Reviewer ’s report  
 
Title: No straight lines – young women’s perceptions of their mental health and wellbeing 
during and after pregnancy: A systematic review and meta -ethnography  
 
Version: 0 Date: 26 Aug 2019  
 
Reviewer: Leif Edward Ottesen Kennair  
 
Reviewer's report:  
 
The following paper is a systematic review of qualitative research on young mothers and their 
health.  
 
The subject matter is interesting and important. The approach chosen therefore needs to not 
merely establish the world view of the researchers, but actua lly provide insights that make policy 
makers and people working in the field better aware of young mothers' situations and how they 
perceive them.  
 
The cultural specificity of this UK, US and Canadian sample is not discussed fully. Would 
similar experiences  be typical in more sexually liberal cultures, where contraception and abortion 
is more available (culturally, too, not merely physically)? We are told that papers were quality 
controlled and that inclusion criteria considered. However, we do not really ge t much 
information about who the young mothers are. Was there a clear social economic aspect in 
selection? Did this influence results? Where they suffering from mental disorder? Also, in such 
research: What were the aims and research questions the 19 studi es were addressing and from 
what theoretical perspectives? Why was not this addressed? Were any of these overlapping? 
Would this not helped us understand better how to interpret patterns in reports?  
 
Also, in an empowering and wellbeing framework, why was t here no focus on benefits to 
individuals of pregnancy and child; increased status, functional aspects, etc. This is mentioned 
merely in passing.  
 
The embodied aspect of the paper seemed at times a little forced. As a clinician I was not certain 
how to inter pret it fully - as an academic I worried that it might be a little to metaphorical. I note 
that in the limitations the authors make a note of this, too, and it would seem that there was not 
full consensus among authors about how strong this aspect should n ecessarily be in the current 
synthesis. It would maybe be beneficial for the group of researchers to develop this aspect 
further, and reach a broader consensus, that both might convey this aspect more clearly or maybe 
reduce the prominence.  
 
Further researc h: What is the next step? How to take these insights further? Is the next research 
step translational or more generalizable in nature? This needs further elaboration. How may we 
improve and womens' health with the current work?  
 
In total, I am not certain w hat I learnt from the current paper; what was the original contribution? 
And I am not certain that the authors are not describing a rather specific socio -cultural set of 
English -speaking young mothers. As such, may it be these specific aspects of selection  criteria in 
the original studies and the theoretical underpinnings of the original research need more 
discussion?  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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