Expectancy violations and boundary management when giving birth during a pandemic: implications for supporting women

ABSTRACTBackground Few life events are as profound as the birth of a child. Yet for those who gave birth during the COVID-19 pandemic, the birth experience and the care of their newborn child were altered in significant ways.Method In this study, we examined the stories of women who gave birth during the COVID-19 pandemic using expectations violations theory and communication privacy management theory.Results Based on focus group interviews with 65 women from 19 states across the U.S., we found that policies imposed by institutions and visitation rules negotiated by women were prominent in women’s birth stories. Policies that affect territorial access to mothers and babies shaped communication to manage health and safety, resulted in intense emotional responses, and affected relationships with women’s partners and families.Conclusions Our findings offer practical implications for both health care systems and health care providers. Systems must communicate proactively to offer compassionate patient care, and physicians should offer guidance to help new parents manage visitors.KEYWORDS: PregnancychildbirthCOVID-19institutional policies Disclosure statementNo potential conflict of interest was reported by the author(s).FundingThis project was supported by a COVID-19 Rapid Response Grant from the Office of the Vice Chancellor for Research at IUPUI.AcknowledgementsAll authors are responsible for the concept for this manuscript and took part in data collection and data analysis. JB drafted the initial manuscript and MB contributed substantially to manuscript structure and revisions. JB and MB developed the proposal for this project and obtained funding.Data availability statementNot applicable.Additional informationNotes on contributorsJennifer J. ButeJennifer J. Bute, Ph.D., is a professor in the Department of Communication Studies at IUPUI. She studies everyday talk about health, with a focus on communication about reproductive health.Maria BrannMaria Brann, Ph.D., M.P.H., is a professor in the Department of Communication Studies at IUPUI. Her translational research focuses on the communication surrounding women’s reproductive health.Susanna Foxworthy ScottSusanna Foxworthy Scott, Ph.D., is an assistant professor of health sciences at Butler University. Her research focuses on how we can improve reproductive health through health communication.Nicole L. JohnsonNicole L. Johnson, Ph.D., is a qualitative researcher at the Center for Access & Delivery Research and Evaluation at Iowa City Veterans Affairs Health Care System. Her research is focused on ways health communication can improve women’s health outcomes.