How to defeat Covid-19 with mental resilience and healthy bodies.

“New brain-building grant paid by Government to women during pregnancy from the 6th month. Children’s physical and mental health improves five-fold; savings are made in prison and hospital costs; Covid-19 is defeated by resilient generation”. Could this ever come true?

Mental resilience and healthy bodies are the result of a good start in life, when a baby is loved and talked to and respected. The website of Unicef says Early Moments Matter. The first 1,000 days can shape a child’s future. We have one chance to get it right.

The foetal brain can be sensitive to maternal stress (or alcohol) all through pregnancy. For the first 20 weeks, the brain cells or neurones are migrating to their final position. But in the second and third trimester, neurones are starting to make links and synapses with each other and form pathways. The last few months of a baby’s time in the womb are the critical ones concerning the number of connections which form between the neurones in the brain. Our genes control the chemicals which encourage the direction and growth of the neurones to make connections, or synapses, with other parts of the brain. Successful connections are strengthened, and unsuccessful connections lead to the neurones dying away (so-called neurone pruning).

Prenatal stress only increases the risk of future neurodevelopmental problems for the child; most children are not affected. There can be environmental effects from the mother all through pregnancy, but what effects these are, differ at different stages. For example, in the first trimester, very severe stress increases the risk of schizophrenia in the child. There can be effects on both boys and girls, but these tend to be different. Alcohol, drugs or stress-induced cortisol are very likely to damage some of the normal formations of the neurone connections. In the later months of pregnancy, the result can be an increase in the risk of future behavioural problems – such as ADHD – and emotional and cognitive problems, as well as physical health effects. Sensitive early mothering can reverse the effects to some extent, but if the babies’ environment doesn’t change for the good, this is going to be more challenging.

In New Zealand, the Dunedin research project, following 940 children through to age 38, (Caspi et. al., 2016) found that a single factor, poor brain health at age 3, was an early statistically significant predictor for high cost economic burdens on the state (such as packs of cigarettes smoked x years smoked; excess kg of weight over obese weight; numbers of prescriptions collected over 38 years; numbers of stays/nights in hospital; convictions for crime etc). They showed that 20% of the population is responsible for a disproportionally large burden of eight social and healthcare costs. Children who scored poorly in early life stress (having four or more risk factors) had a high correlation with the 22% of the cohort who contributed to three or more high cost groups of economic burden on the state. Their list of risk factors included physical and sexual abuse, as well as two or more changes of a child’s primary care-giver, and maternal rejection at age 3.

Since synapses form in the baby’s brain as early as in the last 2 to 3 months of pregnancy, poor brain health at age 3 will include any damage occurring before birth as well as the risk factors studied here in the first few years of life. The devastating effects of Foetal Alcohol Syndrome are widely known. Not so well known is the effect of strong drugs given as medication, even if it can’t be avoided (e.g. to reduce severe pain), or unanticipated stress on the mother. For a mother expecting her first child, stressful relationships at work, and making preparations at work to take Maternity leave, can make life very stressful. Other situations causing high levels of stress which might happen at this time include moving home, family bereavement or even marital disharmony and break-up. Anxiety and pre-natal depression is present in about 14% of expectant mothers (Glover, V., 2015).

When stress causes changes in our brain’s chemicals, the laying down of the connections or synapses in the baby will be affected. When parents are loving, talk to their bump, and take steps to prepare for the arrival with excitement, their oxytocin is helping their baby’s brain to grow. Some women enjoy their work, do not find it too stressful and would like to continue work through pregnancy. Others find it a strain, especially if they do not feel in control, and they should be given the option of earlier maternity leave. But there is not yet much evidence from research about the effects of the mother working in pregnancy on the child.

Let us think about a hypothetical situation when, in the future, it becomes the norm (by choice rather than mandatory) for our Mothers-to-be to reduce their full-time hours to around 20 hours per week at 6 months pregnant.

I am suggesting that the mothers’ gradual slowing down at work, through a drop in hours, is recompensed by the Government as a “brain-building grant”, in addition to the standard Maternity Pay we have now. The employer would employ the replacement maternity-cover employee to overlap and begin at the time of the start of the brain-building grant. In several European countries it is mandatory to take 8 weeks off before the expected birth date (European Parliament). In contrast, in the UK, a mother can take up to 11 weeks, but it is non-mandatory. A flat-rate or blanket grant for all mothers to reduce their work hours more than 4 weeks before the birth could be based on 40% of the average UK male wage in 2020 (2 months = £2,000). It should be the same for all infants, and not dependent on their mother’s salary.

Mothers would have time to meet up with other mothers-to-be and mothers-of-babies to make friends in their area. Their workplace would have time to find employees to learn the role and cover for the mother on Maternity Leave. The expectant mother would have time to bond with her unborn, to sing, laugh and love, to think about the couple’s future life bringing up their family, and to form networks within her community or “village”. All this will help to build her baby’s brain, and also build her baby’s physical and mental health for the future (and even withstand our current threat, Covid-19). It will also be good for the mother’s own mental health, by giving her time to adjust to her new role. The expenditure on brain- building grants will be more than paid back in the future, by improving the health of the nation, reducing heart disease and diabetes and improving the outcomes for children.

We need to petition our Government to kick off with a baby-brain grant, and follow it up with more universally available post-natal support from Children’s Centres and Health Visitors, a joined-up approach of all services concerned with families, including reducing taxation on single-income families with young children and financial support for all during pregnancy and the first 3 years.

Vivette Glover, Professor of Perinatal Psychobiology at Imperial College London, advises that we need improved screening of pregnant mothers by health professionals to detect maternal anxiety and depression, help with couple relationships, social and community support, and access to affordable and family friendly housing.

It is essential that our teenagers and young adults, who are our future parents, are taught that when a community gives mothers the best support, we give babies the best start. By changing the behaviour of the next generation of parents, we will be investing in the physical and mental health and wellbeing of future generations, and we will be able to reduce the economic burden on the state.