{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:31:34Z","timestamp":1787232694493,"version":"build-2736575974"},"reference-count":51,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1F31NR020134-01A1"],"award-info":[{"award-number":["1F31NR020134-01A1"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Duke University School of Nursing, Diane Holditch Davis Award"},{"name":"Ruth L. Kirschstein National Research Service Award","award":["1F31NR020134-01A1"],"award-info":[{"award-number":["1F31NR020134-01A1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The COVID-19 pandemic created unprecedented challenges to social connection, significantly intensifying maternal isolation and unmet needs. This purpose of this study was to explore birthing parents\u2019 experiences of isolation and unmet maternal needs during the COVID-19 pandemic through a socioecological lens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative descriptive design was used, involving semi-structured interviews with 22 birthing parents from a southeastern U.S. state. Data were collected in 2021 during the COVID-19 pandemic. Participants were recruited through social media, parenting groups, and snowball sampling. Data on maternal experiences during pregnancy, childbirth, and the postpartum period were inductively coded using a content analysis approach and then organized using the socioecological model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The COVID-19 pandemic exacerbated unmet maternal needs. Maternal perinatal needs were multifactorial and relational, reflecting complexity within and across levels of the socioecological framework (e.g., within individuals; in relation to their children, co-caregivers, other social support persons, healthcare professionals; and in the context of organizations, communities, culture, and policies.) In many cases, birthing parents faced exacerbation of challenges as they coped with the limited in-person support of the pandemic coupled with typical postpartum experiences such as fragmented sleep, depression, or other mental health challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perinatal care can be strengthened to be more supportive of maternal social and additional needs by designing and operationalizing a more holistic approach that honors individuals\u2019 experiences, more meaningfully engages clinicians and social networks, and addresses systemic factors. While the COVID-19 pandemic uniquely increased isolation, the findings underscore the need for adaptable and responsive perinatal healthcare services across socioecological domains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00469580261480371","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:14:46Z","timestamp":1787055286000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Qualitative Descriptive Analysis of the Exacerbation of Unmet Maternal Needs During the COVID-19 Pandemic Using the Socioecological Framework"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0971-9682","authenticated-orcid":false,"given":"Bonnie","family":"Hepler","sequence":"first","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Brandon","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin P.","family":"Tully","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharron L.","family":"Docherty","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13812"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1398-1"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31086-4"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.03.032"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002633"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03858-7"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2024.104098"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.32.7.513"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.4363"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.13099"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.16355"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.04.008"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001000"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-2113-2739"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.2910"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004253"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.40907"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001141.pub6"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012099.pub2"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251419"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.49923"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.10.007"},{"key":"e_1_3_8_24_2","unstructured":"Silverstein J. 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