‘No lu’au for baby's 1st birthday’: becoming a mother during the COVID-19 pandemic in Hawai’i

INTRODUCTION: The COVID-19 pandemic had deleterious effects across healthcare. People who gave birth during this time experienced increases in mental health challenges compared to their non-pandemic counterparts. Given Hawai'i's geographical location, people who gave birth there may have experienced additional impacts not experienced on the US mainland. The purpose of this study was to investigate experiences of becoming a mother in Hawai'i during COVID-19. METHODS: Story inquiry, a qualitative research method that is culturally appropriate, was used. Inclusion criteria were that participants had to be 18 or older, English-speaking, living in Hawai'i, and had to have been pregnant or given birth during COVID-19. Participants were recruited via social media and interviewed via phone to assess the experience of becoming a mother (BAM) during the pandemic. RESULTS: Interviews with 15 participants revealed stories that began with discussions of the Perinatal Care Environment overall and how it could be both welcoming and lonely due to policy during the pandemic. From there, participants described cultural and geographically specific factors relating to their BAM experiences. The story then transitioned to plot points of new mothering challenges, which included missing out on key features of BAM due to COVID-19 and the isolation that happened because of the pandemic. From there, after birth, shared stories moved on to describe navigating COVID-19-specific mental health challenges. DISCUSSION: Shared plot points that emerged reinforce that healthcare environments and healthcare providers have the ability to support more positive birth experiences and influence mental health outcomes for new mothers. Plot points are also highlighted culturally, and geographically specific factors related to the experiences of becoming a mother, either positively or negatively, in Hawai'i, including spirituality and o'hana. Implications for policy and practice are discussed related to recommendations for mental health practice and policy in the wake of acute stress events like the COVID-19 pandemic.