The impact of Covid-19 on maternity and parental leave Contents

4Becoming a new parent during the pandemic

44.Becoming a new parent is challenging at the best of times. Although it is also a wonderful time, nothing can fully prepare someone for how difficult it can be and the impact the experience can have on parental mental health. The evidence we’ve heard demonstrates the serious and unprecedented impact that the pandemic has had on all new parents and, most importantly, their children—our future generation.55

45.In response to our public engagement, those who had become new parents during the pandemic overwhelmingly expressed a sense of loss for both their babies and themselves, as they missed key opportunities for bonding with extended family and development activities outside of the home.56 Many expressed how the situation had exacerbated or caused depression and anxiety, which impacted on their enjoyment of parenthood and ability to bond with their baby.57 For some, the pandemic had adversely affected their pregnancy with increased anxiety and restrictions surrounding antenatal appointments and their birth experiences.58

Giving birth during the lockdown

46.Restrictions have been put in place on visitors in most hospitals and maternity units. This has meant that many partners or other supportive people were not able to attend routine antenatal appointments, including scans. Where birth partners were self-isolating or unable to travel, some women were not able to have their chosen birth partner with them and we heard from some mothers who had given birth alone. We heard that these experiences had understandably impacted their mental health early on. The Birth Trauma Association told us that increased antenatal anxiety as a result of Covid-19 was likely to lead to a spike in birth trauma.59 We have also heard that stress and anxiety during pregnancy can negatively affect the development of the unborn child.60

One mother told us:

The stress of the Coronavirus pandemic, lockdown, having to give birth alone, no visitors after having a c-section etc has ruined the beginning of what is meant to be a memorable happy time and has led to severe anxiety.61

Another mother told us:

Rather than having a relaxing, exciting build up to my maternity leave my final weeks were filled with anxiety and worry. […] Giving birth in a pandemic was an experience I unfortunately have been left traumatised by; lack of staffing and the restrictions on birth partners affected me.62

A pregnant woman told us:

I have not had my baby yet I’m due this month. It has been very stressful and worrying especially with all the ongoing changes that have been happening with antenatal care and birth […]63

Combined with some of the other issues faced by pregnant women within the workplace and limitations on government guidance as to their rights, which we discussed in Chapter 3, it’s clear that pregnant women have been seriously impacted by the pandemic and experienced great stress and anxiety which may negatively impact their pregnancy and birth experience.

Isolation and support

47.In response to our public engagement, new parents overwhelmingly spoke of their isolation and lack of support which new parents often rely on.64 There is some great support available within the UK, and we’ve heard about the fantastic work of health visitors; professional and volunteer-led support groups and baby groups which all play a crucial role in supporting new parents. Like many essential services, however, this support has not been available during the pandemic. This is not through want of trying: Health visitors and other medical professionals have done their best using technology and many support groups have been able to take place online—but we have been told that this has not been enough.65 We heard compelling evidence that action needs to be urgently considered to ‘catch up’ on the support that this cohort of new parents have missed out on and to provide additional support for those who have experienced extreme trauma and hardship as a result of the pandemic. The Institute for Health Visiting told us:

The easing of some COVID-19 restrictions in early June will be welcome but continue to diminish what mothers would have expected in maternity leave and cannot restore lost opportunities that are foundational for parenting, family life and early infant development.66

The Birth Trauma Association said:

For us, the main concern is not that maternity leave should be extended but the quite alarming cut-off of postnatal care services—this is what is going to create greater problems for these women down the line.67

New mother Bethany Power told us:

Covid-19 has affected me massively […]. I have worked really hard to secure maternity leave in order to have a job to go back to. I have planned and prepared what I would like to do in my maternity leave and that has been disrupted. I have been unable to get the support I need, like breastfeeding support and weaning support. I am unable to weigh my baby. I am unable to get the support in terms of how to bond with my baby. For me, my baby is the first baby I have ever looked after, so not to get the support from parent and baby groups and professionals has been really hard.68

Another new mother told us:

With lockdown in place it has been difficult to enjoy being a new mum without the support of family and friends. Access to my health visitor for weight and health checks hasn’t been available which would normally provide me with reassurance of my baby’s development. My daughter has also missed her hospital appointments to review her health after her admission to NICU at birth. My husband is an NHS anaesthetist, the added demands of his job during the COVID-19 pandemic has further increased the periods I am completely isolated at home without support and affected bonding time as a family. I feel that it has been difficult to maintain a positive outlook at times because of the lack of socialisation and a feeling that I am missing out on many important experiences with my daughter.69

Health visitors

48.Health visitors—nurses or midwives who have undertaken additional public health training—play a crucial role in supporting new parents and identifying vulnerable and at-risk families. In the words of the Institute for Health Visiting:

Their training equips Health Visitors to use their understanding of public health, the wider determinants of health and impact of health inequalities in their skilful work, recognising and responding to individual needs with the aim of improving health outcomes for every child and family.70

49.The lockdown has seriously impacted the ability of health visitors to build the relationships with new parents that are so crucial for identifying and supporting those who are seriously struggling or at risk.71 Health visitors report that it’s difficult for mothers to admit they are struggling to a near stranger, which means they may wait longer to seek help.72 Research shows that 7 in 10 women will hide or underplay the severity of their perinatal mental illness.73 The Institute for Health Visiting told us that the prioritisation of community services due to Covid-19 has reduced the health visitor-led Healthy Child Programme to just two of the normal five minimum mandated contacts, with more limited targeted support for some families. To comply with social distancing rules, most contacts are largely taking place remotely. They told us that this made it very difficult to identify serious problems such as domestic violence and abuse; mental health; or substance misuse which may be placing them and their children at risk. They also told us that breastfeeding support and physical assessments of the baby are difficult to do without face-to-face contact.74 The number of health visitors has fallen in England over the last five years from 12,094 in March 2015 to 9,164 in March 2019.75 The Institute for Health Visiting told us that numbers have continued to fall since March 2019 and that the redeployment of health visitors to assist with the pandemic has reduced the service further in many locations. It told us that prior to the pandemic, 29% of health visitors who were surveyed were responsible for 500–1000+ children when the recommended maximum number of children per health visitor is 250.76

50.It is difficult to see how health visitors will be able to ‘catch-up’ with their important contact visits to provide the much-needed support for new parents and to help identify those who are vulnerable and most in need. This risks more vulnerable children and families becoming hidden. The Government should review the provision of health visitor services in light of Covid-19 and consider funding increased numbers of health visitors and other allied professionals to ensure that vulnerable families are identified and given the support they need.

Isolation

51.We heard from many mothers who were experiencing severe isolation as a result of the lockdown with their new babies, with often serious consequences for their mental health and wellbeing.77 Dr Cheryll Adams, Executive Director of the Institute of Health Visiting, told us:

When mums are alone, loneliness is a really difficult thing with a new baby […] You have many moments of the day when it is helpful to talk to somebody and get information. You are just wondering what is going on and you would like to pass it by somebody. Imagine if that goes on into days and weeks, and you do not have good access to support. Many families are Skyping or Zooming grandparents and friends. That helps a lot. They are using online forums and they help enormously, but the days are long. Anybody who has been a mum at home knows just how long the days can be, particularly in the early days when you are not terribly sure about what you are doing.78

Although we heard from many mothers who have experienced serious isolation during the lockdown, single mothers have been particularly affected by the Covid-19 restrictions. One single mother told us:

I’m a single mother of four children and I haven’t had any one to one time to bond with my baby or take him out and get him socialised, I suffer with depression and anxiety and I’ve had no time to get help and I feel this could impact on our relationship.79

Another single mother told us:

I wasn’t able to have anyone in theatre when my son was born which was a horrendous time. Also being a single mother I have to rely on people to drop essential items I need for my baby at my front door. None of my family or friends have met my son and this is time wasted being stuck in the house with him.80

Baby classes and groups

52.The petition that triggered this inquiry highlighted the inability for new parents to attend baby groups.81 There are a huge range of classes and groups that are usually available for new parents, from free support groups provided by local councils and volunteers; play clubs and groups organised by local churches and community groups; to the huge array of classes from baby sensory to swimming and sign language. It became very apparent that these classes and groups, which were talked about fondly, were not just a bit of fun where parents could take their babies swimming or enjoy a cup of tea and a chat. These classes can be lifelines for new parents. We heard that they provide struggling new parents with a reason to leave the house, they provide a space where they can make friends with other parents adding to an informal network of support. We heard how parents rely on these groups and classes for professional and informal parenting advice. For example, we heard from new mothers who had struggled to breastfeed without being able to attend their local support group. We also heard how parents value these classes as an opportunity for their babies to interact with other people and experience new things outside of the home.82

53.In our first survey to petitioners, we asked what the most important benefits for attending baby groups and classes were.

Table 3: What people told us they thought the main benefits of attending baby groups and classes were

Ranking	Reason
1	The baby’s development
2	Professional parenting support
3	Peer parenting support
4	Making friends with other parents

Source: Survey to petitioners, Annex 183

54.Many parents were concerned that their babies were missing out on developmental opportunities through these classes and groups. We were reassured by both the Institute for Health Visiting and Professor Elizabeth Meins, a developmental psychologist and professor of psychology from the University of York, that it was nurturing interactions with their caregivers that contributed the most to baby development.84 However, the groups are still valuable, not least because of the support and interaction they provide for parents. Parents taking part in our public engagement told us:

“I was so scared to even leave the house when I first became a mum, I attended baby massage when my baby was 5 weeks old and instantly felt less alone, more supported, a weight off my shoulders. The confidence gained can’t be quantified or underestimated.”

“Attending parent and baby groups provides a safe space away from family members where it is a safe space to seek support be it weaning, breastfeeding, mental health support that we wouldn’t reach out to a partner or family member in the same way. The groups also provide great reassurance about baby’s development and give tips and ideas that can be shared.”85

55.Some providers of baby classes and groups have gone online to provide interactive classes for parents; however, we heard that many of the free classes, such as those provided by local authorities, had simply stopped and had been replaced with non-interactive classes that didn’t provide the same level of support.86 Petitioner Jessie Zammit told us:

“[…] you have to pay for a lot of these interactive baby groups, especially in the area I live. That is absolutely fine if you are able to put yourself in that sort of position, but I know the council often runs baby groups that are free and get a lot of use. For those people who are not able to support themselves financially to do these Zoom meetings and stuff, how are they going to be able to do stuff like that at home?”87

We heard from representatives of the baby class industry and entrepreneurial mothers who have set up businesses to help parents find baby groups and connect with other parents following their experiences of postnatal depression. This sector, like most others, has been hit hard financially due to the pandemic, with classes and groups having to close their doors or move online with reduced numbers.88

Emily Tredget told us:

“Baby classes have small margins, so this [social distancing] will not be viable unless they increase their prices 3 fold—and then those who are likely to most be struggling with mental health at the moment […] still won’t be able to attend. These class providers are likely to be struggling at the moment, with no access to government help due to being sole directors of Ltd companies […]. If you want this provision to be available, you will need to support them in a way that doesn’t undermine the entire market and kill off these parent-run businesses.”89

56.While baby classes may not be directly vital to baby development, they provide important support to new parents, which will benefit the care they can provide. From our discussions with the sector and with the Minister, there has not been sufficient engagement with these groups or appropriate consideration of the contribution that they make to the lives of new parents. The Government should engage fully with this important sector and consider how it can be better supported. We were pleased that the Minister for Small Business, Consumers and Labour Markets, Paul Scully MP, has committed to Government engagement with the baby class sector. The Government should provide an update on its discussions with the baby group sector as part of its response to this report.

57.New parents have missed out on vital support from professionals such as health visitors and baby classes and groups. We’ve heard how important this support is for parental mental health and for helping to lay the foundation for parenting, family life and early infant development. The Government has announced a £1 billion catch-up fund for older children who have missed out on valuable education. These new parents have also missed out at a crucial time for both them and their children. The Government should fund and provide additional catch-up support targeted at this cohort of parents to enable them to access both the professional and more informal support that plays such an important role during the first few months of parenting.

Dental care

58.All pregnant women and new mothers are entitled to free dental treatment up to 12 months after giving birth. However, many new mothers have told us that they have been unable to use their free dental care as a result of the lockdown.90 One mother told us:

I have lost the benefit of my NHS exemption certificate when it comes to dental care as I am unable to visit the dentist. As we know pregnancy takes its toll on a woman’s body in all aspects and I will now potentially have to pay for any remedial dental work as a result of not being able to visit the dentist due to the lockdown prior to my exemption expiring.91

59.This is an important benefit for new and expectant mothers as increased hormone levels can leave them more vulnerable to dental problems including gum disease and increased risk of tooth decay.92 This entitlement is particularly important for those with low incomes or struggling on Statutory Maternity Pay, Maternity Allowance or unpaid portions of their leave entitlement. Free dental care is an important benefit that most pregnant and new mothers have been unable to access as the result of the pandemic. The Government should extend maternity dentist provision for new and expectant mothers affected by the pandemic for at least six months, so new mothers have the opportunity to access this important benefit.

55 See, for example, The Institute for Health Visiting (GRC0024) and oral evidence from Dr Alain Gregoire and Dr Trudi Seneviratne

56 Annex 1

57 Annex 1

58 Annex 1; also see, for example, The Birth Trauma Association (GRC0012); The Fatherhood Institute (GRC0007).

59 Birth Trauma Association (GRC0012)

60 Q48 and Q49. Also see written evidence, for example from the First 1001 Days Movement (GRC0006).

61 Annex 1

62 Annex 1

63 Annex 1

64 Annex 1

65 Q10

66 Institute of Health Visiting (GRC0024)