Targeted services are recommended to pregnant women/parents in vulnerable positions to support their well-being and improve health outcomes; however, being offered extra services is associated with feelings of fear and anxiety. Adopting an ethnographic approach, we explore what parents fear, how and why they experience fear, and how this shapes their childbearing experience and engagement with Danish maternity care services. We made field observations and conducted interviews with 39 parents in vulnerable positions, who shared multiple, ambiguous, and interrelated fears. Four main themes were constructed: fear of going back to a dark place, of having a negative impact on the baby, of being labeled, and of the consequences of service engagement and being open. We conclude that what parents fear, the intensity of these fears, and what potentially triggers it are contingent on their life story, their care pathways, and the maternity care system.

Background Pregnant women and partners with psychological and/or social challenges are exposed to adverse health outcomes. It is therefore recommended that they receive targeted maternity care services. The relationship between parents and professionals is key to help parents engage with services and experience them as supportive. However, more knowledge is needed on parents’ care experiences during encounters with professionals to further understand when and how these are experienced as supportive. Objectives This study aimed at identifying the key elements of supportive care practices by exploring how parents in vulnerable positions experience their relationship and encounters with the professionals involved in their pregnancy and postnatal care. Design Ethnographic fieldwork was conducted in a Danish municipality, including 50 semi‐structured interviews with parents and 51 field visits during parent‐professional encounters, including informal interviews and participant observation. Using a purposive recruitment strategy, 26 women and 13 men were recruited, who varied in age, socioeconomic background and vulnerability factors. COREQ reporting guidelines were used. Results The analysis identified five themes: (a) Having a voice: Feeling listened to, (b) Being met with empathy: Feeling understood, (c) Worthy of attention: Feeling taken seriously, (d) On equal terms: Feeling like a normal family and (e) Moving in the right direction: Feeling reassured. Conclusion Positive care experiences facilitate engagement with services and professionals as this contribute to parents feeling included, respected and safe. Conversely, negative care experiences leave parents feeling excluded, judged and anxious, potentially reinforcing and adding to existing feelings of anxiety and stigma. This requires that professionals have good communication skills and are able to approach parents in an open and non‐judgmental way. Relevance to clinical practice Understanding the significance of supportive care practices is paramount for health visitors, midwives and other professionals involved in providing for parents in vulnerable positions during pregnancy and the postnatal period.

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Meeting the need of the familyAn ethnographic study on the care experiences of parents in vulnerable positions during pregnancy and the postnatal period

Background Mental illness can have negative impact on pregnant women, their infants and their families, including adverse birth outcomes, as well as place children at risk of developing mental illness later in life. It is recommended to offer additional support in the ante - and postnatal period, but to be able to offer appropriate, timely and effective care, more knowledge is needed on women's own experiences. The aim of this paper is to explore women's experiences with mental illness in the context of pregnancy and early motherhood, and how they experience and engage with supportive services. Methods This paper presents selected findings from an ethnographic field study carried out in a Danish municipality. The findings are based on data from 22 women, who were recruited when they were pregnant or had a newborn baby. The women were currently facing or had previously suffered from one or multiple mental health conditions. Results Analysis found that women with current or prior mental illness experienced a high level of fear, worries and uncertainty during pregnancy and early motherhood, which shaped how they engaged with supportive maternity services. Some were deeply worried about their mental health and reached out for support to cope with this. Concerns about being a bad mother and about the potential influence of their mental illness on their infants were common. Furthermore, some women were scared of being judged as unfit mothers and losing custody of their children. Many experienced stigma surrounding mental illness, making some more hesitant about reaching out for support. Conclusions By providing new insight into women's own perspectives, this study contributes with in-depth knowledge on women's experiences with mental illness during pregnancy and early motherhood, and illustrates how engaging with supportive services may be an ambivalent experience.