Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 1, 2020
Date Accepted: Aug 17, 2020
Date Submitted to PubMed: Aug 28, 2020
Perinatal distress during COVID-19: a thematic analysis of an online parenting forum.
ABSTRACT
Background:
The novel coronavirus 2019 (COVID-19) global pandemic has impacted the whole of society, requiring rapid implementation of individual, population and system level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing and postpartum) have unique and timely needs for directives on health, safety and risk aversion during periods of isolation and physical distancing for themselves, their child or children and other family members. In addition, they are a vulnerable group, at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high risk external environment.
Objective:
Examination of the public discourse of a perinatal cohort to understand unmet health information and support needs and impacts on mothering identity and social dynamics, in the context of COVID-19.
Methods:
A leading Australian online support forum for women pre- through to post-birth was used to interrogate all posts related to COVID-19 from Jan 27 to May 12 2020 inclusive. Key search terms included: ‘COVID’, ‘corona’ and ‘pandemic’. A three-phase analysis was conducted including: thematic analysis, sentiment analysis and word frequency calculations.
Results:
The search yielded 960 posts, of which 831 were included in our analysis. Qualitative thematic analysis demonstrated reasonable understanding, interpretation and application of relevant restrictions in place, with five emerging themes identified. These were: 1) heightened distress related to a high-risk external environment; 2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; 3) altered family and support relationships; 4) guilt tampered happiness; and, 5) family future postponed. Sentiment analysis revealed content was predominantly negative (very negative: 537 and moderately negative: 443 compared to very positive: 236 and moderately positive: 340). Negative words were frequently used with associated derivates including ‘worried’ (19.9%); ‘risk’ (17.2%); ‘anxiety’ (11.8%); ‘concerns’ (8.8%) and ‘stress’ (8.3%).
Conclusions:
Women in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.
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