Postpartum women’s psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis

Abstract

Background COVID-19 has placed additional stressors on mothers during an already vulnerable lifecourse transition. Initial social distancing restrictions (Timepoint 1; T1) and initial changes to those social distancing restrictions (Timepoint 2; T2) have disrupted postpartum access to practical and emotional support. This qualitative study explores the postpartum psychological experiences of UK women during different phases of the COVID-19 pandemic and associated ‘lockdowns’. Methods Semi-structured interviews were conducted with 12 women, approximately 30 days after initial social distancing guidelines were imposed in the UK (22 April 2020). A separate 12 women were interviewed approximately 30 days after the initial easing of social distancing restrictions (10 June 2020). Data were transcribed verbatim, uploaded into NVivo for management and analysis, which followed a recurrent cross-sectional approach to thematic analysis. Results Two main themes were identified for T1: ‘Motherhood is Much Like Lockdown’ and ‘A Self-Contained Family Unit’. Each main T1 theme contained two sub-themes. Two main themes were also identified for T2: ‘Incongruously Held Views of COVID-19’ and ‘Mothering Amidst the Pandemic’. Each main T2 theme contained three sub-themes. Comparisons between data gathered at each timepoint identified increased emotional distress over time. Current findings call for the improvement of postpartum care by improving accessibility to social support, and prioritising the re-opening of schools, and face-to-face healthcare appointments and visitation. Conclusion Social distancing restrictions associated with COVID-19 have had a cumulative, negative effect on postpartum mental health. Recommendations such as: Allowing mothers to ‘bubble’ with a primary support provider even at their healthcare appointments; allowing one support partner to attend all necessary healthcare appointments; and providing tailored informational resources, may help to support postpartum emotional wellbeing during this, and similar health crises in the future.

Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic

“…Analyses relating to maternity care reconfiguration, extended the idea of the pandemic causing isolation and loneliness with fragmented care and faraway families. As in other research about maternity care during the pandemic [ 5 , 6 ], women frequently reported the detrimental effects of increased virtual care and decreased face-to-face care. These changes were often discussed in interviews as leading women to feel alone during their pregnancy, especially when they found out their baby had died, whilst their partners had been confined to the carpark.…”

“…Restrictions on movement were double-edged for many; lockdowns providing the conditions and excuse to grieve privately, but also restricted family gatherings and access to usual support networks. These restrictions were similarly felt by many parents receiving maternity care, both globally [ 31 , 32 ] and also in the UK [ 5 , 6 ]. Similarities can also be drawn with other work in the study of bereavement, where the pandemic has redrawn social geographies and grounded people in their homes [ 33 ].…”

“…Parents also reported seeking support in new, virtual, ways (such as on-line counselling or support networks) which occasionally felt ineffective, especially when access to usual support networks and loved ones was not available. This often rendered bereavement care impersonal, which is again reminiscent of women’s entire journeys through pregnancy and childbirth from what we know from other research conducted during the pandemic [ 5 , 6 , 31 , 32 ].…”

“…For perinatal women, COVID-19 has caused “unprecedented challenges that can significantly impact on women’s mental health” ([ 2 ]; p.310). Given the negative impact of both pregnancy loss and perinatal death [ 3 , 4 ], and the pandemic on maternity care provision [ 5 , 6 ], investigation of how bereaved parents have experienced reconfigured services is crucial to future learning, providing important insights for service provision.…”

“…In the UK, these changes have been consistently monitored [ 23 ] and guidance as well as service provision has been frequently adapted in an attempt to augment care [ 5 , 21 – 23 ]. For perinatal women receiving maternity care, we have already seen reports of devalued care [ 5 ], poor psycho-social outcomes [ 6 , 24 ], and worrying projections suggesting rates of stillbirth are expected to double globally [ 25 ].…”