Mothers are at increased risk of mental health problems as they struggle to balance the demands of childcare and remote working in COVID-19 lockdowns, according to new research from an international team of researchers.
The findings, published in the journal Psychological Medicine, were drawn from a comprehensive, online survey of mothers in China, Italy and the Netherlands.
Changes to their working lives, family strife and loss of social networks emerged as common factors affecting the mental health of mothers in all three countries.
The study was carried out by a team from Radboud University, Peking University, Tilburg University, Vrije Universiteit Amsterdam, and Padua University, to compare the factors affecting and protecting mothers' metal health in lockdown across countries and cultures.
A total of 900 Dutch, 641 Italian, and 922 Chinese mothers with children aged between one and 10 years participated in the study and reported on their mental health, family functioning, the support they received, and their demographic characteristics during the first lockdown in April and May 2020.
The researchers found women in all three countries shared three big risk factors: changes to work through unemployment, reduced job security and the shift to remote working; marital problems and conflict with other family members, and what the researchers called pandemic-related distress, caused by reduced access to food and essentials, healthcare and social networks.
There were also smaller risks to mental health, which differed across the three countries.
In the Netherlands, unemployed mothers reported high levels of mental health problems, possibly because of financial insecurity. At the same time, highly educated Dutch mothers also reported more symptoms. The researchers suggest this may be because of the need to combine demanding work, often remotely, with child care responsibilities.
In China, highly educated or high income mothers, single mothers, and mothers with poor physical health all reported more mental health symptoms, while in Italy, lower maternal age and poor physical health emerged as risk factors.
Regardless of country, the researchers found mothers who were more resilient and generally able to cope effectively with stressful events experienced lower mental health problems during the lockdown. In China, a large number of children as well as support in childcare from grandparents living in the same household decreased the risk of mental health problems. The researchers conclude that an extended family may be a source of resilience as the unexpected burden of the pandemic is shared among more people.
Dr Madelon Riem, from Radboud University, said: "With closures of schools and day care centres, COVID-19 continues to drastically impact the lives of parents. The burden of the pandemic may be disproportionality placed on women who are still often the primary caregiver. Mothers are, therefore, at increased risk for mental health problems."
Her colleague, Jing Guo, from Peking University, said: "These findings may inform future interventions aimed at improving maternal mental health during future pandemics. For instance, the current lockdown policies may ignore the advantages of grandparental childcare that support mother's mental health, as shown in China.
"Families without grandparental support show a clear need of childcare facilities during lockdowns. Improving maternal mental health not only benefits mothers, but also their children. For mothers who are disproportionately burdened by the pandemic, good mental health may be a necessary prerequisite for providing adequate care of their children."