MONTREAL -- The COVID-19 pandemic and the curfew and lockdown that have accompanied it have increased the food needs of pregnant women and their infants, but the situation also often prevents them from getting the help they need, warn two community workers.

The Olo Foundation, which offers vulnerable families nutritional monitoring during pregnancy and for the two years following birth, estimates that the number of women who would need such monitoring has jumped by 10 per cent since last March, to about 11,000 in Quebec.

At the same time, however, the group observed a drop of at least 20 per cent in registrations for Olo follow-up across the province.

"Obviously, there are brakes that prevent families who have needs, who have great vulnerabilities, but who do not seek services for different reasons," said Olo executive director Elise Boyer.

The message from health authorities since the start of the pandemic has been clear: stay at home as much as possible and minimize contact with others to reduce the risk of infection.

This has encouraged some women, out of fear of the novel coronavirus, not to access available resources.

"In the field, we notice that the concern surrounding this virus means that families tend to isolate themselves more and protect their family cocoon, their newborn, and they do not use the services adequately," said Amelie Landry, executive director of the Network of Perinatal Resource Centres of Quebec (RCRPQ).

Since the start of the pandemic, the RCRPQ has maintained its home service. The service was deemed essential, especially since families are now often deprived of the family support that they might otherwise have enjoyed with their new baby.

The network nevertheless notes a 30 per cent to 50 per cent decrease in the use of this service "because families find it anxiety-provoking to bring someone in, even if we respect the prescribed health measures," said Landry.

The pandemic also led to a major reorganization of the health network and the community network, when resources were reallocated to the fight against the coronavirus.

Some vulnerable women who would otherwise have been identified and referred to the appropriate resources are now falling through the cracks.

VIRTUAL ACTIVITIES

The novel coronavirus pandemic has meant many activities and resources that were previously offered in person are now offered virtually, and this often deprives workers of the human contact they need to reach out to mothers, said Boyer.

"For a mother who went to a talk in a family home, it is only after three or four meetings that a worker notices that this mother seems to have very great difficulties, she seems more isolated, she has less support from her family," said Boyer.

"Quietly the bond of trust sets in, and eventually she asks if she has thought of asking her CLSC if she would be eligible for Olo... In the current context, that cannot be done because the activities are virtual. As a speaker, you cannot invite her for a coffee after a Zoom."

Technology can also be problematic since not all vulnerable families have internet access at home.

Many rely instead on free Wi-Fi offered by establishments that are currently closed, which further intensifies their isolation.

"We have been wondering about access to technology for a low-income clientele for 10 years and more," said Boyer.

PRIDE AND MISTRUST

Some women who previously made a good living have been plunged into insecurity and vulnerability by the pandemic.

This is particularly the case for those who worked in sectors that have been hit hard by the health crisis, such as hotels, restaurants and tourism.

"In the current context, we have an even larger pool of women and deeper needs to serve," said Landry.

These women find themselves needing help from organizations they knew and appreciated, and may have even been able to support financially.

Self-esteem can then take a hit that will be hard to take.

Other women will have to overcome their mistrust if they still bear the consequences of the family experiences they had during their youth or if they had negative experiences with the health-care system, said Boyer.

PROTECTING THE BABY

Medical advances have increasingly shown that a mother's stress and anxiety can have long-term effects on her baby's health.

The Ice Storm Project - which has been monitoring babies born during the 1998 Quebec ice storm for 20 years - indicates that babies can be born prematurely or have a lower birth weight. The impacts would then be observable in children for several years.

"The context is not easy, the environment is hostile, (and) we have been exposed to this for months. There is wear and tear, it is normal, but because we want to shelter the baby from that, as a future parent you really gain by carefully getting out of your bubble," said Boyer. "There is a way to do it, there is a way to seek listening and kindness."

Doctors have often worried, since the start of the pandemic, that patients wait too long before going to the hospital for fear of COVID-19, but also not to monopolize resources that others may need.

When the patient finally decides to consult a doctor, it is often too late, or almost.

The same phenomenon is observed in certain vulnerable families, said Landry.

"Prospective parents don't have to judge if it's a basic need or if their need is greater than someone else's," she said. "Sometimes families say they won't use a service because they don't want to deprive another family that has more needs. We hear it regularly. These women all have different needs. They should not be embarrassed by the nature of the need."

-- this report by The Canadian Press was first published Jan. 23, 2021.