The COVID-19 pandemic disproportionately impacted the mental health of pregnant and postpartum women. Mexico experienced high infection and death rates, with social distancing measures exacerbating existing mental health challenges. Perinatal women, already navigating complex adaptations, faced increased stress and anxiety during this period. Studies showed significant increases in antenatal anxiety, antenatal depression, and postnatal depression symptoms globally. Fear of contagion, the future, and loss were major psychosocial stressors. Digital tools, including Facebook, emerged as crucial resources for mental health care during lockdowns. Facebook is a significant online communication medium; users frequently rely on social media for health information. Professionally mediated social media support groups can positively impact stress and anxiety levels. This study aimed to examine the role of a CFG in providing social support and information to Mexican perinatal women during the pandemic, addressing the limited research on this topic in Latin America. The qualitative approach allowed for in-depth analysis of women's experiences and responses to the support offered via the CFG.

The literature review highlights the significant mental health challenges faced by perinatal women during the COVID-19 pandemic, particularly in countries like Mexico with less effective pandemic responses. Studies revealed increased prevalence of anxiety and depression symptoms among this vulnerable group. Fear, uncertainty, and social isolation emerged as key stressors. Existing research emphasized the role of digital tools, including Facebook, in providing mental health support and information during this period. The review also indicated the potential of professionally mediated online support groups in reducing stress and anxiety for pregnant women, though the specific context of Latin American countries remained under-researched.

This qualitative study analyzed posts and comments from a closed Facebook group, "Pregnancy and the Postpartum Period during the COVID-19," created by a perinatal mental health research group. The group operated from May 2020 to October 2021, encompassing three waves of the pandemic in Mexico. The group's 1707 members ranged in age from 18 to 44, with a majority being Mexican, and followed guidelines for confidentiality and respectful communication. A clinical psychologist facilitated the group, offering resources and support. The study analyzed 2680 posts (2331 from participants and 349 from the facilitator) using thematic analysis. The pandemic period was divided into five three-month stages to allow comparison of experiences across different phases. The thematic analysis involved six steps: familiarization with the data, generating preliminary categories and codes, identifying themes within each stage, cross-checking for consensus, a second round of coding, and report drafting. The categories included COVID-19 infections, fear of infection, infection prevention practices, experiences with health services, vaccine-related concerns, non-COVID-19 health concerns, the impact of social isolation, potential mental health issues, and experiences related to work outside the home. Ethical considerations followed CIOMS guidelines, with data being publicly available and anonymized.

Participants frequently discussed contracting COVID-19 themselves or within their families. This led to intense fear and worry, particularly as pregnancies neared their due dates. Women took on significant responsibility for infection prevention measures, sometimes facing family conflict over their approach. Access to healthcare services was a major concern; women sought hospitals without COVID-19 patients and faced challenges with prenatal and postnatal care. Vaccine information was initially scarce, causing uncertainty and anxiety. Non-COVID-19 related health issues, such as infant vaccine shortages and maternal health complications, were also frequently discussed. Social isolation significantly impacted mental wellbeing, leading to feelings of loneliness and impacting the psychosocial development of infants. Although only four participants had formal mental health diagnoses, many expressed symptoms suggestive of depression or anxiety. Work outside the home created additional stress due to uncertain maternity leave policies and fear of infection. The group's facilitator provided consistent support and encouragement, emphasizing empathy and resource provision. Participants actively engaged with each other, offering support, sharing experiences, and providing practical advice. The group dynamic revealed a strong sense of community and mutual support among participants, with expressions of gratitude and feeling understood.

The study findings underscore the immense challenges faced by Mexican perinatal women during the COVID-19 pandemic. Experiences aligned with global trends of increased mental health distress among this population, with unique aspects related to Mexico's pandemic response and cultural context. The findings confirm that the fear of infection and social isolation significantly impacted mental wellbeing. The heavy burden of caregiving responsibilities and uncertainties regarding healthcare access and workplace policies exacerbated these effects. The study highlights the critical role of social support in mitigating these challenges. The closed Facebook group provided a valuable platform for women to share experiences, access information, and receive emotional support, demonstrating the potential of digital tools in addressing mental health gaps during crises. The women's reliance on their religious faith as a coping mechanism is consistent with Mexican cultural practices. The success of the CFG highlights the effectiveness of professionally moderated online support groups. The study's limitations include its self-selected sample, potentially not representing all perinatal women in Mexico.

This study demonstrates Facebook's effectiveness as a tool for providing social support and information to perinatal women during the COVID-19 pandemic. The findings highlight the significant mental health challenges faced by these women due to the pandemic and underscore the importance of social support in mitigating these challenges. The study's findings suggest the need for Mexican health institutions to incorporate digital tools in their mental health service delivery strategies. Future research should focus on developing tailored interventions to reach more disadvantaged women with limited access to technology and resources.

The study's limitations include the use of a self-selected sample, primarily comprising women with medium to low socioeconomic status and access to healthcare. This limits the generalizability of findings to other populations, particularly those with limited access to technology and resources. The study also does not capture the experiences of women who may have faced domestic violence or other relationship difficulties, issues commonly associated with pandemic stress.