Impact of Facebook on Social Support and Emotional Wellbeing in Perinatal Women during Three Waves of the COVID-19 Pandemic in Mexico: A Descriptive Qualitative Study

The study addresses how the COVID-19 pandemic, which led to widespread disruptions and heightened mental health risks, uniquely impacted pregnant and postpartum women in Mexico. Perinatal periods already entail complex emotional and adaptive demands that can trigger anxiety and depressive symptoms. During the pandemic, fears regarding infection, uncertainty, changes in health care delivery, and social isolation heightened these risks. With in-person services constrained, digital tools became vital for information and support. The primary aim was to examine the role of a closed Facebook group (CFG) in providing social support and information to Mexican perinatal women during the pandemic. A secondary aim was to explore their experiences, concerns, and emotional wellbeing across different phases of the pandemic. The study is important for informing how social media can be leveraged to mitigate stress and prevent progression to clinical mental health disorders during crises, particularly in contexts where traditional services are disrupted.

Prior work documents significant increases in anxiety, depression, and stress among perinatal women during COVID-19, with fear of contagion, uncertainty about the future, and disruption of care as salient stressors. Digital platforms, especially social media like Facebook, were widely used to obtain real-time information, peer support, and reassurance. Professionally moderated groups can enhance trust, reduce misinformation, and directly impact stress and anxiety. Online communities for specific mental health conditions provide opportunities for shared experiences and peer support. Evidence from multiple countries indicates that perinatal women faced intensified worries about infection, prenatal and delivery care changes, vaccine decision-making, and social isolation; Latin American populations, including Mexico, reported high levels of worry. The Mexican context additionally involved limited testing, high infection and mortality rates, service disruptions, and pre-existing gaps in perinatal mental health care, underscoring the potential role of social media as an accessible support tool.

Design: Descriptive qualitative study using thematic analysis of posts and comments from a closed Facebook group (CFG) titled “Pregnancy and the Postpartum Period during the COVID-19.” The CFG was created two months after Mexico’s March 2020 lockdown by a perinatal mental health research team to provide information and emotional support to pregnant and postpartum women during the pandemic. Context and Participants: The CFG operated on Facebook (accessed 10 December 2022). Entry required self-identifying as perinatal, agreement to maintain confidentiality, preserve a nonjudgmental safe space, and refrain from referrals/advertising. A clinical psychologist facilitated, commenting several times daily and sharing hotlines for psychological support. No personal data questionnaires were collected. Sample: During the study period, 1707 women joined (ages 18–44). Based on open profile statistics: 57% Mexican, 34% from Latin America, 9% other countries. The self-selected sample likely reflected women with medium to medium-low socioeconomic status with internet access and social health security (some private care access). Data Collection: All posts (n=2680; 349 from facilitators, 2331 from participants) from 2 May 2020 to 31 October 2021 were retrieved, pasted into a Word document, and analyzed. Pandemic Stages: Data were segmented into five stages for comparison: (1) Lockdown (2 May–31 Jul 2020); (2) Reopening (2 Aug–1 Nov 2020); (3) Second wave (2 Nov 2020–8 Feb 2021); (4) Vaccine available to vulnerable groups (9 Feb–7 May 2021); (5) Vaccination of pregnant women and third wave (8 May–31 Oct 2021). Analysis: A six-step thematic analysis was conducted: (1) familiarization (all authors read the corpus); (2) preliminary categories and codes; (3) theme search within each stage; (4) cross-checking among three authors to consensus; (5) second round reading and refinement of categories/definitions; (6) report drafting with all authors contributing. Repeated cross-checking ensured reliability. Predefined categories: (1) COVID-19 infections in participants/families; (2) fear of infection; (3) infection prevention; (4) health services; (5) COVID-19 vaccines; (6) non-COVID-related health concerns; (7) effects of social isolation; (8) probable mental health cases; (9) work outside the home. Ethics: Per CIOMS guidelines, the study qualified for exemption from ethics review: minimal risk, public/decoded data, identities protected. A public announcement of research intent was made; posts were analyzed without interpreting personal data and remained publicly available.

- Participation and data: 2680 posts analyzed (349 facilitator; 2331 participants) from 1707 members between 2 May 2020 and 31 October 2021. Members’ locations: 57% Mexico, 34% Latin America, 9% other. - Thematic categories (nine): (1) COVID-19 infections among women, babies, and family members; anxiety heightened around infection near delivery and implications for fetus and breastfeeding. (2) Intense, constant fear and worry about infection, especially close to due dates and upon returning to work; uncertainty about the future. (3) Prevention: Women took primary responsibility for strict measures (isolation, disinfection, masks), sometimes causing family tensions; skipped medical appointments to avoid exposure; cared for infected relatives, increasing personal risk. (4) Health services: Disrupted prenatal/postnatal care, hospital reassignments, preference for non-COVID facilities (often private), differences in delivery protocols (PPE, limited/no visitors), immediate neonatal discharge when mothers were COVID-positive. (5) Vaccines: Progressive concern and discussion as vaccine availability evolved; early contradictory guidance from providers; decisions left to mothers; later vaccination of pregnant women raised questions about vaccine type and side effects during pregnancy/lactation. (6) Non-COVID health issues: Shortages of infant vaccines; high-risk pregnancies; fetal/neonatal complications; challenges with breastfeeding in crowded settings. (7) Social isolation effects: Emotional strain, inability to prepare for baby, missing physical contact with loved ones, reduced household support postpartum, concern about infants’ social development; family tensions over restricting visits. (8) Probable/diagnosed mental health cases: Four diagnosed (borderline personality disorder; prenatal depression; postpartum depression; bipolar disorder) and two probable clinical cases; grief after fetal loss; group provided supportive responses and referrals to professional care. (9) Work outside the home: Anxiety over returning to in-person work, possible infection and transmission to baby; unclear policies for maternity leave and vulnerable status; employer variability in remote work allowances; family criticism for working; fear persisted even post-vaccination. - Group dynamics: Facilitator modeled empathy, shared coping strategies (breathing, mindfulness, journaling, maintaining connections), and ensured adherence to respectful guidelines. Over time, participants increasingly led interactions, offering mutual encouragement, practical advice (e.g., not self-medicating, consulting doctors), vaccine experiences, and strong emotional support often rooted in religious faith. The group environment was described as warm and reassuring, reducing feelings of isolation and enhancing perceived support. - Coping: Religious faith emerged as a primary coping mechanism alongside peer support, positive reframing, and practical self-care. - Overall: The CFG functioned as an efficient, responsive, and low-cost support and information platform during a period of constrained services and heightened stress, aligning with broader evidence on social media’s role in health support.

The findings directly address the study aims by showing that a professionally facilitated Facebook group provided timely social support and information to perinatal women during a period of considerable uncertainty and service disruption. Women experienced heightened fear and stress due to infection risk, altered perinatal care, vaccine uncertainty, social isolation, and increased domestic and caregiving burdens, often compounded by employment demands and unclear leave policies. These burdens underscore widened gender inequities and the cultural expectation to prioritize others’ needs, which affected emotional wellbeing. The CFG offered an accessible channel for immediate, empathetic, and context-relevant support, complementing insufficient hotlines and disrupted in-person services. The trust fostered by facilitation and peer sharing helped validate experiences, reduce isolation, and provide practical guidance, potentially mitigating progression to clinical disorders in some cases. The prominence of religious faith as coping highlights cultural dimensions important for tailoring support. These results reinforce international literature indicating that digital platforms can effectively deliver psychosocial support during public health crises, particularly where traditional services are constrained. They suggest that integrating moderated social media support within perinatal services could enhance reach, reduce distress, and help bridge care gaps.

Facebook, via a closed and professionally facilitated group, was an efficient, low-resource mechanism to deliver social support and information to pregnant and postpartum women in Mexico during COVID-19. Participants reported feeling accompanied, reassured, and better informed, reflecting the platform’s capacity to reduce isolation and address urgent concerns amid rapidly changing circumstances. The study also documents the spectrum of stressors faced by perinatal women—fear of infection, service disruptions, vaccine uncertainty, social isolation, and work-related pressures—and highlights religious faith and peer support as salient coping strategies. Strengths include real-time, participant-driven accounts that reduce recall bias and illustrate the feasibility of social media to address perinatal mental health care gaps. This appears to be the first published study using Facebook in Mexico for this population and purpose. Future directions include institutional integration of moderated social media supports into perinatal care pathways, development of clear guidelines and information dissemination (e.g., vaccination during pregnancy/lactation), and targeted strategies to reach more vulnerable women with limited digital access.

Findings derive from a self-selected sample likely comprising women of medium to medium-low socioeconomic status with internet access and some health coverage; results may not generalize to more disadvantaged women with limited connectivity, fewer health resources, and greater vulnerability. The sample characteristics may also explain the absence of reported domestic violence or partner difficulties, which were otherwise prevalent during the pandemic. Reliance on publicly available Facebook data limits depth of individual sociodemographic information.