Abstract: Narrative Sense-making during COVID-19: Using Stories to Understand Birth in a Global Pandemic

◆ Maria Brann, Indiana University - Purdue University Indianapolis
◆ Jennifer J. Bute, Indiana University - Purdue University Indianapolis
◆ Susanna F. Scott, Indiana University - Purdue University Indianapolis
◆ Nicole L. Johnson, Iowa City VA Health Care System

Pennebaker (2000) argues that the act of storytelling can help individuals better understand their experiences. Storytelling serves a sense-making function and has the potential to improve well-being (Koenig Kellas, 2018; Pennebaker, 2000). Particularly salient to the present context, storytelling can help individuals process their birthing experiences (Johnson et al., 2020). “Stories are the fundamental way for … making sense of lives and coping with difficult experiences” (Koenig Kellas & Kranstuber Horstman, 2015, p. 83), such as giving birth during a pandemic. Grounded in the communicated sense-making model (Koenig Kellas, 2018) and through qualitative analysis (Tracy, 2020) of 71 written stories about giving birth during the COVID-19 pandemic, we focused on the content of women’s retrospective storytelling. We determined that women’s birth experiences during the COVID-19 pandemic elucidated three primary narrative themes: COVID-19’s shaping of the experience often overshadowed the actual birth, women’s agency over their birth experience was threatened by COVID-19 restrictions, and birth experiences led to mixed emotions that affected women’s mental health in unexpected ways. Nearly all women’s stories were marked by how COVID-19 disrupted their birth plan (e.g., where to give birth, how to give birth, with whom to give birth), and these changes became the focus of their narratives, taking precedence over the actual birth of their child. For example, numerous women discussed planning inductions to mitigate exposure to COVID patients in hospital settings. They attributed these changes and their effects to the pandemic, often personifying the virus. As Koenig Kellas and Kranstuber Horstman (2015) noted, attributions in stories are the reasons given for behaviors, which were evident in how women wrote about what they, and others, did. For example, the language in women’s stories reflected their loss of control as they shared what they were no longer “allowed” to do because of the virus. They often focused on institutional restrictions, such as how they were not allowed to have visitors, leave their room, or even get a meal due to cafeteria shutdowns. Despite the negative emotional responses to COVID-19 and the resulting effects on mental health, the narrative tone of the stories were not all negative and suggested that many women were still processing their experience and its health effects. For example, even when sharing how anxious, scared, and sad they were about not having anticipated support persons present at the birth, some women chose to highlight how COVID restrictions forced them to focus more on their immediate relationships with their partner and child, thus choosing to highlight the positive in a threatening situation. Finally, the tone in which a story is framed reveals one’s well-being status (Koenig Kellas, 2015). Arguably one of the most life-changing events in a woman’s life was drastically affected by the presence of a worldwide pandemic, and women were faced with greater uncertainty and unexpected outcomes, yet they were able to make sense of their birth during a pandemic by retrospectively telling their stories.