Mothers' Experiences of the First Postpartum Year after Giving Birth at the Start of the COVID-19 Pandemic: Enduring Impacts and Maternal Meaning-Making

Background: The first postpartum year is a time of vulnerability and opportunity as mothers get to know their baby, develop an identity as a parent to this baby, care for and bond with the baby while navigating changes in relationships, roles, and routines. The onset of the COVID-19 pandemic had a profound effect on communities nation- and worldwide, increasing stresses and reducing support available to new mothers, their infants, and families. This study sought to understand the experiences of new mothers across the first postpartum year after giving birth in the U.S. at the start of the COVID-19 pandemic. While prior research has established declines in parent wellbeing during the pandemic, this study explored mothers’ retrospective meaning-making and perceptions of enduring impacts of welcoming a baby at a time when uncertainty permeated every aspect of life.

Methods: We conducted semi-structured interviews with 34 mothers who gave birth in the month that the World Health Organization declared COVID-19 a global pandemic (March 2020). Participants were recruited through online mothers’ groups. They came from 20 states representing every region of the United States. They ranged in age from 26 to 40 years old (mean age 33.7), and the majority identified their race and ethnicity as non-Hispanic white and reported annual household income greater than $75,000. All participants were partnered and most (67.7%) were first-time mothers. Interviews addressed experiences of giving birth near the start of the pandemic, the “fourth trimester,” and across the first postpartum year as the pandemic continued. Participants were asked to both relate their experiences and reflect on them, with an emphasis on considering how COVID-19 shaped and continues to influence their well-being and experiences as a parent. Using an iterative, inductive process, we conducted thematic analysis of the data. Transcripts were independently coded by two members of the research team, with disagreements resolved through discussion.

Results: Five core themes were identified: (1) difficulty disentangling the experience of becoming a parent from the experience of a world changed by the pandemic; (2) immediate and enduring consequences of limited access to social support and professional care; (3) complexity of developing a new identity (as a mother) during a time of isolation; (4) pandemic-incurred blurring of boundaries, such as returning to work after maternity leave when work had become remote; and (5) ongoing salience of the pandemic, including continuing grief and need to process losses.

Conclusions and Implications: For mothers who gave birth in March 2020, childbirth, recovery, and the first postpartum year were substantially impacted by the pandemic. This study adds to understanding of mothers’ experiences and the meaning of those experiences for mothers and their families, demonstrating a continuing need for support for those who feel lingering effects of magnified isolation incurred by experiencing the postpartum period amid a global pandemic. Social work research and practice should attend to the need for consistent support for new parents, infants and young children throughout the sensitive early months and years, even and especially during times of heightened stress and uncertainty.