The present study identified two higher-order categories of maternal peer support preferences that aid in facilitating a positive and supportive relationship in perinatal peer support programs: personal and interpersonal qualities, and similar background factors.
Personal qualities and the provision of support
Mothers described the need to have an affable support person who displays warmth and is trustworthy. While individuals are often more likable when possessing such desirable traits [33], there may be nuanced effects to these traits in the context of maternal relationships. Within this theme, mothers described needing a trustworthy, friendly, caring person with whom they feel at ease speaking about their experiences. Recently, attention has been given to the need for increased trust in support relationships, particularly when one party is in a state of vulnerability [34]. Considering the susceptibility of new mothers to mental ill-health, characteristics of warmth and trustworthiness in others may enable mothers to feel less embarrassed or ashamed when discussing challenging topics [18].
Mothers also considered values such as parenting styles and cultural perspectives to be important. Several mothers felt strongly about having aligned parenting style and practices (such as breastfeeding vs. milk formula). Many of the participants’ attitudes resulted from experiencing or witnessing negative interactions on social media and within mothers’ groups. Mothers felt that having differing parenting styles would mean they would be criticised, judged or pressured to change their parenting practices. Mothers acknowledged that it would be challenging to align on every parenting practice; therefore, they would need a support person who was non-judgemental and open to other parenting perspectives so as not to compromise the support relationship. Mothers also considered values from a cultural perspective, highlighting the need for autonomy to connect with either a mentor with similar or different cultural perspectives. Based on the same premise as parenting values, participants recognised that parenting perspectives and styles can differ cross-culturally [35, 36](35; 36).
Mothers recognised that they needed a support person who could provide adequate emotional support – to be able to listen and be emotionally attuned and responsive. This is consistent with research by Hetherington et al. [9], which found that emotional and informational support are the most impactful types of support after childbirth. Mothers’ reports also aligned with research indicating that adequate emotional support is predictive of enhanced well-being [37], and research indicating that mothers experience stress when feeling judged [12, 17]. Therefore, the provision of adequate emotional support is beneficial to the peer support relationship and has the potential to enhance maternal health and well-being [38]. The present study highlights the need for mentors who are non-judgemental and emotionally supportive.
Peer support expectations
Support expectations, namely the need to have a shared understanding with mentors about the type and extent of support being provided, were also highlighted as important to facilitating strong relationships [17]. As one mother indicated, overstepping helping boundaries can be ‘help hindering’—that support can be unexpected and unwelcome at times. Boundaries can provide a sense of security and safety within therapeutic relationships [39]. Therefore, establishing boundaries is important for mothers to feel safe within the peer support relationship.
The availability of mentors was considered key in driving a supportive climate for mothers. Mothers felt that having similar availability for contact and a similar preference for contact frequency was important. It is widely understood that increased proximity and frequency of contact can predict the formation of friendships and enhance interpersonal attraction [40]. Milgrom et al.’s [41] research with perinatal women indicated that when receiving support, mothers needed a ‘reliable alliance’- a relationship in which they could count on another for assistance and support when needed. Mothers with a ‘reliable alliance’ had reduced depression and anxiety symptoms perinatally [41].
Shared experiences and background
New mothers described a preference for a peer support person with shared experiences and similar circumstances, which Law et al. [17] found to impact the strength of the peer support relationship. While numerous studies have demonstrated that similarity enhances interpersonal attraction and increases friendship intensity [43, 44], the present study specifies the similarities to consider for new mothers – specifically, age-related factors, available support systems, socioeconomic factors, location and shared perinatal experiences. Factors such as socioeconomic status and social support systems may be especially important as they are particularly impactful to mental health during the perinatal period [45].
In comparison to personal and interpersonal qualities, there was relatively more mention of the need for similar background factors to facilitate positive and supportive relationships. Indeed, shared perinatal experiences were most frequently discussed. Mothers passionately described how they would benefit from a support person who had similar conception, pregnancy, and/or birth experiences. This may be considered beneficial for two reasons. Firstly, new mothers would feel less inclined to compare their experience or resent their peer’s perinatal experience if their experiences were similar [16, 23]. Secondly, mothers felt they would establish a deeper connection if their peer support person was relatable and seen as a symbol of having experienced and successfully navigated similar challenges. The current finding suggests that sharing similar background factors enhances positive relationships in the perinatal period.
Implications for the development of social support programs
Peer support program developers should attempt to match mothers on shared background and experiences, as well as preferences concerning parenting values and parenting styles. In particular, mentors of a similar age (for mentees to be paired with a ‘friend’ rather than a ‘maternal figure’) and similar perinatal and family experiences (e.g., conception and birth experiences, youngest child’s age) are beneficial to ensure that their knowledge and experiences are both current and relevant to new mothers. Similar life stage, socioeconomic status, and perceived nature of social networks at the time of the mentor’s perinatal experience are additional considerations for matching mothers beyond shared values and priorities. To that point, though, while many people prioritised having aligned parenting style and practices, participants did recognise there can be value from learning from different experiences and perspectives.
However, beyond matching efforts, given the numerous parenting approaches, program developers will also need to train mentors to have active listening skills and an open and non-judgmental approach when parenting perspectives differ. Training of this nature will underpin mentors’ ability to provide quality emotional support, noted by study participants as critical to the peer support relationship. Further to this, program developers could draw from guidelines for clinicians providing both in-person and online supports. As the participants raised, shared or similar availability and contact preferences will likely underpin expectations as well as a sense of security within the peer support relationship. For instance, Drum and Littleton [42] recommend a proactive approach, including discussing hours for interaction and respecting set meeting times and timely feedback within these times while avoiding excessive communication. Additionally, mentors should be supported to provide a private, consistent, professional, and culturally sensitive environment when engaging with the mentee. Ideally, these conversations could occur in an initial meeting between the mentor and mentee, with program developers facilitating discussions and training around support boundaries and expectations.
Limitations and future directions
Study limitations concern the representativeness and generalisability of the sample. Participants were similar across demographic features; predominantly being Caucasian, in a relationship, residing in Australia, with high educational attainment, and from middle-to-high income households. While the sample mainly consisted of women from outer regional and remote Australia, the sample is representative of advantaged women in these areas [46]. Therefore, it is recommended that further research include various populations such as those from disadvantaged groups and from more diverse cultural backgrounds, including Australian Aboriginal and Torres Strait Islander peoples, as research has suggested that relational needs, parenting, and perinatal experience may differ cross-culturally [35, 36]. Some factors and preferences were more readily mentioned than others (e.g., the need for shared perinatal experiences) in the present study. Future research should examine the frequency and prioritisation of preferences and factors to support positive peer relationships, perhaps utilising consensus techniques. It would be useful for this work to also consider support preferences based on level of well-being (e.g., for those with and without perinatal anxiety and depression). Such research could inform pair matching processes to ensure that pairs are formed on factors that are most important.
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