and MacLachlan, APA Newsletter, 2020). Furthermore, caring for older adults who may have a physical ailment is accompanied by logistical issues such as access to medical help. Among those elderly who are residing in nuclear setups, lack of physical contact with their children, grandchildren, relatives has led to significant alterations in kinships, family rituals and routines, during Covid-19. Social isolation thus has caused a proportional rise in geriatric issues such as loneliness, alienation, emptiness, despair, and vulnerability among the elderly.

In my clinical exchanges, the lived experience of women amid a pandemic reveals overwhelming feelings of inadequacy or difficulties in maintaining personal boundaries for altered roles. Many women have experienced a restricted agency and freedoms, frequent emotional upheaval, loss of their precious “work-free mid-day time zones” and undue burden of care giving. Another unit of psychosocial analysis is studying the effect of ‘forced, continuous cohabitation of family members’ among those who had relational difficulties, marital conflicts, family disputes, interpersonal violence prior to the lockdown. Pandemics were times under which prior interpersonal transgressions (intrafamilial conflicts, parent child relations, and spousal relations) resolved as well as worsened for some, under the newfound milieu.

The pandemic has influenced women to varying degrees depending on class and caste location. The silent struggles of socio-economically disadvantaged women have been far-reaching. Research reports that women have faced grim realities of enclosures and confinements such as poverty, adverse outcomes of substance dependence in another family member, maltreatment, domestic violence, financial violence, abuse of their young children, intrusions to bodily autonomy,privacy, and limited agency, leading to unwanted conceptions/childbirth and a loss of their sexual and reproductive rights (Topalidou, Thomson and Downe, 2020;Ferrer-Perez, 2020;UN, 2021).

From the vantage point of perinatal psychiatry, the World Health Organisation (WHO) says, “virtually all women can develop mental disorders during pregnancy and in the first year after delivery” (WHO, 2017). Its guidelines for “antenatal and for intrapartum care reinforces the importance of conducive clinical and psychosocial pregnancy and childbirth experiences, to optimize the physical and psychosocial wellbeing of mother, baby, and the family” (WHO, 2017, 2018). The data on the clinical and psychological impact of Covid-19 in women who are contemplating conception, are pregnant, labouring, and postnatal women or their babies reveal possible adverse effects due to limited /timely access to goods, medical services, routine checkups or emergency help, psychosocial restrictions on quality of life and social care (Topalidou, Thomson and Downe, 2020).

Most of these trends have been globally and cross-culturally observed. The United Nations mentions that “even before the Covid-19 crisis, women did three times as much unpaid care, community care and domestic work as men” (UN, 2021).  During the pandemic, women’s altered association with their roles and work has increased structural inequalities.  New implications have risen with regard to health, wellbeing, productivity and careers of men and women (Ferrer-Perez, 2020). Emerging evidence shows that in the context of lockdowns, closures, multiple strains, and competing pressures of time, there has also been a depletion in self-care and  community-centred leisure activities. This is more so for women than men (UN Women, 2021). UN Women also documented significant burnout in staff of women’s rights civil society organizations six months into the ongoing Covid-19 pandemic (UN, 2021).

Given these findings, according to UN Women, “When a crisis occurs, the possibility of transformative action depends on the stock of alternative ideas being proposed. At the global level, transnational women’s rights networks are seizing this opportunity to put forward state level recognition of needs, gaps and feminist alternatives to current economic and social models through the use of online platforms and social media. Campaigns and petitions are taken up in public debates and by the media, and these networks are putting the need for care of people and planet at the centre of demands for long-term recovery from COVID-19. The ‘Call for a Feminist Covid-19 Policy’, published by the Feminist Alliance for Rights and endorsed by over 1,600 individuals and organizations from more than 100 countries and translated into six languages, is a notable example. The statement demands intersectional and rights-based responses to the pandemic, including improved access to health care, rights, education, water, sanitation and food, and an end to social and economic inequality, violence against women and the abuse of power”  (UN Women, 2021). The call for free and open civic spaces for growth for all is thus being strengthened.

Pandemics are times when one talks about privilege and solidarity for each one of us. It is also a time when one makes a shift from regular ways of living. Each of us makes deliberate and conscientious moves. Such a move should be geared towards acknowledging that those who care for others (be it primary caretakers or frontline workers) also need and deserve care. Additionally, each member of the family, and the community at large, needs to come together and pledge to work towards such a multi-system growth. All this can be initiated by creating a mindspace (within ourselves, by conscious thought provoking means) that allows itself to stretch by new experiences and new leanings, in ways that are more adaptive than before.

References

  1. UN Women. (2021) Covid-19 and women’s right organizations: Bridging response gaps and demanding a more just future. Retrieved from https://www.unwomen.org/en/digital-library/publications/2021/03/policy-brief-covid-19-and-womens-rights-organizations
  2. Harbin A, MacLachlan A. (2020) Pandemic Parenting. In The American Philosophical Association Newsletter (2020).  Feminism and Philosophy Special Issue: Feminist Responses to COVID-19 and Pandemics. Available from https://www.apaonline.org/news/527600/Feminist-Responses-to-COVID-19-and-Pandemics.htm
  3. Topalidou A, Thomson G,  Downe S. (2020)COVID-19 and maternal mental health: Are we getting the balance right? Retrieved from https://www.researchgate.net/publication/340469240_COVID-19_and_maternal_mental_health_Are_we_getting_the_balance_right
  4. World Health Organisation (2017).WHO recommendations on antenatal care for a positive pregnancy experience . Available at:https://www.who.int/publications/i/item/9789241549912
  5. World Health Organization(2018). WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization. Available from https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/
  6. Ferrer-Perez V. A. (2020) Coping with the COVID-19 pandemic and its consequences from the vantage point of feminist social psychology.International Journal of Social Psychology, 35:3, 639-646, https://doi.org/10.1080/02134748.2020.1783839

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Article written by:

Dr. Ansha Patel (MPhil, PhD Clinical & Reproductive Psychology) is a consultant clinical psychologist, psychotherapist, researcher, scientific advisor and columnist. She is affiliated to the Dept. of Psychiatry, RNT medical college, Shantirajand Parasjk hospitals, Udaipur, Rajasthan, India. She specializes in Behavior Medicine, Reproductive Psychology & Perinatal Mental health. She has trained in evidence-based and cognitive behavioral therapies and mindfulness-based interventions. She is also a scientific advisor to Vyanasparcolife digital fertility solutions and a peer-reviewer for indexed scientific journals published by Springer Nature, Wolter Kluwer, and Sage groups. Profile: https://orcid.org/0000-0002-1766-9558.

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