Reflexivity and the Risks of Joint Roles in Researching Perinatal Anxiety: Insights from a mother and Researcher

Post by Noureen Shivji AND Carolyn Chew-Graham, Keele University, School of Medicine

Introduction

Reflexivity is a crucial component of qualitative research, particularly when the researcher works on the same subject that has a personal connection to the subject matter (Karcher et al., 2024). The journey as a researcher and mother became more profound while working on a School for Primary Care (SPCR) funded research study – CLASP (Classification and Outcomes of Perinatal Anxiety), navigating a complex interplay between my professional insights and lived experiences of being a mother of two boys. It made me realise on many occasions that working on Perinatal anxiety (PNA) study is not just professional experience for me, but it is deeply personal and close to my heart. This dual role presents both opportunities for deeper understanding and risks related to blurred boundaries (Karcher et al., 2024) and ethical considerations (Ide & Beddoe, 2023; Karcher et al., 2024).

Reflexivity while working on research on Perinatal Anxiety

Reflexivity involves the continuous examination of one's positionality, biases, and emotional responses throughout the research process (Rogers & Allen, 2024). As a researcher investigating about PNA while also being a mother, self-awareness and ongoing reflection is essential (Karcher et al., 2024) to ensure that personal experiences enrich rather than unduly influence the research. Reflexivity enables an acknowledgment of the emotional resonance of the subject matter while maintaining methodological rigor at the same time. Embracing reflexivity helps researchers recognise how their personal experiences influenced the research process they are involved in. It also helps researchers to manage emotional responses during the research process to maintain objectivity and improve credibility by openly addressing personal biases and investments in the topic (Ide & Beddoe, 2023).

While working on the research study related to PNA, I recognised that my path to motherhood was not different to these women I met during my visits to community involvement and engagement activities. I identified very early on in CLASP study that I myself have experienced similar challenges and gone through these struggles during my own perinatal journey and experienced similar challenges.

Both of my pregnancies were classified as high-risk, which brought an overwhelming mixture of emotions such as, fear, worry and hope all intertwined in a complex web. I didn’t fully grasp the reality of PNA until I began researching it myself. It was a chance occurrence that led me to work on this project, but over time, I recognised the significance of this topic in the lives of women and their partners, who go through this journey together.

As I interacted with women in the community organisations, we worked with as part of our Patient and Public Involvement and Engagement (PPIE) activities, I was reminded of my own sleepless nights, intrusive thoughts, and constant worry about providing the best for my children. I often neglected the importance of my own well-being, not realising how crucial it was for the quality of life of both me and my child. When my first son was born in 2014, I wasn’t aware of PNA, and I felt isolated and anxious, unaware of how common these feelings were in women. At that time, most people, like me, had no idea such a condition existed.

Many years later, in 2022 when I embarked on this research project to understand PNA, I approached it with academic mindset. However, what I didn’t expect was how my past experiences would resurface in the stories of the women I met during PPIE meetings. Listening to their voices was like looking into a mirror, reflecting both my past struggles and some of the challenges I confronted during my recent pregnancy in 2022.

Public involvement and Engagement: A Source of Connection and Reflection

Throughout my work on the CLASP study I attended local parent and baby groups as part of the Patient and Public Involvement and Engagement (PPIE) activities. These sessions, which involved women with and without experience of PNA or other perinatal mental health difficulties, proved to be both rewarding and emotionally challenging. Listening to the women’s stories of their struggles with PNA often felt familiar, echoing my own experiences during pregnancy.

Many women shared feelings of guilt for not being “happy enough” during pregnancy, the constant fear that something might go wrong, the barriers to seeking help, and the difficulty in expressing these emotions. These narratives mirrored my own anxieties, especially the isolation I felt when I was pregnant with my sons. These conversations were not always easy, as they often brought up difficult memories and emotional responses. However, as a qualitative researcher, reflexivity has been a core component of my practice (Rogers & Allen, 2024), which allowed me to process these feelings in a more constructive way. I found comfort in keeping a field notes diary and discussing my emotional reactions with a colleague accompanied me during these visits, which prevented me from feeling overwhelmed.

The women I met during the PPIE sessions highlighted the significance of this research, reinforcing my commitment to advancing work in this area, not only for women but also for their partners, should I have the opportunity to expand on this research in the future. Many of the women had carried their worries in silence, unaware that others shared their experiences. It was only through these support groups that they discovered they were not alone. Sharing their stories in a safe and supportive space revealed that experiencing PNA or other perinatal mental health challenges is not a weakness but, in fact, a source of strength.

Finding Purpose in Research: Embracing Gratitude and Mindfulness for the Future

As the study related to PNA is now coming to close and we begin sharing its findings and lessons learned, I have been reflecting deeply on my interactions with the women I have met along the way. One thing that has become clear to me is the immense power of dialogue and conversation. I have come to understand that the ability to share, listen, and validate someone’s experience is not just helpful for them, but also can provide healing affects for ourselves. While research is often focused on collecting data, it’s equally about making a real difference in people’s lives and giving a voice to those who might otherwise remain unheard.

Many of the conversations I had with women were emotionally challenging. They brought up difficult memories, but, as a qualitative researcher, I leaned into reflexivity to prevent myself from getting caught up in those emotions (Rogers & Allen, 2024). I used those feelings as an

opportunity to shape future approaches to maternal mental health support. This study has reminded me that research is not only about statistics and findings; it’s about people, their unique experiences, and the meaningful impact that could last on peoples’ lives.

Looking back on my own journey, I feel grateful for the challenges I experienced, as they provided me with an opportunity to better understand and empathise with other women going through similar experiences. It feels like a privilege to have worked on research that is not only close to my heart but also has real-world significance.

As I move forward, I hope that the work I have contributed to will add to our understanding and provide much-needed support for women, partners, and families navigating perinatal mental health challenges. No one should go through this journey alone, and through research, increased awareness, and shared experiences, we can ensure that support is available for those who need it most. Together, we can make a real difference!

References

Karcher, K., McCuaig, J., & King-Hill, S. (2024). (Self-) Reflection / Reflexivity in Sensitive, Qualitative Research: A Scoping Review. International Journal of Qualitative Methods, 23. https://doi.org/10.1177/16094069241261860

Ide, Y., & Beddoe, L. (2024). Challenging perspectives: Reflexivity as a critical approach to qualitative social work research. Qualitative Social Work, 23(4), 725-740. https://doi.org/10.1177/14733250231173522

Rogers M, Allen D, Embedding Reflexivity in Social Work Research through the Critical Reflexive Framework, The British Journal of Social Work, Volume 54, Issue 4, June 2024,

The CLASP study was funded by SPCR (grant number 565)