Table 4 Themes and subthemes describing salient sources of maternal perinatal distress reported during the COVID-19 pandemic

42 (69)

43 (91)

42 (160)

Concerns for the family’s health and safety during the pandemic

I frequently worry about either my baby catching covid and being ill or myself catching it and dying. The thought of leaving her to grow up without a mother stops me sleeping. (P41)

16 (26)

17 (36)

16 (62)

Fear for the infant’s health, safety, and wellbeing

The fear of SIDS still scares me even 10 months down the line and despite knowing I have done everything to prevent it. I overthink what might happen and why and check on the baby regularly to ease my worry. This can include images of him being dead. (P18)

1 (1)

19 (41)

11 (42)

Obstetric complications

Following a really painful egg retrieval as part of IVF- can’t get over it or let it go even though it was successful as it should not have been painful. (…) I am now frightened about birth where I was unconcerned/no more concerned than anyone else. I often cannot sleep reliving this experience and fear this may happen after birth and I will end up with postnatal depression or that something will go wrong in the pregnancy as it did in the egg retrieval. (A206)

10 (17)

4 (8)

7 (25)

Fears for the pregnancy and birth

I’ve been significantly on edge all day, panicking and on the edge of tears because I am worried about the baby’s movements. I’ve been using an app to track them that’s got 200 individual movements registered on it for today alone but when she’s not moving I’m worried and when she’s moving I’m worried it’s not strong enough. It’s really hard to control the anxiety about her (A202)

13 (21)

< 1 (1)

6 (22)

The unknown long-term implications of social isolation during the pandemic

Even though my child is only a year old all the recent changes due to the pandemic have made me worry that she is perhaps not getting enough socialization and that that could impact him further down the line. (P32)

2 (4)

2 (5)

2 (9)

38 (62)

31 (66)

34 (128)

Isolation and a lack of social support

When baby is crying for long periods of time (teething or over tired) I … desperately need some outside support from family. I often get myself very worked up that my family are missing out on my son’s life (P163)

13 (21)

18 (38)

16 (59)

Unsupportive relationships

Partner disrupted baby’s daytime routine at the weekend. Naps were then out of sync and he slept poorly that night meaning I was up several times as partner doesn’t help overnight. Felt frustrated that partner tries to undo all the hard work I put in and doesn’t recognise how disruptive it is. We landed up in a row and it dragged up old negative feelings about old problems with our relationship. (P162)

10 (17)

11 (23)

11 (40)

Restrictions in perinatal care

At the first scan for our pregnancy, my husband was not allowed to even come in the hospital. Whilst I completely understood the rules, I am very anxious and nervous in hospitals at the best of times and would have loved his support. I was also incredibly sad that he missed such an important moment and couldn’t be there. I found being at the hospital daunting and because it was all unknown, I was very anxious and upset. (A17)

15 (24)

2 (5)

8 (29)

13 (22)

35 (74)

25 (96)

Infant crying and sleep deprivation

The baby was crying and I couldn’t calm her, normally I’m hands on with calming her down but this 1 time I couldn’t and kept thinking something was wrong (P51)

0

16 (34)

9 (34)

Difficulty achieving personal mothering expectations

Too many tasks/chores to do, whilst looking after baby and get upset at not keeping on top of things, plus constant stressing that I’m not doing enough with my baby. (P168)

7 (12)

10 (21)

9 (33)

Competing demands on time

Felt really overwhelmed trying to home school my reception aged son and look after my premature newborn baby (P83)

6 (10)

9 (19)

8 (29)

14 (23)

7 (16)

10 (39)

Loss of normality

When I found out I was pregnant (even though it was planned) we had been trying for a long time. It seemed like the worst time for it to happen with Covid-19 and the restrictions on daily life. (A145)

4 (7)

5 (11)

5 (18)

Feeling trapped

I then couldn’t stop crying and was so frustrated because we couldn’t go anywhere or do anything. (P219)

2 (4)

3 (6)

3 (10)

Lack of autonomy

A couple of weeks into lockdown I had a meltdown and burst into tears. I just felt overwhelmed with all the sudden change, mixed with pregnancy hormones, and the loss of control over my situation. (A127)

5 (8)

< 1 (1)

2 (9)

Unmet mothering tasks

When we went into lockdown for COVID-19 I felt a sense of loss and grief for all the things I was no longer able to do with my baby, going to get him weighed, taking him swimming etc. (P107)

1 (2)

1 (2)

1 (4)

12 (19)

4 (8)

7 (27)

Work stress

I’m currently off work due to stress causing depression and anxiety. Everyday life is easier to cope with, but anything involving contact with work makes me extremely anxious. I took ages to fill in some ACAS paperwork about maternity leave and sent it to my line manager. And then I didn’t check my email for a week (because I find it too stressful to do so). When I did I had two replies. One giving me links to my employer’s forms and procedures and another asking if she can pass my personal email address on to one of the HR managers who needs to speak to me. I really couldn’t cope with all the admin (they know what leave I want to take and when from what I sent them) nor can I face a discussion of anything with HR. (A128)

9 (14)

4 (8)

6 (22)

Financial worries

Household item broke. Got very upset trying to fix it. Started to worry that husband being furloughed and not being able to afford new one I would have to return to work early from my maternity leave. (P142)

3 (5)

0

1 (5)