. 2023 Jun 23;26(4):453–471. doi: 10.1007/s00737-023-01338-9

Table 4.

Thematic structure with illustrate quotes

Theme	Illustrate quotes
Theme 1: Connected relationships 1.1: Relationships with clinician	‘Some staff made an effort to really understand me…the staff [MBU] were very astute at reading my struggling signals’ (Powell et al. 2020, p.5 & 6). ‘She came up after the birth…and she sat with me… I was very lucky. The service I got was fantastic’ (Higgins et al. 2016, p.32). ‘She was a very gentle person. It was a kind of softness, it wasn’t harsh … she listened, and she asked … the right questions … there was something in her approach that made me feel that I could open up to her… and feel comfortable’ (Myors et al. 2014a, p.273). ‘[The clinician] would listen but he wouldn’t pass judgement’ (Coates et al. 2017, p.93). ‘She went through the hospital system and did a complaint for me… no one responded to her or myself, but the fact that she was proactive and really tried to help seek justice in the situation… that helped me emotionally’ (Myors et al. 2014b, p.377). ‘[I] really valued having clinical staff available all the time, it really helped me feel safe and that I could trust enough to relax and recover’ (Wright et al. 2018, p.8). ‘You could definitely see the ones [on the MBU] that were, you know, a bit more under stress and a bit more snappy..’ (Griffiths et al. 2019, p.8).
1.2: Family involvement in care	‘When I went into the mother and baby [unit]… we had support as a family. All of us… They worked with us as a family as opposed to an individual’ (Griffiths et al. 2019, p.7). ‘My mother and I now have a plan if I become unwell again, to manage my situation, now that we know more’ (Wright et al. 2018, p.9). ‘The psychologist at the MBU suggested that my partner comes along to one of the sessions. But he just couldn’t find time for it, basically, and to do his work…it’s a few hours travelling’ (Griffiths et al. 2019, p.7). ‘There was sometimes 15 mins left after which he would be asked to leave’ (Powell et al. 2020, p.5). ‘[The community mental health team] haven’t told me ‘how would you like us to involve [your husband]? They just told me to bring him to appointments. But I didn’t want to bring him to my appointments because they might bring up something that he doesn’t know’ (Lever Taylor et al. 2019, p.9).
1.3: Peer support	‘Other mothers [were] vital in my recovery’ (Powell et al. 2020, p.6). ‘I think you never really know what people are going through, but I think if you’re in a group with other mums with mental health problems, I think that was helpful to me to sort of see them having a relationship with their babies’ (Greaves et al. 2021, p.179). ‘Just knowing that there were other mums, it was just like the biggest comfort ever. I just felt like, oh my gosh, I’m not the only one’ (Griffiths et al. 2019, p.8). ‘I think that would have been helpful for me in terms of getting out of the house and speaking with people who could really understand what I was going through because my husband is super supportive, but he doesn't get it fully’ (Viveiros and Darling 2018, p.12).
Theme 2: New beginnings 2.1: Dealing with the past	‘I didn’t realise myself but that a lot of my issues are from… past experiences and childhood and all that sort of stuff’ (Myors et al. 2014b, p.381). ‘I’ve had in a way a pretty traumatic past, so it was being able to talk to somebody and for them to actually understand and not criticise me was the support I needed’ (Coates et al. 2017, p.94).
2.2 Gaining new insights	‘Once I began to feel better, I was able to learn to see my child’s needs, what my anxiety meant to his experience. It was really hard, but it’s the mother I want to be’ (Wright et al. 2018, p.9). ‘I was supported to work through things myself’ (Coates et al. 2017, p.93).
Theme 3: Meaningful service delivery 3.1: Organisation of services	‘It was very flexible, depending on me too, sometimes I wasn't very good at going out, and they would (fit) in with that, but the home service was the best, that they could come here’ (Myors et al. 2015b, p.246). ‘I just think [my perinatal mental health nurse] was massively reassuring… you have a troop of miscellaneous midwives, it’s a different one each time… so [my perinatal nurse] was like a constant... a sort of counterpoint to all of that’ (Lever Taylor et al. 2020, p.4). ‘…because of the distance, it was really difficult to access, so I feel like more women would go and access these services if they were closer to them’ (Viveiros and Darling 2018, p.12). ‘Having baby on the unit too is such a big healer, just on its own’ (Wright et al. 2018, p.9). ‘I haven’t attended any groups because I’m not confident to do it over the phone. It would have been easier for me in person but because of COVID, I told my nurse that I’m not confident doing these calls with other people over the phone’ (Pilav et al. 2022, p.7).
3.2 Therapeutic interventions	‘to talk to her about things, it was safe, it just felt really safe and comfortable to open up’ (Myors et al. 2014a, p.273). ‘My mood swings aren’t as intense or frequent because I used the tools that I learnt, so that’s going to have a positive impact on Daisy. Her environment is calmer at home’ (Greaves et al. 2021, p.178).
3.3 Care at discharge	‘There needs to be a lot more information provided about…what [is] offered in the community’(Viveiros and Darling 2018, p.10). ‘What was the point of going to [an MBU] if it doesn’t get followed up at all? I still don’t understand’ (Griffiths et al. 2019, p.10). ‘…what do you do with someone who still needs your help? … for some people who don’t need help, their baby’s born and they’re coping ok and that’s good … but for people that turn out to be a more long-term issue, there’s nothing’ (Myors et al. 2014a, p.273). ‘They tried to transition [me] into another service, and that has not been successful … not because of me, but because the other service just … keeps forgetting … It’s very disappointing to me …you get to a point now when they haven’t called you … three times when they said they would, … I don’t want to put myself out and call. I’m not comfortable with that now’ (Myors et al. 2015a, p.10).

Theme

Illustrate quotes

Theme 1: Connected relationships

1.1: Relationships with clinician

‘Some staff made an effort to really understand me…the staff [MBU] were very astute at reading my struggling signals’ (Powell et al. 2020, p.5 & 6).

‘She came up after the birth…and she sat with me… I was very lucky. The service I got was fantastic’ (Higgins et al. 2016, p.32).

‘She was a very gentle person. It was a kind of softness, it wasn’t harsh … she listened, and she asked … the right questions … there was something in her approach that made me feel that I could open up to her… and feel comfortable’ (Myors et al. 2014a, p.273).

‘[The clinician] would listen but he wouldn’t pass judgement’ (Coates et al. 2017, p.93).

‘She went through the hospital system and did a complaint for me… no one responded to her or myself, but the fact that she was proactive and really tried to help seek justice in the situation… that helped me emotionally’ (Myors et al. 2014b, p.377).

‘[I] really valued having clinical staff available all the time, it really helped me feel safe and that I could trust enough to relax and recover’ (Wright et al. 2018, p.8).

‘You could definitely see the ones [on the MBU] that were, you know, a bit more under stress and a bit more snappy..’ (Griffiths et al. 2019, p.8).

1.2: Family involvement in care

‘When I went into the mother and baby [unit]… we had support as a family. All of us… They worked with us as a family as opposed to an individual’ (Griffiths et al. 2019, p.7).

‘My mother and I now have a plan if I become unwell again, to manage my situation, now that we know more’ (Wright et al. 2018, p.9).

‘The psychologist at the MBU suggested that my partner comes along to one of the sessions. But he just couldn’t find time for it, basically, and to do his work…it’s a few hours travelling’ (Griffiths et al. 2019, p.7).

‘There was sometimes 15 mins left after which he would be asked to leave’ (Powell et al. 2020, p.5).

‘[The community mental health team] haven’t told me ‘how would you like us to involve [your husband]? They just told me to bring him to appointments. But I didn’t want to bring him to my appointments because they might bring up something that he doesn’t know’ (Lever Taylor et al. 2019, p.9).

1.3: Peer support

‘Other mothers [were] vital in my recovery’ (Powell et al. 2020, p.6).

‘I think you never really know what people are going through, but I think if you’re in a group with other mums with mental health problems, I think that was helpful to me to sort of see them having a relationship with their babies’ (Greaves et al. 2021, p.179).

‘Just knowing that there were other mums, it was just like the biggest comfort ever. I just felt like, oh my gosh, I’m not the only one’ (Griffiths et al. 2019, p.8).

‘I think that would have been helpful for me in terms of getting out of the house and speaking with people who could really understand what I was going through because my husband is super supportive, but he doesn't get it fully’ (Viveiros and Darling 2018, p.12).

Theme 2: New beginnings

2.1: Dealing with the past

‘I didn’t realise myself but that a lot of my issues are from… past experiences and childhood and all that sort of stuff’ (Myors et al. 2014b, p.381).

‘I’ve had in a way a pretty traumatic past, so it was being able to talk to somebody and for them to actually understand and not criticise me was the support I needed’ (Coates et al. 2017, p.94).

2.2 Gaining new insights

‘Once I began to feel better, I was able to learn to see my child’s needs, what my anxiety meant to his experience. It was really hard, but it’s the mother I want to be’ (Wright et al. 2018, p.9).

‘I was supported to work through things myself’ (Coates et al. 2017, p.93).

Theme 3: Meaningful service delivery

3.1: Organisation of services

‘It was very flexible, depending on me too, sometimes I wasn't very good at going out, and they would (fit) in with that, but the home service was the best, that they could come here’ (Myors et al. 2015b, p.246).

‘I just think [my perinatal mental health nurse] was massively reassuring… you have a troop of miscellaneous midwives, it’s a different one each time… so [my perinatal nurse] was like a constant... a sort of counterpoint to all of that’ (Lever Taylor et al. 2020, p.4).

‘…because of the distance, it was really difficult to access, so I feel like more women would go and access these services if they were closer to them’ (Viveiros and Darling 2018, p.12).

‘Having baby on the unit too is such a big healer, just on its own’ (Wright et al. 2018, p.9).

‘I haven’t attended any groups because I’m not confident to do it over the phone. It would have been easier for me in person but because of COVID, I told my nurse that I’m not confident doing these calls with other people over the phone’ (Pilav et al. 2022, p.7).

3.2 Therapeutic interventions

‘to talk to her about things, it was safe, it just felt really safe and comfortable to open up’ (Myors et al. 2014a, p.273).

‘My mood swings aren’t as intense or frequent because I used the tools that I learnt, so that’s going to have a positive impact on Daisy. Her environment is calmer at home’ (Greaves et al. 2021, p.178).

3.3 Care at discharge

‘There needs to be a lot more information provided about…what [is] offered in the community’(Viveiros and Darling 2018, p.10).

‘What was the point of going to [an MBU] if it doesn’t get followed up at all? I still don’t understand’ (Griffiths et al. 2019, p.10).

‘…what do you do with someone who still needs your help? … for some people who don’t need help, their baby’s born and they’re coping ok and that’s good … but for people that turn out to be a more long-term issue, there’s nothing’ (Myors et al. 2014a, p.273).

‘They tried to transition [me] into another service, and that has not been successful … not because of me, but because the other service just … keeps forgetting … It’s very disappointing to me …you get to a point now when they haven’t called you … three times when they said they would, … I don’t want to put myself out and call. I’m not comfortable with that now’ (Myors et al. 2015a, p.10).