‘Some Days Are Not a Good Day to Be a Mum’: Exploring Lived Experiences of Guilt and Shame in the Early Postpartum Period

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I commend the authors for selecting this important topic. Addressing mothers' mental health is crucial to ensuring quality care for their infants. Below, I offer a few suggestions to further enhance the manuscript.

1. It is important to provide a clear definition of the early postpartum period. Does it refer to up to 16 weeks postpartum? If so, I suggest replacing the term "first year postpartum" in the opening sentences of both the abstract and the introduction.

2. Consider providing more details in the abstract, including the number of participants and specifying that semi-structured interviews were conducted by telephone.

3. Qualitative studies are encouraged to follow the Consolidated Criteria for Reporting Qualitative Research (COREQ). I recommend ensuring compliance with the 32-item checklist to enhance the transparency and comprehensiveness of the study, and explicitly referencing the use of this instrument.

4. In the methods section, indicate which sociodemographic variables were collected. Additionally, I recommend presenting the participants' characterization in the results section.

5. Qualitative studies that are grounded in a theoretical framework often receive more robust evaluations. In the present study, the authors based their analysis on the concepts of guilt and shame. It would be beneficial to clarify this in the methods section, explicitly stating that the results were analyzed through the lens of these concepts, including appropriate citations.

Author Response

Many thanks to the reviewers for their kind words and constructive feedback. We have endeavoured to address the reviewers’ respective concerns and have summarised our amendments in the responses below. Please see tracked changes in the re-submitted manuscript for full details regarding manuscript revisions, in line with standard reporting frameworks for qualitative research. We thank the reviewers for their time in considering this manuscript and value the opportunity to improve its quality and transparency. We are happy to make any additional reasonable adjustments to the manuscript to further improve its transparency.

 

Please see attached for a summary of revisions made, in line with reviewer one and reviewer two's feedback. Thanks again from the research team for your time and consideration.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript reports results from a qualitative investigation of maternal feelings of shame and guilt in the postpartum period. In a sample of 20 mothers, interviewed at 4-8 or 12-16 weeks postpartum, the authors identified three major themes using a thematic analysis. The qualitative material described is rich and very informative not only for researchers but also for clinicians working with families with mental difficulties during the postpartum period.

 

The study, the performed qualitative analysis, and the manuscript are of high quality. The research question is well embedded in the existing literature, the methods employed were adequately chosen and described in detail, and the results’ section summarizes the qualitative material in an informative, nuanced, and succinct way.

 

I only have minor comments and recommend this manuscript for publication.

 

Minor comments:

 

·      Abstract: sample size should be specified

·      Qualitative approach and research paradigm should be justified (rational, cf. e.g. Standards for Reporting Qualitative Research, O’Brien et al, 2014). 

o   O’Brien, Bridget C. PhD; Harris, Ilene B. PhD; Beckman, Thomas J. MD; Reed, Darcy A. MD, MPH; Cook, David A. MD, MHPE. Standards for Reporting Qualitative Research: A Synthesis of Recommendations. Academic Medicine 89(9):p 1245-1251, September 2014. | DOI: 10.1097/ACM.0000000000000388

·      Choice of the name for the themes: were these formulations that were extracted from the interviews? Or did the researchers choose them? More information on how the choice of names for the themes was made would be informative to the reader

·      As part of the limitations, it would be worth to discuss that relationship quality with the partner was not taken into account – although we do know that this is an important predictor of postnatal adjustment

Author Response

Many thanks to the reviewers for their kind words and constructive feedback. We have endeavoured to address the reviewers’ respective concerns and have summarised our amendments in the responses below. Please see tracked changes in the re-submitted manuscript for full details regarding manuscript revisions, in line with standard reporting frameworks for qualitative research. We thank the reviewers for their time in considering this manuscript and value the opportunity to improve its quality and transparency. We are happy to make any additional reasonable adjustments to the manuscript to further improve its transparency.

 

Please see attached for a summary of revisions made, in line with reviewer one and reviewer two's feedback. Thanks again from the research team for your time and consideration.

Author Response File: Author Response.docx