The infant formula shortage and the COVID-19 pandemic have added fuel to an already existing fire in maternal mental health in the United States.

As Adrienne Griffen, Executive Director of Maternal Mental Health Leadership Alliance pointed out at a recent event on the COVID-19 pandemic, maternal mental health, and policy solutions, “maternal mental health conditions, including anxiety, depression, and other issues, affect 1 in 5 pregnant or postpartum people [in the U.S.].”

The COVID-19 pandemic has created universal impacts on mental health.  Anxiety, depression, and other conditions have worsened as financial instability, isolation, gender-based violence, and other factors generated by this crisis have contributed to poor mental health – especially for youth, LGBTQ+ populations, and pregnant/postpartum women. Yet despite the global attention focused on mental health, overall conditions have only worsened in vulnerable communities.

“The COVID-19 pandemic has amplified pre-existing inequalities and vulnerabilities,” writes the United Nations Population Fund (UNFPA) in a recent report on the impact of COVID-19 on sex workers in East and Southern Africa. The pandemic has had an impact on people in marginalized communities around the world, but for sex workers globally, “the impact on livelihoods, human rights and health has been devastating, leaving many struggling to survive,” states the report.

Evidence shows that in low- and middle-income countries, the expansion of health coverage or access to care has not always reduced overall mortality, said Dr. Patricia Jodrey, Child Health Team Lead in the Office of Maternal and Child Health and Nutrition at the U.S. Agency for International Development (USAID). “However, the analysis also showed that when countries have progressed in improving the quality of their health systems, the survival rate tends to improve,” she said.

As the novel COVID-19 coronavirus swept the planet in early 2020, researchers scrambled to find effective treatments and vaccines. Within a year, there was a clarion call from heads of state, the World Health Organization (WHO) and other agencies to create an international “pandemic preparedness and response” treaty. WHO noted that COVID-19 offered “a stark and painful reminder that nobody is safe until everyone is safe” from zoonotic disease outbreaks.

“The pandemic and related global economic recession are severe setbacks to already insufficient progress towards meeting the global nutrition targets set for 2025 for stunting, wasting, maternal anemia and breastfeeding,” write the authors of a 2021 study examining the effects of COVID-19 on child and maternal health and nutrition. Adequate nutrition in the perinatal period is essential for healthy mothers and babies, and COVID-19-induced poverty and disruptions to global supply chains have compromised the food security of people around the world, mostly in low-to-middle-income countries (LMICs).

Since its onset, the impact of the COVID-19 pandemic on maternal mortality has been a question of great concern. And yet, few empirical attempts have been made to capture the potentially profound impact of the pandemic on maternal deaths, particularly in resource-limited settings.