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Seefeld L, Handelzalts JE, Horesh D, Horsch A, Ayers S, Dikmen-Yildiz P, Kömürcü Akik B, Garthus-Niegel S. Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health. J Affect Disord 2024; 348:378-388. [PMID: 38154585 DOI: 10.1016/j.jad.2023.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/27/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Previous research suggests that a negative birth experience is associated with symptoms of postpartum depression and anxiety in mothers and partners. However, this has mostly been investigated within the first year postpartum and research on the long-term effects is lacking. Additionally, the role of relationship satisfaction and the interdependence between parents have not been considered so far. METHODS Couples (N = 1992) completed questionnaires on their birth experience, relationship satisfaction, and symptoms of depression and anxiety at two months, 14 months, and two years after birth, respectively. RESULTS Actor-Partner Interdependence Mediation Models indicated no partner effects, but several significant actor and indirect effects. A more positive birth experience was associated with higher relationship satisfaction and less depression and anxiety symptoms for both parents. Higher relationship satisfaction was in turn associated with less depression (mothers and partners) and anxiety symptoms (mothers). The association between birth experience and depression symptoms was partially mediated by relationship satisfaction for mothers and partners, while the association between birth experience and anxiety symptoms was partially mediated by relationship satisfaction only for mothers. LIMITATIONS Due to the highly educated, very healthy sample with low levels of depression and anxiety as well as high relationship satisfaction, results cannot be generalized to less privileged parents. Moreover, all effects were very small. CONCLUSIONS Results highlight the importance of a positive birth experience for parents' relationship satisfaction and mental health. Negative birth experiences need to be avoided to prevent a negative impact on the whole family.
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Affiliation(s)
- Lara Seefeld
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany.
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo, Tel-Aviv, Israel; Psychiatry Department, University of Michigan, Ann Arbor, MI, USA
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | | | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Technische Universität Dresden, Dresden, Germany; Institute for Systems Medicine (ISM) and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Harte JD, Sheehan A, Stewart S, Foureur M. Application of the Childbirth Supporter Study to Advance the Birth Unit Design Spatial Evaluation Tool. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:148-163. [PMID: 37340757 DOI: 10.1177/19375867231177304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE Translational research to advance design criteria and apply the Childbirth Supporter Study (CSS) findings to practice. BACKGROUND The physical design of birth environments has not undergone substantial improvements in layout or ambiance since the initial move to hospitals. Cooperative, continuously present childbirth supporters are beneficial and are an expectation for most modern birth practices, yet the built environment does not offer support for the supporter. METHODS To advance design criteria, we use a comparative case study approach to create translational findings. Specifically, CSS findings were used as indicators to advance the Birth Unit Design Spatial Evaluation Tool (BUDSET) design characteristics in pursuit of better support for childbirth supporters in the built hospital birth environment. RESULTS This comparative case study provides eight new BUDSET design domain suggestions to benefit the supporter-woman dyad, and subsequently the baby and care providers. CONCLUSIONS Research-informed design imperatives are needed to guide the inclusion of childbirth supporters as both a supporter and as an individual in the birth space. Increased understanding of relationships between specific design features and childbirth supporters' experiences and reactions are provided. Suggestions to enhance the applicability of the BUDSET for birth unit design facility development are made, specifically ones that will better accommodate childbirth supporters.
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Affiliation(s)
- J Davis Harte
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Boston Architectural College, MA, USA
| | - Athena Sheehan
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- School of Nursing and Midwifery, Western Sydney University, New South Wales, Australia
| | - Susan Stewart
- School of Design, Faculty of Design, Architecture and Building, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Seefeld L, von Soest T, Dikmen-Yildiz P, Garthus-Niegel S. Dyadic analyses on the prospective association between birth experience and parent-child-bonding: The role of postpartum depression, anxiety, and childbirth-related posttraumatic stress disorder. J Anxiety Disord 2023; 98:102748. [PMID: 37517159 DOI: 10.1016/j.janxdis.2023.102748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Negative birth experiences are associated with postpartum mental health difficulties in parents. However, research considering the long-term impact of a negative birth experience on parent-child-bonding and the interdependence between parents is rare. This study aimed to investigate actor as well as partner effects for the association between parents' birth experience and parent-child-bonding and whether this association is mediated by postpartum psychiatric symptoms. METHOD A community sample of couples (N = 743) completed questionnaires during pregnancy, 2, and 14 months after birth. RESULTS Applying Actor-Partner Interdependence Mediation Models, structural equation modeling showed that parents' own negative birth experience predicted a poorer bond to their child 14 months postpartum. Compared to mothers, this association was twice as strong for partners and was mediated by symptoms of postpartum depression (mothers and partners), anxiety (partners), and childbirth-related posttraumatic stress disorder (mothers). Negative birth experiences of one parent were not related to the other parent's bonding with the child. CONCLUSION Results underline the importance of parents' positive birth experience for their postpartum mental health and secure bond to their child. The other parent's birth experience or postpartum mental health does not seem to affect one's own bond to the child in the long term.
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Affiliation(s)
- Lara Seefeld
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine TU Dresden, Dresden, Germany.
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway
| | | | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine TU Dresden, Dresden, Germany; Institute for Systems Medicine (ISM) and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Schmitt N, Striebich S, Meyer G, Berg A, Ayerle GM. The partner's experiences of childbirth in countries with a highly developed clinical setting: a scoping review. BMC Pregnancy Childbirth 2022; 22:742. [PMID: 36192684 PMCID: PMC9528111 DOI: 10.1186/s12884-022-05014-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background In Western countries, it is common practice for a woman to be supported by a trusted person during childbirth, usually the other parent. Numerous studies have shown that this has a positive effect both on the woman’s satisfaction with the birth process and on physical outcomes. However, there is little research on the birth experience of partners and their wellbeing. The aim of this review is to summarise the existing literature on partner experience, consider its quality and identify the underlying themes. Methods Both a systematic literature search in three databases and a manual search were conducted, for qualitative, quantitative, and mixed-methods studies from Western countries examining the experiences of partners present at a birth. Results A total of 35 studies were included. Only one study included same-sex partners (the other studies addressed fathers’ experiences only) and only one validated questionnaire examining partners’ birth experiences was identified. Four major themes were found to influence partners’ birth experiences: (1) intense feelings, (2) role of support, (3) staff support, and (4) becoming a father. Conclusions Partners may feel very vulnerable and stressed in this unfamiliar situation. They need emotional and informal support from staff, want to be actively involved, and play an important role for the birthing woman. To promote good attachment for parents, systematic exploration of the needs of partners is essential for a positive birth experience. Because of the diversity of family constellations, all partners should be included in further studies, especially same-sex partners. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05014-1.
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Affiliation(s)
- Nadine Schmitt
- Medical Faculty, Institute for Health and Nursing Science, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Sabine Striebich
- Department of Nursing and Management, Hamburg University of Applied Sciences, Berliner Tor 5, 20099, Hamburg, Germany
| | - Gabriele Meyer
- Medical Faculty, Institute for Health and Nursing Science, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Almuth Berg
- Medical Faculty, Institute for Health and Nursing Science, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Gertrud M Ayerle
- Medical Faculty, Institute for Health and Nursing Science, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
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What are LGBTQI+ parental experiences of healthcare support and decision-making regarding infant feeding options? A grounded theory study. J Perinatol 2022; 42:1083-1090. [PMID: 34725448 DOI: 10.1038/s41372-021-01259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/20/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To explore LGBTQI+ parental experiences regarding their interactions with healthcare professionals as a resource for feeding options during the prenatal-to-neonatal period. STUDY DESIGN This single-center, interview-based qualitative study of LGBTQI+ parents utilized grounded theory to identify and verify emergent themes and subthemes. We developed a conceptual framework to illustrate relationships among themes and subthemes, as well as opportunities for healthcare professionals and families to improve LGBTQI+ parental support. RESULTS Thematic saturation was attained after interviewing 21 parents from 12 families. Analyses revealed four main themes representing opportunities for improvement: education, continuity of care, parental engagement and open communication. Personal and interpersonal factors influenced parental experiences and decisions, which shaped ultimate feeding outcomes. CONCLUSIONS LGBTQI+ parents revealed challenges of establishing feeding practices that best aligned with their values and goals. Recognizing these factors can help healthcare professionals improve their counseling, engagement and support of LGBTQI+ parents.
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Eitenmüller P, Köhler S, Hirsch O, Christiansen H. The Impact of Prepartum Depression and Birth Experience on Postpartum Mother-Infant Bonding: A Longitudinal Path Analysis. Front Psychiatry 2022; 13:815822. [PMID: 35706472 PMCID: PMC9189288 DOI: 10.3389/fpsyt.2022.815822] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Negative effects of impaired postpartum mother-infant-bonding on mental health of mothers, their newborn children and subsequent child development are well documented. Previous research demonstrated an association between a negative birth experience and postpartum mental health affecting postpartum mother-infant bonding. This study investigates the extent to which prepartum depression and birth experience influence the postpartum mental health of mothers and their bonding toward their newborns, and whether these influences differ according to parity and self-reported prior mental health problems. METHOD Three hundred and fifty-four women (18-43 years; M = 30.13, SD = 5.10) filled in the Edinburgh Postnatal Depression Scale (EPDS), the Maternal-Fetal Attachment Scale (MFAS), Salmon's Item List (SIL) assessing the birth experience, and the Postpartum Bonding Questionnaire (PBQ) at pre- and postpartum; they were also asked about birth complications and parity status. RESULTS Primipara reported significantly more birth complications (p = 0.048), with path analysis confirming this result (p < 0.001). Birth complications were associated with a more negative rating of the overall birth experience (p < 0.001). Mothers with self-reported prior mental health problems had higher prepartum depression scores (p < 0.001) but did not differ in other variables from mothers without prior self-reported mental health problems. Differences in depression scores between mothers with self-reported prior mental health problems and those without vanished at postpartum assessment (p > 0.05). Path-analysis highlighted the key role of postpartum depression, which was the only significant predictor of postpartum impairment in maternal-child bonding (p < 0.001). Birth experience and prepartum depression scores exerted an indirect effect on postpartum maternal-child bonding, mediated by postpartum depression. DISCUSSION The present study demonstrates the relevance of prepartum mental health of expectant mothers, especially of those who self-report prior mental health problems. The results support that reducing mental health problems of pregnant mothers might contribute to a more positive birth experience and potentially reduce postpartum depressive symptoms. As postpartum depression is associated with impaired parent-child bonding, such targeted interventions could promote child development. Group differences between primiparous and multiparous mothers suggest that the birth experience may be an influential factor for postpartum mental health.
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Affiliation(s)
- Pia Eitenmüller
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Siegmund Köhler
- Department of Obstetrics and Gynecology, University of Giessen-Marburg, Marburg, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, Germany
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
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Weigl T, Garthus-Niegel S. [Questionnaires for the Assessment of Birth Expectancy and Birth Experience (Part 2 of a series on psychological assessment during the peripartum period)]. Z Geburtshilfe Neonatol 2021; 225:392-396. [PMID: 34058777 DOI: 10.1055/a-1471-7714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Giving birth is an intense experience and typically accompanied by severe pain. In addition to medical complications, subjective factors are likely to affect the birth experience. These include previous experiences with pregnancy and birth, previous traumatic experiences as well as birth expectations. Various questionnaires allow a standardized assessment of birth expectations and the birth experience. However, to date there is no questionnaire available in the German language that is based on diagnostic symptoms of birth-related posttraumatic stress disorder. Furthermore, current screening-tools were developed for women while men's perspectives have been neglected in research on the parental birth experience. Nonetheless, questionnaires seem to be well suited for the assessment of the birth experience of both mothers and fathers. In this way, support services could be expanded, since parents sometimes report a negative birth experience even in medically uncomplicated births. Along with the goal of enabling parents to have a positive birth experience, the prevention of the development of subclinical or even full-blown posttraumatic stress disorder after birth also plays an important role.
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Affiliation(s)
- Tobias Weigl
- Psychology School, Hochschule Fresenius - University of Applied Sciences, Düsseldorf, Deutschland
| | - Susan Garthus-Niegel
- Fakultät Medizin, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Hamburg, Deutschland.,Institut und Poliklinik für Arbeits- und Sozialmedizin, TU Dresden, Dresden, Deutschland
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8
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Krulis J, König-Bachmann M, Zenzmaier C. [Factors Influencing the Paternal Experience of Birth in the Labour Ward: A Qualitative Study]. Z Geburtshilfe Neonatol 2020; 225:167-175. [PMID: 32942323 DOI: 10.1055/a-1204-2212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Today the majority of fathers-to-be are present at the birth of their children in the labour ward. Their presence at the birth is a significant event in their lives. The aim of this study is to identify factors influencing the paternal birth experience in the labour ward. MATERIAL AND METHODS The experiences of 12 first-time fathers during pregnancy and birth and their perception of birth in the labour ward were gathered through problem-centred interviews. The transcribed and anonymised interviews were analysed by means of content analysis according to Mayring. RESULTS All fathers retrospectively assessed the experience of the birth of their child positively. A large number of potential factors influencing the paternal birth experience were identified, both biographical factors and factors during pregnancy and birth. In particular, the medical staff, especially the midwife, proved to be of importance. CONCLUSION Medical professionals should pay more attention to the paternal birth experience. The focus for further research could lie on concepts to promote a positive birth experience for fathers.
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Affiliation(s)
- Jennifer Krulis
- FH-Bachelor-Studiengang Hebamme, fh gesundheit, Innsbruck, Österreich
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Andersen BR, Rasmussen MB, Christensen KB, Engel KG, Ringsted C, Løkkegaard E, Tolsgaard MG. Making the best of the worst: Care quality during emergency cesarean sections. PLoS One 2020; 15:e0227988. [PMID: 32084173 PMCID: PMC7034794 DOI: 10.1371/journal.pone.0227988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/03/2020] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to identify factors influencing mothers’ and their partners’ perceptions of care quality, and to identify associated clinical factors. Methods Questionnaires were developed based on eight interviews with couples after emergency Cesarean Sections (ECS). The internal structure of the questionnaires was examined using Rasch analysis. Cronbach’s alpha was calculated to evaluate internal consistency of questionnaire items. Finally, associations between questionnaire scores and ECS characteristics were determined. Results Thematic analysis of interview data demonstrated that team-dynamics, professionalism, information, safety, leadership and mother-child continuity of care are important to patient- perceived quality of care. Questionnaire responses from 119 women and 95 partners were included in the validation and demonstrated satisfying fit to the Rasch model. The questionnaires had acceptable internal consistency with Cronbach’s alpha 0.8 and 0.7 for mothers and partners, respectively. Perceived quality of care was negatively associated with increasing urgency of the CS. Spearman rank correlation coefficients were -0.34 (p <0.001) and -0.32 (p = 0.004) for mothers and partners, respectively. Perceived quality of care differed significantly across CS indications for both mothers (p = 0.0006) and their partners (p<0.0001). Conclusion Team-dynamics, professionalism, information, safety, leadership and mother-child-continuity affect patients’ perceptions of care. Perceptions of care were highly influenced by CS indications and urgency.
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Affiliation(s)
- Betina Ristorp Andersen
- Department of Gynaecology and Obstetrics, Hillerød Hospital, Northzealand Hospital, University of Copenhagen, Hillerød, Denmark.,Copenhagen Academy of Medical Education and Simulation, Rigshospitalet, Capital Region of Denmark, Copenhagen, Denmark
| | | | - Karl Bang Christensen
- Department of Health, Section of Biostatistics, University of Copenhagen, Øster Farimagsgade, Copenhagen, Denmark
| | - Kirsten G Engel
- Copenhagen Academy of Medical Education and Simulation, Rigshospitalet, Capital Region of Denmark, Copenhagen, Denmark
| | - Charlotte Ringsted
- Center for Health Science Education, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Hillerød Hospital, Northzealand Hospital, University of Copenhagen, Hillerød, Denmark
| | - Martin G Tolsgaard
- Copenhagen Academy of Medical Education and Simulation, Rigshospitalet, Capital Region of Denmark, Copenhagen, Denmark.,Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Matthies LM, Wallwiener S, Müller M, Doster A, Plewniok K, Feller S, Sohn C, Wallwiener M, Reck C. Maternal self-confidence during the first four months postpartum and its association with anxiety and early infant regulatory problems. Infant Behav Dev 2017; 49:228-237. [PMID: 28987983 DOI: 10.1016/j.infbeh.2017.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/24/2017] [Accepted: 09/18/2017] [Indexed: 12/23/2022]
Abstract
Maternal self-confidence has become an essential concept in understanding early disturbances in the mother-child relationship. Recent research suggests that maternal self-confidence may be associated with maternal mental health and infant development. The current study investigated the dynamics of maternal self-confidence during the first four months postpartum and the predictive ability of maternal symptoms of depression, anxiety, and early regulatory problems in infants. Questionnaires assessing symptoms of depression (Edinburgh Postnatal Depression Scale), anxiety (State-Trait Anxiety Inventory), and early regulatory problems (Questionnaire for crying, sleeping and feeding) were completed in a sample of 130 women at three different time points (third trimester (T1), first week postpartum (T2), and 4 months postpartum (T3). Maternal self-confidence increased significantly over time. High maternal trait anxiety and early infant regulatory problems negatively contributed to the prediction of maternal self-confidence, explaining 31.8% of the variance (R=.583, F3,96=15.950, p<.001). Our results emphasize the transactional association between maternal self-confidence, regulatory problems in infants, and maternal mental distress. There is an urgent need for appropriate programs to reduce maternal anxiety and to promote maternal self-confidence in order to prevent early regulatory problems in infants.
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Affiliation(s)
- Lina Maria Matthies
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Stephanie Wallwiener
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
| | - Mitho Müller
- Ludwig Maximilian University, Department of Psychology, Leopoldstr. 13, 80802 Munich, Germany
| | - Anne Doster
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Katharina Plewniok
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Sandra Feller
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Christof Sohn
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Markus Wallwiener
- University of Heidelberg, Department of Obstetrics and Gynecology, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Corinna Reck
- Ludwig Maximilian University, Department of Psychology, Leopoldstr. 13, 80802 Munich, Germany
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