Maternal Psychological Difficulties: A Journey Through Self-Expression on a Mobile App (Preprint)

BACKGROUND Perinatal depression (PND) affects 10 to 20% of women worldwide and often remains undetected and untreated due to stigma, lack of awareness, and structural barriers in healthcare systems. Psychological maternal difficulties, such as feeling overwhelmed, guilty, or inadequate, are common, yet rarely expressed during traditional consultations. Digital platforms may facilitate earlier and more authentic disclosure of such distress. OBJECTIVE This study aimed to describe the profiles and communication patterns of 1,011 women who used a secure, professionally moderated chat on the May mobile app to express psychological maternal difficulties between April 2022 and April 2024. METHODS It also examined the range and evolution of topics discussed before and after such expressions. RESULTS A total of 10,757 messages were analyzed. Notably, 35% of women mentioned psychological difficulties in their first message, while others discussed up to 15 different issues beforehand. After disclosure, users more frequently addressed practical and emotional caregiving topics. Communication patterns were not significantly associated with marital status, number of children, or duration of app use. CONCLUSIONS Anonymity, accessibility, and the absence of time constraints could have facilitated self-expression. Beyond support, smart digital tools offer a new window into real-world maternal experiences. By capturing spontaneous, large-scale qualitative data in daily life contexts, they may enrich our understanding of perinatal mental health and help identify forms of suffering that often go unnoticed in clinical settings.