Depression of being "down to my last diaper": A qualitative descriptive study of associations between diaper insecurity and maternal health.

Background: Diaper insecurity, unmet need for infant/child diapers, is a form of material deprivation associated with worse maternal mental health, including higher levels of stress, anxiety, and depression. Objectives: To examine retrospective reports of mothers’ experiences of diaper insecurity and coping strategies as they related to maternal physical and mental health, health behaviors, and social interaction. Design: This study used semi-structured, in-depth interviews with 70 mothers who lacked enough diapers. A thematic analysis using abductive coding was conducted to identify related factors connecting diaper insecurity and mothers’ health outcomes. Methods: Mothers who self-identified as experiencing diaper insecurity were interviewed about reasons they struggled to access diapers, coping strategies, and perceived effects on their financial situations, social relationships, and well-being. Results: Qualitative analysis identified three themes centered around mothers’ experiences of diaper insecurity: (1) common ways of managing diaper insecurity, such as missing work, school, or medical appointments and having to forgo other basic needs, shopping, and socializing, which can mean less income, less access to health care, and fewer social interactions; (2) additional physical, cognitive, and emotional labor associated with managing diaper insecurity that contributes to worse physical and mental health; and (3) maternal shame associated with an inability to provide a basic need of early childcare and fear of stigma that hinders parental self-efficacy and sense of self-control. Conclusion: Beyond its association with other factors, including low income and social isolation, known to negatively affect psychological well-being, lack of access to enough diapers may contribute to maternal stress, anxiety, and depression. Interviews with mothers revealed the mental, physical, and social toll of diaper insecurity and point to public diaper support as a possible pathway for supporting women’s health.