The Professional Counselor | Volume 14, Issue 3 256 Postpartum Social and Emotional Experiences Social support or the absence of social support can be connected to maternal rates of depression, anxiety, self-harming behaviors, and general maladjustment (Bedaso et al., 2021; Milgrom et al., 2019). Enlander and colleagues (2022) qualitatively explored relevant themes regarding mothers’ perceptions of support as they related to perinatal distress and recovery. They found that mothers communicated themes of limited practical and emotional support, vulnerability to long-term relational or familial norms, and the relevance of sociocultural norms related to subjective feelings of perinatal distress. In addition, they found that having supportive and understanding relationships with friends and family can help protect against feelings of postpartum distress. On the other hand, a lack of such supportive relationships can reinforce unhelpful social norms related to motherhood and mental health (Enlander et al., 2022). These norms include both high expectations of new mothers and mental health stigma. Furthermore, the cumulative benefit of large support systems throughout the perinatal period can be beneficial in promoting psychological wellness (Vaezi et al., 2019). Like the quantity of maternal social relationships, the quality of relational support is also an influential characteristic in new mothers’ social and emotional experiences. The quality of social relationships or support, including romantic and familial, can significantly minimize the maternal risk of postpartum psychosocial distress (Smorti et al., 2019). For example, the influence of new mothers having contact with other new mothers has been identified as beneficial social support in early postpartum recovery, as it promotes confidence and connection through shared history (Darvill et al., 2010; Enlander et al., 2022). Acknowledging the skills and abilities of mothers, as well as forming reliable and unconditional relationships where support is provided consistently, can not only serve as protective measures against postpartum depression, anxiety, and stress (Milgrom et al., 2019), but can also promote positive postpartum recovery (Zamani et al., 2019). Given that social support has been found to be associated with a decreased probability of a mother developing postpartum depression (Cho et al., 2022), it can be inferred that public health guidance such as social distancing measures, neonatal visitation limitations, and reduced interpersonal contact with hospital staff during COVID-19 have had an impact on the maternal social and emotional experiences that can contribute to maternal psychosocial well-being or distress. For example, Ford and Ayers (2009) found that the support provided by hospital staff during childbirth had a more significant impact on mothers’ emotional responses to childbirth than perinatal and postpartum stressors. Rural Postpartum Social and Emotional Experiences Mothers who reside in rural localities have unique challenges compared to their urban and suburban counterparts. Due to the scarcity of health care providers and infrastructure in rural communities, significant differences in access to critical care obstetrics in rural and frontier areas of the United States exist (Kozhimannil et al., 2016, 2019; Kroelinger et al., 2021). Mothers in these areas often cope with challenges such as poverty, transportation barriers, and long distances to health care facilities, sometimes beyond a 50-mile radius. Hung and colleagues (2017) found that 45% of rural counties had no hospitals with obstetric services, with 9% experiencing a loss of in-county obstetric services. Rural counties that did not have hospital obstetric services tended to be smaller in geographical area; more significant gaps in service increased with the removal of hospital-based obstetric care. This evidence points to an overall decline in critical infrastructure related to childbirth and postpartum care in rural communities.
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