Background: The 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: The aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the 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 postbirth was used to interrogate all posts related to COVID-19 from January 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. The 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 that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including “worried” (n=165, 19.9%), “risk” (n=143, 17.2%), “anxiety” (n=98, 11.8%), “concerns” (n=74, 8.8%), and “stress” (n=69, 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 the 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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中文翻译：

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COVID-19期间的围产期困扰：在线育儿论坛的主题分析。

背景：COVID-19全球大流行已经影响到整个社会，需要迅速实施个人，人群和系统级的公共卫生应对措施，以控制和减少感染的传播。围产期（怀孕，分娩和产后）的妇女在其自身，子女或其他家庭成员的孤立和身体疏远期间，对健康，安全和规避风险的指示具有独特及时的需求。此外，他们是一个弱势群体，心理困扰的风险增加，在社会支持被剥夺和高风险的外部环境中，这种情况可能会加剧。目的：这项研究的目的是检查围产期队列的公众话语，以了解未满足的健康信息和支持需求，以及在COVID-19的背景下对母亲身份和社会动力的影响。方法：利用澳大利亚领先的产前妇女在线支持论坛来审讯2020年1月27日至5月12日（含）的所有与COVID-19相关的帖子。关键搜索词包括“ COVID”，“电晕”和“大流行”。进行了三个阶段的分析，包括主题分析，情感分析和词频计算。结果：搜索产生960篇文章，其中831篇被纳入我们的分析。定性的主题分析显示出对相关限制的合理理解，解释和应用，确定了五个新兴主题。这些是（1）与高风险外部环境有关的困扰加剧；（2）由于缺乏社会和家庭支持以及束缚仪式而感到绝望和悲痛；（3）改变家庭和抚养关系；（4）内的幸福；（5）家庭未来推迟。情绪分析显示，该含量主要为阴性（非常阴性：n = 537，中等阴性：n = 443，相比之下，非常阳性：n = 236和中等阳性：n = 340）。831个帖子中经常使用否定词，并带有相关的衍生词，包括“担心”（n = 165，19.9％），“风险”（n = 143，17.2％），“焦虑”（n = 98，11.8％），“关注”（n = 74，8.8％）和“压力”（n = 69，8.3％）。结论：围产期妇女受到当前大流行的独特影响。有关COVID-19安全行为的一般信息不符合该队列的特殊需求。在这个脆弱的高风险人群中，缺乏细致及时的信息可能会加剧心理和社会心理困扰的风险。州和联邦公共卫生部门需要提供集中的信息库，这些信息应有针对性，一致，可访问，及时且令人放心。应该考虑使用补偿性的社会和情感支持，并使用替代措施来减轻该人群中精神健康疾病的风险。

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