Postpartum Issues for Expectant Mothers and Fathers (original) (raw)
Related papers
Journal of Affective Disorders, 2004
Objective: To determine the effectiveness of a psychosocial intervention, provided to expectant couples in routine antenatal classes, on the postpartum psychosocial adjustment of women and men. Design: A 3*3 between subjects randomised control design was utilised. The two factors were condition and self-esteem. Preparation for Parenthood programs were randomly allocated to one of three conditions: usual service ('control'), experimental ('empathy'), or non-specific control ('baby-play'). The latter condition controlled for the non-specific effects of the intervention, these being: the provision of an extra class; asking couples to consider the early postpartum weeks; and receiving booster information after the antenatal class, and again shortly after the birth. Women and men were categorised into three levels of self-esteem, as measured antenatally: low, medium and high. Methods: 268 participants were recruited antenatally. Interview data and self-report information was collected from 202 of these women at 6 weeks postpartum, and 180 women at 6 months postpartum. The intervention consisted of a session focusing on psychosocial issues related to becoming first-time parents. Participants discussed possible postpartum concerns in separate gender groups for part of the session, and then discussed these issues with their partners. Hypothetical scenarios depicting stressful situations in the early postpartum weeks for women and men were discussed, with solutions that parents have found useful given to the participants. In the non-specific control condition, the session focused on the importance of play with a baby, with videotapes and discussion around how parents can play with infants. Results: At 6 weeks postpartum there was a significant interaction effect between condition and self-esteem on maternal adjustment. Women with low self-esteem, who had received the intervention, were significantly better adjusted on measures of mood and sense of competence than low-self-esteem women in either of the two control conditions. There were no main or interaction effects by 6 months postpartum. The beneficial effect at 6 weeks was related to partners of these women being more aware of how the mother was feeling, and with women reporting greater satisfaction with the sharing of home and baby tasks. There were no significant main or interaction effects for men at either time point, other than men with low self-esteem reporting poorer adjustment. Conclusion: This brief and inexpensive intervention was effective in reducing postpartum distress in some first-time mothers at 6 weeks postpartum. The effectiveness of this intervention was related to an increased level of awareness in the men as to how their partners were experiencing the early postpartum weeks. That the effect was only evident for women who, antenatally, reported being low in 0165-0327/$ -see front matter D Journal of Affective Disorders 79 self-esteem, is an important advance in our knowledge of the effectiveness of such prevention programs. No previous studies have investigated the differential effectiveness of such programs depending upon the woman's level of self-esteem, and this finding indicates that future work should measure this variable. These findings should be understood in the context that the population sampled were those attending preparation for parenthood classes, and thus different interventions will be needed for couples who do not attend such classes. This brief psychosocial intervention can be readily applied to antenatal classes routinely conducted in hospitals or the community. D
Transition to parenthood: the needs of parents in pregnancy and early parenthood
BMC Pregnancy and Childbirth, 2008
Background: Pregnancy and the transition to parenthood are major adjustment periods within a family. Existing studies have asked parents, retrospectively, about their experience of antenatal education, mainly focusing on women. We sought to address this gap by asking first-time mothers and their partners about how they could be better supported during the antenatal period, particularly in relation to the transition to parenthood and parenting skills. Methods: Purposive sampling was used to recruit 24 nulliparous women with a range of ages from two healthcare organisations in SouthWest England, 20 of whom had partners. Recruitment took place antenatally at around 28 weeks gestation. Semi-structured interviews were undertaken at home in the last trimester of pregnancy and between 3-4 months postpartum. Content analysis of the interview data was undertaken. Results: Several common themes emerged from both the ante-and postnatal data, including support mechanisms, information and antenatal education, breastfeeding, practical baby-care and relationship changes. Knowledge about the transition to parenthood was poor. Women generally felt well supported, especially by female relatives and, for those who attended them, postnatal groups. This was in contrast to the men who often only had health professionals and work colleagues to turn to. The men felt very involved with their partners' pregnancy but excluded from antenatal appointments, antenatal classes and by the literature that was available. Parents had been unaware of, and surprised at, the changes in the relationship with their partners. They would have liked more information on elements of parenting and baby care, relationship changes and partners' perspectives prior to becoming parents. Conclusion: Many studies and policy documents have highlighted the paucity of parents' preparation for parenthood. This study has indicated the need for an improvement in parents' preparation for parenthood, the importance of including fathers in antenatal education and that inadequate preparation remains a concern to both women and their partners. This paper identifies several avenues for action and further research to improve both new parents' experience of antenatal education and their preparation for parenthood.
Midwifery, 2010
Objective: childbearing is a significant transition, especially for first-time mothers. The objectives of this study were to explore the maternal transition from womens' perspectives and to identify any unmet needs for support. Design: grounded theory was chosen as the most appropriate method of analysis due to its ability to identify social processes in an inductive way. Semi-structured interviews were used to collect data from the participants, and the interview transcripts were analysed using the constant comparative method. Setting: communities within one region of the UK. Participants: 13 women (aged X16 years) who had delivered their first child six to 15 weeks prior to the interview were recruited to the study. Findings: three main themes (control, support and forming a family) all contributed to the core category: 'changes in the woman's self-concept'. Women felt that they had lost some control over their lives in the early stages of pregnancy and after the birth. The early changes in their self-image and the shift in focus from themselves to the needs of the fetus indicate that the transition may begin at a very early stage in the first trimester. The unfamiliar territory of pregnancy and early motherhood created a need for a mentor or mentors to help guide them through the transition, and to 'normalise' their feelings and experiences. Finally, the women recognised that the act of childbearing fundamentally transformed them and their partners from individuals or a couple into founding members of a new family. Key conclusions: first-time mothers start to undergo a transition at an early stage in their pregnancy. They face difficult periods both early in the pregnancy and after the birth, and have unmet needs for support in those periods, particularly the support of other new mothers. Implications for practice: providing more information about early pregnancy before conception may enable women to form more accurate expectations of this period. Facilitating contact between pregnant mothers would help them to establish a more appropriate support network prior to the birth.
Psychosocial assessment of expectant fathers
Archives of Women's Mental Health, 2008
Background: Comprehensive antenatal psychosocial assessment of mothers prior to the birth is established in many regions. While the influence of fathers on infant and maternal well-being is also recognised as commencing before birth, the early identification of needs among expectant fathers has not been addressed.
BMC Public Health, 2010
Background: Whilst the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. Studies have described the association between socio-demographic factors and postpartum depression, yet few have explored the association between stressors in women's lives around the time of having a baby and maternal psychological morbidity. This study aimed to describe the population prevalence of postpartum depression, anxiety, co-morbid anxiety and depression and social health issues; and to examine the association between postpartum psychological and social health issues experienced in the six months following birth. Methods: Population-based survey of all women who gave birth in Victoria and South Australia in September/ October 2007. Women were mailed the survey questionnaire six months following birth. Anxiety and depression were measured using the Depression Anxiety Stress Scales (DASS-21). Results: Questionnaires were completed by 4,366 women. At six months postpartum the proportion of women scoring above the 'normal' range on the DASS-21 was 12.7% for anxiety,17.4% for depression, and 8.1% for comorbid depression and anxiety. Nearly half the sample reported experiencing stressful life events or social health issues in the six months following birth, with 38.3% reporting one to two and 8.8% reporting three or more social health issues. Women reporting three or more social health issues were significantly more likely to experience postnatal anxiety (Adj OR = 4.12, 95% CI 3.0-5.5) or depression (Adj OR = 5.11, 95% CI = 3.9-6.7) and co-morbid anxiety and depression (Adj OR = 5.41, 95% CI 3.8-7.6) than women who did not report social health issues. Conclusions: Health care providers including midwives, nurses, medical practitioners and community health workers need to be alert to women's social circumstances and life events experienced in the perinatal period and the interplay between social and emotional health. Usual management for postpartum mental health issues including Cognitive Behavioural Therapy and pharmacological approaches may not be effective if social health issues are not addressed. Coordinated and integrated perinatal care that is responsive to women's social health may lead to improvements in women's emotional wellbeing following birth.
Midwifery, 2016
Objective: contribute to the existing body of knowledge about the specific needs of first-time parents specifically for early parenthood. Method: the databases PubMed, MEDLINE, PSYCINFO, CINAHL, EMBASE, Family Studies Abstracts, and Web of Science, were searched using search terms: prenatal, antenatal, preparation, education, parents, parenthood. The meta-synthesis included 12 articles representing 12 studies. The meta-ethnographic approach of Nobilt and Hare was used in the meta-synthesis. Synthesis and Findings: first-time expectant and new parents reflect a need for antenatal education to actively include male partners pre-and postnatal. Participants wished for early and realistic information about parenting skills, and to have the opportunity to seek support and help from health professionals when need arose especially during the early postnatal period. Another element was the need to learn both from peers and other new parents coming as guest speakers. Participants wished to have been well informed ahead of time, about the possible changes in their conjugal relationship and the related coping strategies. Key conclusions: equal emphasis should be placed both during the prenatal and postnatal periods in antenatal education classes. Implications for practice: interventions aiming at enhancing positive transitions to parenthood could be introduced early during the postnatal period. Parenthood education classes could adopt adult learning strategies that are participatory, and experiential in nature.
Support Needs of Expectant Mothers and Fathers: A Qualitative Study
The Journal of Perinatal Education, 2012
The aim of this study was to describe expectant mothers' and fathers' perceived needs of support during pregnancy. Twenty-two women and 10 men were interviewed in four focus groups and 13 individual interviews. Systematic text condensation was performed to analyze the data. Parents described not only a broad spectrum of social support needs but also needs of psychological and physical support. They also requested to share their experiences with others. The foci of care and parents' needs of support are more harmonized with medical support than with psychological and emotional support. Mothers' needs were predominately addressed in the health services, but fathers often felt "invisible." Antenatal services may need to offer more customized individual support and emphasize peer support in groups; the challenge is to involve both parents through communication and encouragement so they can support each other.
BMC Public Health, 2010
Background: Prevention of postnatal mental disorders in women is an important component of comprehensive health service delivery because of the substantial potential benefits for population health. However, diverse approaches to prevention of postnatal depression have had limited success, possibly because anxiety and adjustment disorders are also problematic, mental health problems are multifactorially determined, and because relationships amongst psychosocial risk factors are complex and difficult to modify. The aim of this paper is to describe the development of a novel psycho-educational intervention to prevent postnatal mental disorders in mothers of firstborn infants.