[Psychological changes and contributing factors, weighted by resilience, among mothers from pregnancy to early childrearing during the COVID-19 pandemic: A life-line method approach].

Objective　The COVID-19 pandemic has significantly affected the families of infants and young children. This study explored psychological changes in mothers from pregnancy through early childrearing, related factors, and resilience-based support strategies.Methods　Surveys and semi-structured interviews were conducted with 51 mothers who had experienced pregnancy, childbirth, and childrearing during the COVID-19 pandemic. Participants were asked about the changes in their psychological state and related factors from pregnancy to the time of the survey using the life-line method. Resilience was measured before pregnancy, during their worst psychological state, and upon survey. Qualitative analysis identified factors triggering or explaining for the changes in their psychological states. Resilience scores corresponding to the relevant time points were assigned to these factors and weighted by calculating the average scores of participants who cited them.Results　Changes in psychological state were categorized as experiencing recovery and stability after learning of one's pregnancy or a worsening or low psychological state, with both patterns observed amid various fluctuations until the present. Twenty categories related to these changes were identified across different periods of pregnancy through childrearing, including the "COVID-19 pandemic" and associated domains, such as "pregnancy," "childbirth," "physical condition," "childcare," "interpersonal relationships," "support," and "social resources." The most frequently cited factors for psychological decline were "fear and anxiety related to the COVID-19 pandemic" during pregnancy and "the burden from the lack of child-rearing support and environment" during the first postpartum year. Contrastingly, the most frequently cited factors for recovery were "joy and gratitude regarding pregnancy." The lowest average resilience scores were associated with "limited societal and public understanding and support for families with young children" from pregnancy until two years postpartum, whereas the highest scores were linked to "involvement in child-rearing support" and "reassurance by improvement disinfection" after two years postpartum.Conclusion　Mothers' psychological responses varied, influenced by personal, social, and environmental factors unique to the COVID-19 pandemic. Supporting pregnancy, childbirth, and childrearing during crises and reducing isolation and anxiety, requires mitigating factors undermining psychological well-being and resilience and enhancing those that aid recovery. Public health efforts should offer individual support, cross-sector collaboration among medical, health, and welfare services, and inclusive environments in which mothers and families feel secure and connected.