Generation COVID

This story is one of a two-part series about the impact of the pandemic on newborns and their families. Read the other story — about the babies of the pandemic — here.

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It was about 2 a.m. when Daítza Cohen bolted awake, convinced her month-old baby was going to suffocate.

Monti was sleeping on the crib mattress handed down from Cohen’s toddler, Juniper. Yet in the early days of the COVID-19 pandemic, Cohen couldn’t shake the conviction that her baby, a restless sleeper, was in danger. As her husband slept, Cohen searched for the internet’s best breathable, organic crib mattress. She ordered it with rush delivery.

Fear of getting sick, isolation from extended family, and the stress of caring for a newborn were a recipe for postpartum anxiety.

“I was constantly scared and dreading the future, and anxious about it,” the 38-year-old Collingswood mother said. “Monti would cough and I would think: ‘She’s going to die.’”

Caring for a newborn was hard enough pre-pandemic, when many parents could count on help from their parents and friends. Parents’ stress, loneliness, anxiety, and depression all spiked at the beginning of the pandemic and have yet to return to pre-pandemic levels, according to a University of Oregon survey that’s been tracking child and parent well-being since April 2020. Many of those families faced exhausting COVID infections and a baby’s needs without respite.

Everyone has faced challenges during the pandemic. But these times have been uniquely trying for many of the roughly seven million families that welcomed a baby in 2020 and 2021, enduring significant life changes with little to no support — and the potential for long-lasting consequences.

» READ MORE: Generation COVID: What it’s like to start life during a deadly pandemic

Perhaps most troubling, postpartum depression and anxiety have increased dramatically during the pandemic, with steeper increases among people of color. About a third of women reported serious postpartum symptoms during the pandemic, a February review of international studies found, almost 20 percentage points higher than reported in the developed world before COVID.

For parents whose children have never lived outside a pandemic, it’s been a time with limited choices, few of them ideal. Parents who choose to isolate their families to protect newborns and toddlers — who still cannot be vaccinated against COVID — often do so at the expense of their own mental health. And those who had no choice but to go to work at the height of the pandemic did so with guilt and anxiety over their children.

“We all had to do what we could do to flatten the curve,” said Wanjikũ F.M. Njoroge, a psychiatrist and medical director of the Young Child Clinic at Children’s Hospital of Philadelphia. “No parent I think should feel guilt about what they had to do during that period of time.”

Hardship amplified

DaJonna Bruce’s second child, Aubri’Skye Robinson, was born about two weeks after the nationwide shutdown in March 2020.

Before the pandemic, Bruce, 28, spent a lot of time with her grandmother and mother. As COVID spread, everything changed. Bruce closed the small child-care business she ran out of her home, but her fiancée, Shanell Robinson, continued working in person for the postal service. For months, the family coped with less income from one parent, and fears of COVID exposure from the other. Bruce rarely visited her family, she said, out of fear that Aubri’Skye would get COVID-19.

“It was very overwhelming,” said Bruce, of Southwest Philadelphia.

They weren’t uniformly bleak times. Mornings, when the family was together, were joyful, and she loved the time with her baby and older child, Kaylee Farlow, 9. Sometimes, though, the isolation became oppressive. She didn’t want to eat or do much at all.

“Stress to me is less of an appetite,” Bruce recalled. “I didn’t feel like getting up some days. I would just lay around.”

She doesn’t think she had postpartum depression, she said, because she could usually rally and Robinson’s return from work brightened her mood.

Many other new parents cannot say the same.

There is no single cause of postpartum depression, but contributing factors include a dramatic drop in hormones after giving birth, the stress of a dramatic life change and caring for a newborn, sleep deprivation, financial problems, and a weak support system. The pandemic exacerbated many of these issues, experts said.

“This brought isolation in a way we’ve never dealt with, to be left alone during a period that requires community, requires family and togetherness,” said Evana Cooper, an assistant midwife and doula based in New Jersey. “We’re seeing families go through such a severe loss, and they don’t understand why they’re struggling.”

This brought isolation in a way we’ve never dealt with, to be left alone during a period that requires community, requires family and togetherness.

Evana Cooper

At first, the forced quiet of the pandemic was a relief for the Cohens, who welcomed the time for uninterrupted family bonding. But before long, Daítza began experiencing loneliness, which worsened into feeling inadequate, insignificant, and forgotten about.

The anxiety became so overwhelming she felt unable to care for Juniper and Monti alone all day.

“Every pore in my body felt like the pandemic was inside my house and inside me,” she said.

Her husband, Matt, a self-employed professional poker player, adjusted his work schedule to relieve his wife. He wanted her to know she could get through this and didn’t have to do it alone.

“People don’t want to talk about the downsides of having a child. You’re not really encouraged to talk about it,” he said. “I figured this is something that’s happening — but we can deal with it. It doesn’t have to be permanent.”

Life goes on

For many families, caring for a newborn and the pandemic were accompanied by other complications.

Fajr Gay’s daughter Asiyah Leon, now 4, was diagnosed with autism not long before the birth of little sister Aerie on March 5, 2020, by an unplanned cesarean section.

Gay, 25, doesn’t have a car and wouldn’t take public transit for fear of her children getting COVID. The only way she could get from West Philadelphia to St. Christopher’s Hospital for Aerie’s many follow-up visits was by Lyft, she recalled, at a cost of $100 round trip because demand was so high for private cars. Gay is not working, in part due to a gunshot injury she sustained when Asiyah was a baby.

Her relationship with her daughters’ father ended before Aerie was born, she said. Gay was staying with her mother, but like many other single parents during the pandemic, she felt isolated and overwhelmed even as she kept up a positive facade for the children.

“Every night I would just be staring at the wall once they went to sleep, just crying, and I didn’t know what I was crying for,” she said. “I just started feeling sad, feeling alone.”

Therapy and talking to friends helped her with her postpartum depression, she said, but the biggest change came in July 2021, when she was able to move into her own home.

“I had to find a place for me and my kids,” she said.

Single parents typically experience anxiety, depression, and loneliness more intensely than those in other households, and that pattern held at least through the first year of the pandemic, a November 2020 study found.

» READ MORE: Pandemic life may have lasting effects on babies, but it’s taking an even greater toll on their parents

For Black families, pandemic anxiety was compounded by stress over the fallout of the police killing of George Floyd, said Iheoma U. Iruka, a research professor at the University of North Carolina at Chapel Hill and director of the university’s Equity Research Action Coalition.

“In some ways you internalize that,” she said. “It’s almost like the air you walk through — is this going to be my child next?”

Aimée Jean-Louis Rooney, of West Philadelphia, attended a Black Lives Matter demonstration on June 4, 2020, the day before she gave birth to her daughter, Grace. Fearful of getting sick, she and her husband, Horace, both educators, chose a less congested suburban event and stayed at the crowd’s periphery, but being present felt important. Floyd’s killing renewed her fears for her older children, and she wondered what world she was bringing her daughter into.

“In my mind I was thinking, ‘Grace, you’ve got to get out here, help us clean up this mess,’” Rooney remembered.

Almost a year after her daughter’s birth, Rooney, 42, was diagnosed with breast cancer. Chemotherapy and radiation treatments weakened her immune system, and she worried she wouldn’t be able to take care of Grace if either of them caught the virus. When the whole family got COVID at the end of 2021, Aimee and Horace, 46, took turns caring for the baby and resting.

“I was exhausted all the time,” Rooney said. “Exhausted because I’m a parent, exhausted because I have cancer, or exhausted because I had COVID.”

The path ahead

Even as health officials warn that the pandemic is not over, lower case rates, rolled-back safety restrictions, and the availability of both vaccines and effective COVID treatments have changed how people live with the virus. Loneliness, depression, anxiety, and stress all have plummeted since late January, about the time the omicron surge faded, among parents surveyed by the University of Oregon.

The Rooneys are hoping for a summer without COVID fears and cancer treatments. The experience they want most for Grace is her first flight, possibly to visit family in Miami.

“She’s been talking about airplanes now for quite some time,” Rooney said. “She’s not going to know what to do with herself.”

For many families, the impact of two years in a pandemic has not been undone. DaJonna Bruce, whose mother was upset COVID kept her from seeing her new granddaughter, said their relationship still hasn’t fully recovered. Bruce is still uncertain about vaccines and has not received doses, so her caution has mostly not changed, she said. She still encourages her older daughter to wear a mask.

Parents who remain worried about the risk of COVID-19 may find that their children, too, are more anxious about being in new places and meeting new people. Parents, too, can struggle with separation anxiety.

“I’m so used to her being home that I don’t even want her to go to school yet,” Gay said.

Parents’ stress and anxiety may ultimately be what most affects their children, researchers have found. That University of Oregon study found children’s well-being fluctuated in step with parents’ emotional states during the pandemic.

“We all need help,” said Ebony White, interim director of the Stephen and Sandra Sheller 11th Street Family Health Services Center in North Philadelphia and faculty in the counseling and family therapy department at Drexel. “And it’s important that you’re asking for it, not just for your well-being but for your children’s well-being.”

Monti was 9 months old when Cohen decided to see a medical professional, who prescribed an antianxiety medication.

“I was fighting it for a while, and I’m not sure why. I think maybe I just felt like a failure. I felt inadequate,” she said. She wishes she’d gotten help sooner.

“I feel liberated now,” Cohen said. “I don’t wake up in the middle of the night thinking my daughter can’t breathe — but for a while, I couldn’t see the light.”

Her mind feels clearer, and she can see that while she felt bludgeoned by the pandemic, Monti thrived and is now an observant, adventurous, unafraid 2-year-old.

Help is available if you or someone you know is experiencing postpartum depression or anxiety. Call or text "Help" to the Postpartum Support International helpline at 800-944-4773. Visit https://ppdphilly.com/ for more resources in the Philadelphia area.

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