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Bresnahan M, Zhuang J, Elam K, Goldbort J, Shareef S, Bogdan-Lovis E. Awe and Trepidation: The Role of Perinatal Care Providers in Black Fathers' Experiences of Childbirth in the U.S. HEALTH COMMUNICATION 2024; 39:1923-1931. [PMID: 37580862 DOI: 10.1080/10410236.2023.2247607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Care provider communication with Black birthing families is impactful. This cross-sectional study asked 216 Black fathers to recall treatment by birthing care providers and tested variables contributing to birth satisfaction and fathering identity salience. Most fathers reported that care providers were respectful resulting in a positive birthing experience; however, 15% reported negative experiences with care providers. Perceived social support was shown to be a mediator between disrespect, mistreatment, inclusive communication, trust, and positive emotion with birth satisfaction and fathering identity salience. Care provider disrespect served as a "spoiler" of the birthing experience and subsequently diminished positive fathering identity salience. Analysis of open-ended comments showed that contrary to stereotypes about absent, disengaged Black fathers, fathers in this study were caring toward their newborns, present for them, and engaged in fathering. More work needs to be done with care provider communication to make every birth a positive and inclusive experience for Black fathers and their partners.
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Affiliation(s)
| | - Jie Zhuang
- Department of Communication Studies, Texas Christian University
| | - Kendra Elam
- College of Nursing, Michigan State University
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Nordin-Remberger C, Johansson M, Lindelöf KS, Wells MB. Support Needs, Barriers, and Facilitators for Fathers With Fear of Childbirth in Sweden: A Mixed-Method Study. Am J Mens Health 2024; 18:15579883241272057. [PMID: 39268989 PMCID: PMC11406616 DOI: 10.1177/15579883241272057] [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: 09/15/2024] Open
Abstract
The aim of this mixed-method study was to identify support needs, as well as barriers and facilitators to seeking support in a sample of Swedish fathers with a fear of childbirth (FOC). Participants completed an anonymous quantitative online survey (N = 131), with three free-text items for those self-identifying as having an FOC (N = 71) and five individual in-depth interviews. Data analysis included descriptive and chi-square analyses for quantitative data, and manifest content analysis for qualitative data. Those with a severe FOC were more likely to report having on-going mental health difficulties (p = .039) and one fifth (21%) of the participants with severe FOC wanted to receive professional treatment, but only 8.1% received treatment. Most participants either preferred individual support or to receive support together with their partner. Fathers with severe FOC were more likely to report one or more barriers than those without FOC (p = .005), where unwanted social stigma was the single largest barrier. Qualitative findings identified one main category: Expectant fathers missing and wishing for support for FOC composed four generic categories: (1) support in developing an understanding of their fear, (2) coping by being aware of feelings, (3) professional support through trust and respect, and (4) needing individualized support. To encourage healthy fathers, clinical professionals should find ways to support fathers, such as by providing them with their own perinatal appointments, asking them about their feelings, as well as screening, diagnosing, and treating fathers with severe FOC.
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Affiliation(s)
- Carita Nordin-Remberger
- Obstetric and Reproductive Health Research, Department of Women's and Children's Health, Akademiska University Hospital, Uppsala University, Uppsala, Sweden
- Women's Mental Health During the Reproductive Lifespan-WOMHER, Uppsala University, Uppsala, Sweden
| | - Margareta Johansson
- Obstetric and Reproductive Health Research, Department of Women's and Children's Health, Akademiska University Hospital, Uppsala University, Uppsala, Sweden
| | | | - Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
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Klittmark S, Niit JKP, Nerström E, Grundström H, Nieminen K, Wells MB, Malmquist A. LBTQ parents' needs for support postpartum following a complicated birth: A matter of reproductive justice. JOURNAL OF LESBIAN STUDIES 2024:1-18. [PMID: 39049779 DOI: 10.1080/10894160.2024.2367869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
LBTQ people have increased risks of complications during birth, risks potentially driven by minority stress and increased levels of mental illness and fear of childbirth. With the aim of exploring reproductive injustices in postpartum care for LBTQ people, we analyzed qualitative interviews where 22 LBTQ birth and non-birth parents shared their experiences of support needs during the postpartum period after births where complications had arisen. Results point to the importance of providing an LBTQ safe space, which includes the need to feel safe regarding one's gender or sexual identity, by avoiding cisheteronormative assumptions and using inclusive language. In the context of recently experiencing birth complications, parents needed a space where they were able to focus on physical and mental healing. The results further show the need for validation of the non-birth parent and inclusive breast/chest-feeding support. Results emphasize the need for more psychosocial support around the birth experience, including better medical support and information during the whole process of childbirth.
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Affiliation(s)
- Sofia Klittmark
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Jaqueline K P Niit
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Nerström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Grundström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Katri Nieminen
- Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Malmquist
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Morrison S, Bryanton J, Murray C, Foley V. Lived Experiences of Fatherhood After Infertility. J Obstet Gynecol Neonatal Nurs 2024; 53:245-254. [PMID: 38242532 DOI: 10.1016/j.jogn.2023.12.002] [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] [Received: 07/26/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To explore the lived experiences of fathers in the perinatal period after infertility. DESIGN A descriptive, phenomenological study. SETTING Researcher's private office and participants' homes in an Eastern Canadian province. PARTICIPANTS Eight fathers who met the eligibility criteria. METHODS We recruited a purposive sample of eight participants and held one-on-one interviews in person, by telephone, and via virtual platforms. We analyzed the verbatim transcripts of the audiotaped interviews using Colaizzi's phenomenological data analysis method. RESULTS We uncovered seven themes that described the lived experiences of participants: The Journey: A Long Winding Road, Roles and Responsibilities: Supporter and Protector, Support: The Often-Forgotten Parent, Challenges and Hurdles: Bumps on the Road, So Many Feelings: The Rollercoaster, Coping: Living on the Road, and Reflection: An Unforgotten Journey. Participants shared their experiences of the perinatal period after infertility as long journeys and described how bumps along the road marked these journeys. The journeys were essential parts of their lives that they continued to remember years later. CONCLUSION The perinatal experience after infertility is an important and remembered time for fathers. It is essential to involve and support them in the perinatal process to facilitate positive experiences and overall family health, especially after infertility. There is an ongoing need to conduct research with fathers and to develop evidence-based programming and resources to assist them in the perinatal period after infertility.
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Charman C, Masterson C, Russell AM. 'Would I risk it again?' The long-term impacts of a traumatic birth, as experienced by fathers. J Reprod Infant Psychol 2024:1-15. [PMID: 38676931 DOI: 10.1080/02646838.2024.2346893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Extensive research has explored the impact of traumatic births on mothers, capturing enduring adverse outcomes as well as post-traumatic growth. The literature on fathers' experiences of birth trauma is more limited and little is known of the ongoing impact. The present study aimed to investigate the long-term effects of attending a traumatic birth. METHOD Semi-structured interviews were completed with fathers who identified as having a traumatic birth experience two or more years ago. Thematic analysis was conducted on eight interview transcripts. RESULTS Despite the time since the birth trauma, fathers described ongoing impact, which is captured in five themes. Four of these focus on the negative impacts: their attempts to cope by boxing away emotions, which they thought they should not feel; anxieties over having further children; negative effects on parenting; and ongoing distress or negative impact on their wellbeing. The final theme highlighted some positives from the experience, primarily a strengthened relationship with their partner. CONCLUSIONS Traumatic birth can result in fathers experiencing difficulties beyond the perinatal period, whilst thinking that they should not feel or discuss their distress. As a result of a traumatic birth fathers can experience ongoing guilt and poor mental health, which may lead them to delay subsequent pregnancies. Most participants had not accessed support regarding the traumatic birth, instead coping by trying to avoid their memories and emotional reaction. These findings highlight the need for increased acknowledgement of the impact of birth trauma and intervention for fathers, during and after the perinatal period.
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Affiliation(s)
- Clare Charman
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ciara Masterson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Lindgren L, Holmlund S, Dunge J, Nording ML, Vinnars MT, Lindqvist M. "Navigating in a maze without a map". Partners' experiences of hyperemesis gravidarum- a qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 40:100976. [PMID: 38696948 DOI: 10.1016/j.srhc.2024.100976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE A supportive environment for women with Hyperemesis Gravidarum is crucial but not always provided. There is a lack of research regarding Hyperemesis Gravidarum, its impact on the family, and the partner's perception of supporting their spouse. Thus, this study aims to explore partners' experiences of Hyperemesis Gravidarum during their spousés pregnancy. METHODS Data were gathered through 13 individual, semi-structured, in-depth, digital interviews with partners of women who had experienced Hyperemesis Gravidarum and analysed with Qualitative Content Analysis. The partners were recruited through advertisement on a social media platform and were exclusively males, representing 8 of 21 Swedish regions. The mean age was 34, and they had, on average, 1 previous child. The mean time from the experience to the interview was 12 months. FINDINGS The main theme, "Navigating in a maze without a map", explains partners' situation as stressful and demanding when their spouse suffers from Hyperemesis Gravidarum, with insufficient support and guidance from healthcare providers. The analysis resulted in three themes: "Standing alone with a demanding responsibility", "Being in a lottery when facing healthcare", and "Climbing the mountain together." The themes display challenges within everyday life and healthcare, as well as strained relations within the family. CONCLUSION Partners experience a need to support their spouse in every aspect of daily life and advocate for adequate healthcare. Healthcare professionals must support and acknowledge the partners' struggles during the demanding situation with Hyperemesis Gravidarum.
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Affiliation(s)
| | - Sophia Holmlund
- Department of Nursing, Umeå University, Sweden; Department of Clinical Sciences, Division of Obstetrics and Gynecology, Umeå University, Sweden; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, VIC, Bundoora, Australia
| | - Johanna Dunge
- Department of Clinical Sciences, Division of Obstetrics and Gynecology, Umeå University, Sweden
| | | | - Marie-Therese Vinnars
- Department of Clinical Sciences, Division of Obstetrics and Gynecology, Umeå University, Sweden
| | - Maria Lindqvist
- Department of Nursing, Umeå University, Sweden; Department of Clinical Sciences, Division of Obstetrics and Gynecology, Umeå University, Sweden
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Wynter K, Mansour KA, Forbes F, Macdonald JA. Barriers and opportunities for health service access among fathers: A review of empirical evidence. Health Promot J Austr 2024. [PMID: 38494641 DOI: 10.1002/hpja.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 03/19/2024] Open
Abstract
ISSUE ADDRESSED Engagement with health supports benefits the whole family, yet few health services report successful engagement of fathers. Our aim was to describe available evidence on barriers and opportunities relevant to health system access for fathers. METHODS Scoping reviews were conducted seeking empirical evidence from (1) Australian studies and (2) international literature reviews. RESULTS A total of 52 Australian studies and 44 international reviews were included. The most commonly reported barriers were at the health service level, related to an exclusionary health service focus on mothers. These included both 'surface' factors (e.g., appointment times limited to traditional employment hours) and 'deep' factors, in which health service policies perpetuate traditional gender norms of mothers as 'caregivers' and fathers as 'supporters' or 'providers'. Such barriers were reported consistently, including but not limited to fathers from First Nations or culturally diverse backgrounds, those at risk of poor mental health, experiencing perinatal loss or other adverse pregnancy and birth events, and caring for children with illness, neurodevelopmental or behavioural problems. Opportunities for father engagement include offering father-specific resources and support, facilitating health professionals' confidence and training in working with fathers, and 'gateway consultations', including engaging fathers via appointments for mothers or infants. Ideally, top-down policies should support fathers as infant caregivers in a family-based approach. CONCLUSIONS Although barriers and opportunities exist at individual and cultural levels, health services hold the key to improved engagement of fathers. SO WHAT?: Evidence-based, innovative strategies, informed by fathers' needs and healthy masculinities, are needed to engage fathers in health services.
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Affiliation(s)
- Karen Wynter
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kayla A Mansour
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Faye Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Butterworth S, Butterworth R, Law GU. Birth trauma: the elephant in the nursery. J Reprod Infant Psychol 2023:1-22. [PMID: 37791520 DOI: 10.1080/02646838.2023.2264877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
METHOD The current study used a multiperspectival (dyadic) IPA approach to interview eight participants (N = 4 heterosexual couples) where one parent was help-seeking for the experience of birth trauma. RESULTS Analysis resulted in four superordinate themes: (1) From perfect plan to shattered reality, (2) Trauma in the healthcare system, (3) Trauma in the family system and (4) The post-trauma family: Navigating the new normal. DISCUSSION Parents described a shared experience of birth trauma during birth. However, fathers' perceived trauma ended in the delivery room whilst mothers' continued far beyond this. The dyadic focus showed a divergence of experience postnatally: differing levels of awareness to distress existed between partners, mothers experienced bonding difficulties and parents took to separate coping mechanisms. The trauma remained invisible and unspoken as couples avoided discussions about the birth, coped silently and separately. The parents identity changed following the trauma as individuals, couples and as a family. CONCLUSION The time following a traumatic birth is experienced differently by mothers and fathers. Parents seldom discuss the trauma, hold differing perceptions of roles and needs, and struggle to support each postnatally. Clinical implications and recommendations are discussed.
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Affiliation(s)
| | - Ruth Butterworth
- Northwest Neonatal ODN, Alder Hey Children's NHS Foundation Trust, liverpool, UK
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Latt SM, Alderdice F, Elkington M, Awng Shar M, Kurinczuk JJ, Rowe R. Primary postpartum haemorrhage and longer-term physical, psychological, and psychosocial health outcomes for women and their partners in high income countries: A mixed-methods systematic review. PLoS One 2023; 18:e0274041. [PMID: 37315027 PMCID: PMC10266652 DOI: 10.1371/journal.pone.0274041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES Most research about outcomes following postpartum haemorrhage (PPH) has focused on immediate outcomes. There are fewer studies investigating longer-term maternal morbidity following PPH, resulting in a significant knowledge gap. This review aimed to synthesize the evidence about the longer-term physical and psychological consequences of primary PPH for women and their partners from high income settings. METHODS The review was registered with PROSPERO and five electronic databases were searched. Studies were independently screened against the eligibility criteria by two reviewers and data were extracted from both quantitative and qualitative studies that reported non-immediate health outcomes of primary PPH. RESULTS Data were included from 24 studies, of which 16 were quantitative, five were qualitative and three used mixed-methods. The included studies were of mixed methodological quality. Of the nine studies reporting outcomes beyond five years after birth, only two quantitative studies and one qualitative study had a follow-up period longer than ten years. Seven studies reported outcomes or experiences for partners. The evidence indicated that women with PPH were more likely to have persistent physical and psychological health problems after birth compared with women who did not have a PPH. These problems, including PTSD symptoms and cardiovascular disease, may be severe and extend for many years after birth and were more pronounced after a severe PPH, as indicated by a blood transfusion or hysterectomy. There was limited evidence about outcomes for partners after PPH, but conflicting evidence of association between PTSD and PPH among partners who witnessed PPH. CONCLUSION This review explored existing evidence about longer-term physical and psychological health outcomes among women who had a primary PPH in high income countries, and their partners. While the evidence about health outcomes beyond five years after PPH is limited, our findings indicate that women can experience long lasting negative impacts after primary PPH, including PTSD symptoms and cardiovascular disease, extending for many years after birth. PROSPERO REGISTRATION PROSPERO registration number: CRD42020161144.
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Affiliation(s)
- Su Mon Latt
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Madeline Elkington
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Mahkawnghta Awng Shar
- Health and Nutrition Specialist, United Nations International Children Fund, Myanmar
| | - Jennifer J. Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rachel Rowe
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Döblin S, Seefeld L, Weise V, Kopp M, Knappe S, Asselmann E, Martini J, Garthus-Niegel S. The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM. BMC Pregnancy Childbirth 2023; 23:285. [PMID: 37098555 PMCID: PMC10127505 DOI: 10.1186/s12884-023-05611-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.
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Affiliation(s)
- Svenja Döblin
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lara Seefeld
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Evangelische Hochschule Dresden (Ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway.
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Th Thorgeirsdottir L, Linden K, Bergman L, Sengpiel V, Nyman V, Elden H. The experience of being a partner to a childbearing woman whose pregnancy is complicated by pre-eclampsia: A Swedish qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100847. [PMID: 37080010 DOI: 10.1016/j.srhc.2023.100847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/28/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Pre-eclampsia affects 3-5% of all pregnant women and is among the leading causes of maternal morbidity and mortality as well as iatrogenic preterm birth worldwide. Little is known about the experience of partners of women whose pregnancy is complicated by pre-eclampsia. AIM To describe partners' experience of having a spouse whose pregnancy was complicated by pre-eclampsia. METHODS A qualitative study with in-depth interviews. Eight partners of women whose pregnancy was complicated by pre-eclampsia were interviewed and data were analysed using content analysis. FINDINGS Partners found themselves in an unfamiliar and unexpected situation. They experienced an information gap in which they tried to make sense of the situation by interpreting subtle signs. The situation left them feeling emotionally stretched, feeling like an outsider while trying to provide support for their extended family. The partners experienced a split focus after the baby was born, prioritising the baby while worrying about their spouse. Post-partum, they expressed needing time to process and heal after childbirth. A need for professional support was highlighted and concerns about a future pregnancy were voiced. CONCLUSION Having a spouse who is diagnosed with pre-eclampsia is challenging and overwhelming. Our findings imply a need to develop a model of care for women with pre-eclampsia that includes their partner, i.e., the other parent.
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Affiliation(s)
- Lilja Th Thorgeirsdottir
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lina Bergman
- Region Vastra Gotaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Verena Sengpiel
- Region Vastra Gotaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Viola Nyman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Research and Development, NU-Hospital Group, Trollhattan, Sweden
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Vastra Gotaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Wells MB, Gedaly LR, Aronson O. Midwives and child health nurses' support is associated with positive coparenting for fathers of infants: A cross-sectional analysis. J Clin Nurs 2023; 32:1443-1454. [PMID: 35441382 DOI: 10.1111/jocn.16329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/02/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To examine if the professional support that fathers received from midwives and child health nurses was associated with improvements in fathers' coparenting. A secondary aim was to investigate if there were any support differences between fathers based on parity. BACKGROUND Stronger coparenting is associated with improved maternal, paternal and child health. It is unclear if routine prenatal and postnatal professional support is associated with improved coparenting in fathers of infants. DESIGN Cross-sectional online survey. METHODS In total, 612 fathers of infants (aged 0-24 months) completed baseline data between November 2018 and March 2020. Socio-demographics, pregnancy control variables, social support, professional support, being invited to attend and attending three specific visits for fathers, respectively, and the fathers' coparenting relationship, using the Brief Coparenting Relationship Scale, were assessed. The STROBE checklist was used as the reporting guideline for this study. RESULTS Fathers' attendance at child health visits, support from the prenatal and postnatal midwife, respectively, and total support from the child health nurse, are associated with more positive coparenting. Primiparous fathers reported more received social and professional support, as well as a more positive coparenting relationship than multiparous fathers. CONCLUSIONS Receiving clinical support from both midwives and child health nurses is associated with fathers' positive coparenting. All fathers should be invited and encouraged to attend prenatal, postnatal and child health visits to further support their coparenting relationship. Relative to primiparous fathers, multiparous fathers may require targeted and additional clinical support regarding their coparenting relationship. RELEVANCE TO CLINICAL PRACTICE With fathers becoming more involved in childrearing, having stronger coparenting skills can help them better adapt to their parental roles. Our findings help understand how routine professional support from midwives and child health nurses are experienced among new fathers and that multiparous fathers are in further need of coparenting support.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lindsey R Gedaly
- Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Olov Aronson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,School of Humanities, Education and Social Sciences, Örebro University, Örebro, Sweden
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13
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Kothari A, Bruxner G, Dulhunty JM, Ballard E, Callaway L. Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes. BMC Pregnancy Childbirth 2022; 22:956. [PMID: 36550457 PMCID: PMC9773585 DOI: 10.1186/s12884-022-05288-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes. METHODS A prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose male partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event. RESULTS Data for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%). CONCLUSION Our study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
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Affiliation(s)
- A. Kothari
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia
- The University of Queensland, Brisbane, Queensland Australia
| | - G. Bruxner
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia
- The University of Queensland, Brisbane, Queensland Australia
| | - J. M. Dulhunty
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia
- The University of Queensland, Brisbane, Queensland Australia
| | - E. Ballard
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - L. Callaway
- The University of Queensland, Brisbane, Queensland Australia
- The Royal Brisbane and Women’s Hospital, Brisbane, Queensland Australia
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14
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Factors that influence father’s experiences of childbirth and their implications upon postnatal mental health: a narrative systematic review. Nurse Educ Pract 2022; 65:103460. [DOI: 10.1016/j.nepr.2022.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/23/2022] [Indexed: 11/20/2022]
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15
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Eri TS, Blix E, Downe S, Vedeler C, Nilsen ABV. Giving birth and becoming a parent during the COVID-19 pandemic: A qualitative analysis of 806 women's responses to three open-ended questions in an online survey. Midwifery 2022; 109:103321. [PMID: 35349790 PMCID: PMC8935971 DOI: 10.1016/j.midw.2022.103321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 03/03/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND When Europe was hit by the COVID-19 pandemic, changes were made in maternity care to reduce infections. In Norway, hospital maternity wards, postnatal wards, and neonatal units' companions and visitors were restricted. We aimed to explore the experiences of being pregnant, giving birth and becoming a parent in Norway during the COVID-19 pandemic. METHODS The study is based on the responses from women who provided in-depth qualitative accounts to the ongoing Babies Born Better survey version 3 during the first year of the COVID-19 pandemic. The responses were analysed with inductive thematic analysis. RESULTS In all, 806 women were included, regardless of parity and mode of birth. They gave birth in 42 of 45 available birthing units across Norway. The analysis resulted in four themes: 1) Pregnancy as a stressful waiting period; 2) Feeling lonely, isolated, and disempowered without their partner; 3) Sharing experiences and becoming a family; and 4) Busy postnatal care without compassion. CONCLUSION The COVID-19 pandemic seems to have affected women's experiences of giving birth and becoming a parent in Norway. The restrictions placed on companionship by the healthcare facilities varied between hospitals. However, the restrictions seem to have affected a range of aspects related to women's experiences of late pregnancy, early labour and birth and the early postpartum period. Postnatal care was already poor, and the pandemic has highlighted the shortcomings, especially where companionship was banned.
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Affiliation(s)
- Tine S Eri
- Research Group Midwifery Science, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Ellen Blix
- Research Group Midwifery Science, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Soo Downe
- Research in Childbirth and Health (ReaCH) group/THRIVE Centre, University of Central Lancashire, Preston, United Kingdom.
| | - Carina Vedeler
- Research Group Midwifery Science, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Anne Britt Vika Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
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16
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Kothari A, Bruxner G, Callaway L, Dulhunty JM. "It's a lot of pain you've got to hide": a qualitative study of the journey of fathers facing traumatic pregnancy and childbirth. BMC Pregnancy Childbirth 2022; 22:434. [PMID: 35610624 PMCID: PMC9128289 DOI: 10.1186/s12884-022-04738-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to explore the emotional and behavioural responses and coping strategies of fathers or expectant fathers who faced a significant traumatic event during a partner's pregnancy, labour, or the postpartum period. METHODS This prospective qualitative study of 24 fathers was conducted at a public teaching hospital in Brisbane, Australia. 'Traumatic pregnancy' was defined as a pregnancy complicated by life-threatening or severe risk to the mother and the fetus, termination of pregnancy, intrauterine fetal death or stillbirth. Semi-structured interviews of participants were conducted 3-4 months after the traumatic event. An initial qualitative analysis with automatic coding was performed using Leximancer and later followed by a six-phase manual thematic analysis. RESULTS A pregnancy-related traumatic event had significant mental and physical impacts on fathers. Participants' reactions and coping strategies were varied and influenced by their background history, pre-existing vulnerabilities, and the gap between expectation and reality. Most fathers described a fluctuating state between their needs 'not being met' and 'being met'. These needs were conceptualised using Maslow's hierarchy and Calman's gap theory to construct a composite thematic model to depict the universal requirements of men facing a traumatic pregnancy or childbirth. CONCLUSIONS A greater understanding of the needs of men and gaps in their care is urgently needed. A targeted effort is required to make maternity services father-inclusive. This approach may assist in preventing long term consequences on fathers, partners, and their children.
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Affiliation(s)
- A. Kothari
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia
- The University of Queensland, St Lucia, Queensland 4067 Australia
| | - G. Bruxner
- Metro North Mental Health Service, Butterfield St, Herston, Queensland 4029 Australia
| | - L. Callaway
- The University of Queensland, St Lucia, Queensland 4067 Australia
- The Royal Brisbane and Women’s Hospital, Herston, Queensland 4006 Australia
| | - J. M. Dulhunty
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia
- The University of Queensland, St Lucia, Queensland 4067 Australia
- The Royal Brisbane and Women’s Hospital, Herston, Queensland 4006 Australia
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17
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Schobinger E, Vanetti M, Ramelet AS, Horsch A. Social support needs of first-time parents in the early-postpartum period: A qualitative study. Front Psychiatry 2022; 13:1043990. [PMID: 36590631 PMCID: PMC9794858 DOI: 10.3389/fpsyt.2022.1043990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Background The early postpartum period is a critical time for first-time parents as they adapt to their new role. Perceived lack of social support is a risk factor for developing mental health problems. Insufficient or inappropriate professional support for both parents has been reported by many studies. Social support that appropriately meets parents' needs is an important protective factor for parents' wellbeing; however, little is known about the social support needs of both first-time parents. Aims and objectives To describe both first-time parents' formal social support needs in the early postpartum period. Method Individual semi-structured interviews were conducted with first-time parents recruited on the postpartum ward of a Swiss university hospital. Thematic analysis was used to identify themes and sub-themes. Results Fifteen mothers and eleven fathers were interviewed. Twelve themes were identified. Mothers' themes were "experiencing postpartum changes," "creation of a family unit," "self-esteem," "emotional needs," "difficulty in communicating their needs," and "the postpartum stay." Fathers' themes were "to be included in care procedures on the postpartum ward," "to be reassured," "to anticipate their postpartum stay" and "to consider their need as non-priority." Parental shared needs were: "to care for their newborn," and "returning home." Conclusion Mothers' and fathers' needs differed. Mothers needed more emotional support than fathers and fathers considered themselves as the main support for their partner. Fathers wanted to be integrated in the care of their newborn.
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Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
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18
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Johansson M, Wells MB, Thies-Lagergren L. A dreaded delight: A longitudinal qualitative interview study of paternal childbirth fear during the transition to fatherhood. Eur J Midwifery 2021; 5:52. [PMID: 34805781 PMCID: PMC8579550 DOI: 10.18332/ejm/142783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/08/2021] [Accepted: 10/01/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Childbirth is a life-changing event where fathers desire being involved. As fathers take a more active role, fear of childbirth can arise. The aim of this study was to explore fathers' experiences of childbirth fear during pregnancy and after the birth of their baby. METHODS This was a qualitative longitudinal prospective study that included 14 interviews with seven fathers, one during the prenatal period, and one follow-up interview after childbirth. Data were analyzed using thematic analysis according to Braun and Clark. RESULTS The main theme 'Being vulnerable during the transition to fatherhood' was based on the perception of childbirth as risky with threats toward the woman's and baby's health, not being able to give and receive enough support, unable to handle the unknown process of birth, and not being a good father. Helpful strategies for coping with fear were to talk about fear, to learn more about childbirth and techniques on how to handle fear, and to avoid dealing with fear. Fathers' fear of childbirth changed after the birth of their baby. Their thoughts of another childbirth did not evoke the same strong feelings of fear. Issues important for the reduction of childbirth fear were: receiving professional support, actively taking part in the childbirth process, and the partner having an uncomplicated birth. CONCLUSIONS Fathers with childbirth fear regarded childbirth as risky, but they expressed helpful coping strategies. After the birth of their baby, they became less fearful. Quality of fear-reducing support to expectant fathers may influence how they cope with their transition into fatherhood.
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Affiliation(s)
- Margareta Johansson
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Li Thies-Lagergren
- Department of Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Lund, Sweden.,Department of Obstetrics and Gynecology, Helsingborgs Lasarett, Helsingborg, Sweden
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19
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Franzen J, Cornet I, Vendittelli F, Guittier MJ. First-time fathers' experience of childbirth: a cross-sectional study. Midwifery 2021; 103:103153. [PMID: 34628181 DOI: 10.1016/j.midw.2021.103153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 06/09/2021] [Accepted: 09/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purposes of this study are to report first-time fathers' experiences of childbirth through three dimensions (professional support, worries and prenatal preparation) and to analyse the influence of sociodemographic, antenatal and obstetrical factors on the three dimensions. SETTING Participants were recruited in France and Switzerland from two university hospitals that routinely manage high-risk pregnancies (level 3 - perinatal care level), with 4,000 to 5,000 annual births each. METHODS This is a secondary analysis of a cross-sectional study. The data initially were collected for the cross-cultural validation of the First-Time Father Questionnaire (FTFQ) into French. Descriptive statistics were used to report the participants' characteristics and their questionnaire responses. Multivariate linear regression analysis was carried out to stress the positive or negative factors linked with fathers' experiences of childbirth. FINDINGS Among 350 first-time fathers, 160 completed the FTFQ (response rate of 45.7%). The average age of the participants was 33 years old. We observed 12 questionnaire items with more than 20% unfavourable responses, seven of which involved the measurement of the worry dimension. Antenatal education and the prenatal-preparation dimension were positive factors linked with fathers' experiences. In addition, 57% of participants reported using one means of antenatal education, and 45% accessed information from family or friends. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The results suggest that first-time fathers need more professional support to foster positive experiences of childbirth. Their experiences of childbirth are associated with considerable worry. Antenatal classes specifically for fathers could reduce this worry and support the fatherhood process. Research should be carried out on these topics.
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Affiliation(s)
- Jessica Franzen
- School of Health Sciences Geneva HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Isabelle Cornet
- School of Health Sciences Geneva HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Françoise Vendittelli
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Marie-Julia Guittier
- School of Health Sciences Geneva HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland; University Hospitals of Geneva, Department of Obstetrics & Gynaecology, Switzerland.
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20
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Vedeler C, Nilsen A, Blix E, Downe S, Eri TS. What women emphasise as important aspects of care in childbirth - an online survey. BJOG 2021; 129:647-655. [PMID: 34532959 DOI: 10.1111/1471-0528.16926] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore and describe what women who have given birth in Norway emphasise as important aspects of care during childbirth. DESIGN The study is based on data from the Babies Born Better online survey, version 2. SETTING The maternity care system in Norway. STUDY POPULATION Women who gave birth in Norway between 2013 and 2018. METHOD Descriptive statistics were used to describe sample characteristics and to compare data from the B3 survey with national data from the Medical Birth Registry of Norway. The open-ended questions were analysed with an inductive thematic analysis. MAIN OUTCOME MEASURES Themes developed from two open-ended questions. RESULTS The final sample included 8401 women. There were no obvious differences between the sample population and the national population with respect to maternal age, marital status, parity, mode of birth and place of birth, except for the proportion of planned home births. Four themes and one overarching theme were identified; Compassionate and Respectful Care, A Family Focus, Sense of Continuity and Consistency, and Sense of Security. Overarching theme: Coherence in Childbearing. CONCLUSIONS Norwegian women across all birth settings emphasise maternity care that authentically focuses on both socio-cultural and psychological aspects of care, and physical and clinical factors. If the positive aspects of care identified in this study are adopted at all levels of the maternity care system and from all care providers, there is a high chance that most women will have a safe outcome, and a strong sense of coherence related to a positive birth and motherhood experience. TWEETABLE ABSTRACT Having a baby is a pivotal life changing experience and not just a clinical event, according to a survey of 8400 women in Norway. Positive birth and motherhood experiences depend on maternity staff who are both skilled and kind.
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Affiliation(s)
- C Vedeler
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Abv Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - E Blix
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - S Downe
- Research in Childbirth and Health (ReaCH) Group/THRIVE Centre, University of Central Lancashire, Preston, UK
| | - T S Eri
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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21
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Biden EJ, Greenwood CJ, Macdonald JA, Spry EA, Letcher P, Hutchinson D, Youssef GJ, McIntosh JE, Olsson CA. Preparing for Future Adversities: Lessons From the COVID-19 Pandemic in Australia for Promoting Relational Resilience in Families. Front Psychiatry 2021; 12:717811. [PMID: 34421689 PMCID: PMC8371315 DOI: 10.3389/fpsyt.2021.717811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic has placed considerable pressure on families, testing the quality of relationships and the strength of social support within and beyond the family network. However, little is known about the pre-pandemic factors that predict family relational resilience and social functioning during times of natural disaster or global crisis. Here we use data from one of Australia's longest running studies of social and emotional development to examine the nature and timing of possible relational and social support intervention aimed at preparing families for future adversities. Methods: Data were from the Australian Temperament Project Generation 3 (ATPG3) Study, a population representative three generation cohort study of families established in 1983. A subset of Generation 2 parents completed a COVID-19 specific survey in May-September 2020 (502 parents of 871 children; 60% mothers; 37-38 years). These participants had completed the Quality of Relationships Inventory to assess social support during young adulthood, at 23-24 years (2006) and 27-28 years (2010), before next generation conception. Participants had also completed the Maternity Social Support Scale 1 year postpartum for each child born across the ATPG3 assessment period (2012-2019). In 2020, during the height of the Australian lockdowns, participants rated the quality of their relationships with their partners, children and broader family and friends, in addition to social support within and extended beyond their family. Results: Pre-pandemic partner support was associated with partner relationship quality during the pandemic (β = 0.22). Pre-pandemic support from friends was associated with relationship quality with other family and friends during the pandemic (β = 0.12 - 0.18). Pre-pandemic support (from partner, family and friends) was consistently associated with social support within families during the pandemic (β = 0.11 - 0.21). Pre-pandemic support from friends was also associated with family support extended to others within their local community during the pandemic (β = 0.12 - 0.13). Conclusions: Strengthening supportive relationships during major life transitions, prior to the start of family life and in early parenthood, may have long-term and intergenerational benefits years into the future for both families and communities. This may promote resilience during future crises and other more normative stressful life events.
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Affiliation(s)
- Ebony J. Biden
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jacqui A. Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A. Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - George J. Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jennifer E. McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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22
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. Nurs Womens Health 2021; 25:e8-e53. [PMID: 34099430 DOI: 10.1016/j.nwh.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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23
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. J Obstet Gynecol Neonatal Nurs 2021; 50:e1-e46. [PMID: 34099348 DOI: 10.1016/j.jogn.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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24
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Vahtel K, Eilmann K, Pühvel J, Kangasniemi M. Expectant fathers' experiences of family-centred births in Estonia: a qualitative study. Midwifery 2021; 96:102948. [PMID: 33631412 DOI: 10.1016/j.midw.2021.102948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/19/2020] [Accepted: 02/10/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE One of the aims of family-centred care is to provide expectant fathers with positive experiences during childbirth, so they can support their partners and bond with their new baby. However, research in this area has been limited. This study described men´s experiences with family-centred births in Estonia, Northern Europe. DESIGN Qualitative study with open-ended interviews that were audio taped and analysed by inductive content analysis by Elo and Kyngäs (2008). SETTING Birth units at one central and one regional hospital in Estonia. PARTICIPANTS Twelve Estonian fathers aged 22-44, interviewed 4-12 weeks after their baby's birth. KEY CONCLUSIONS Fathers' experiences of family-centred care during their baby's birth focused on their transition to fatherhood, their experiences of birth as a multifactorial life event and the experiences they shared with other fathers. They discussed supporting their partners during the birth, their involvement in decision making, the attitudes of healthcare professionals and how their role in the family changed. The fathers said that the birth was a private and public event, where their own role, and the roles of healthcare professionals, were confusing. This made family-centred care difficult during the birth. Sharing experiences with other fathers decreased their fears and increased their understanding of becoming fathers. Some fathers were not ready for fatherhood and midwives needed to assess how involved fathers wanted to get during the birth. IMPLICATIONS FOR PRACTICE Family-centred care is important during birth, but more research is needed into how fathers see their role. The roles played by medical staff also need to be clearer. Better knowledge about what fathers expect and need, can help midwives to involve and support them at a level they feel comfortable with. Peer support can play a vital role in preparing fathers for birth and fatherhood.
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Affiliation(s)
- Käthlin Vahtel
- Health Education Centre, Midwife Curriculum, Tallinn Health Care College, Tallinn, Estonia.
| | | | - Janne Pühvel
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Mari Kangasniemi
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia; Department of Nursing Science, Faculty of Medicine, University of Turku, Finland.
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Wells MB, Aronson O. Paternal postnatal depression and received midwife, child health nurse, and maternal support: A cross-sectional analysis of primiparous and multiparous fathers. J Affect Disord 2021; 280:127-135. [PMID: 33212403 DOI: 10.1016/j.jad.2020.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/21/2020] [Accepted: 11/07/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fathers want more professional and social support during the transition to fatherhood. It is unclear if these supports are associated with decreased depressive symptoms in fathers of infants. AIM The aim of the current study was to assess if fathers' self-reported received professional and social support were related to changes in the odds for having depressive symptoms, with interaction terms focusing on differences of support based on the fathers' parity. METHODS In total, 612 fathers from Sweden completed a Facebook-advertised anonymous online survey. The Edinburgh Postnatal Depression Scale was used to detect depressive symptoms (≥10 points). Multiple imputation of missing data was performed. Logistic regressions were used, with interaction terms for fathers' parity. RESULTS Around 21% of fathers had depressive symptoms. There were no associations between depressive symptoms frequencies and paternal parity. Fathers reported fewer depressive symptoms when they received professional support from the prenatal midwife (OR = .39, p = .007), labor/birth midwife/nurse team (OR = .42, p = .021), and child health nurse (OR = .25, p = .001), as well as social support from their partner and if they had a higher income (odds ratios vary in different models). Multiparous fathers received significantly less professional and social support and were less frequently invited to child health visits than primiparous fathers. LIMITATIONS The data collected was cross-sectional; therefore, causal links cannot be determined. CONCLUSIONS Both primiparous and multiparous fathers should receive postnatal depression screenings and interventions to help reduce their depressive symptoms.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet.
| | - Olov Aronson
- School of Health and Welfare, Jönköping University
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Barriers and Facilitators of Safe Communication in Obstetrics: Results from Qualitative Interviews with Physicians, Midwives and Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030915. [PMID: 33494448 PMCID: PMC7908168 DOI: 10.3390/ijerph18030915] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/13/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022]
Abstract
Patient safety is an important objective in health care. Preventable adverse events (pAEs) as the counterpart to patient safety are harmful incidents that fell behind health care standards and have led to temporary or permanent harm or death. As safe communication and mutual understanding are of crucial importance for providing a high quality of care under everyday conditions, we aimed to identify barriers and facilitators that impact safe communication in obstetrics from the subjective perspective of health care workers. A qualitative study with 20 semi-structured interviews at two university hospitals in Germany was conducted to explore everyday perceptions from a subjective perspective (subjective theories). Physicians, midwives, and nurses in a wide span of professional experience and positions were enrolled. We identified a structural area of conflict at the professional interface between midwives and physicians. Mandatory interprofessional meetings, acceptance of subjective mistakes, mutual understanding, and debriefings of conflict situations are reported to improve collaboration. Additionally, emergency trainings, trainings in precise communication, and handovers are proposed to reduce risks for pAEs. Furthermore, the participants reported time-constraints and understaffing as a huge burden that hinders safe communication. Concluding, safety culture and organizational management are closely entwined and strategies should address various levels of which communication trainings are promising.
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Morton CH, Hall MF, Shaefer SJM, Karsnitz D, Pratt SD, Klassen M, Semenuk K, Chazotte C. National Partnership for Maternal Safety: Consensus Bundle on Support After a Severe Maternal Event. J Obstet Gynecol Neonatal Nurs 2021; 50:88-101. [PMID: 33220179 DOI: 10.1016/j.jogn.2020.09.160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2020] [Indexed: 11/20/2022] Open
Abstract
Supporting women, families, and clinicians with information, emotional support, and health care resources should be part of an institutional response after a severe maternal event. A multidisciplinary approach is needed for an effective response during and after the event. As a member of the maternity care team, the nurse's role includes coordination, documentation, and ensuring patient safety in emergency situations. The National Partnership for Maternal Safety, under the guidance of the Council on Patient Safety in Women's Health Care, has developed interprofessional work groups to develop safety bundles on diverse topics. This article provides the rationale and supporting evidence for the support after a severe maternal event bundle, which includes structure- and evidence-based resources for women, families, and maternity care providers. The bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning, and it may be adapted by nurses and multidisciplinary leaders in birthing facilities for implementation as a standardized approach to providing support for everyone involved in a severe maternal event.
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Jarneid H, Gjestad K, Røseth I, Dahl B. Fathers' Experiences of Being Present at an Unplanned Out-of-Hospital Birth: A Qualitative Study. J Multidiscip Healthc 2020; 13:1235-1244. [PMID: 33132700 PMCID: PMC7591965 DOI: 10.2147/jmdh.s272021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/24/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate fathers' experiences of being present at an unplanned birth outside a maternity facility. MATERIALS AND METHODS This was a qualitative interview study with 12 fathers from six of Norway's eleven counties. All had been present at an unplanned out-of-hospital birth in 2015-2020. Data were analyzed using systematic text condensation. RESULTS The data analysis resulted in four themes. The first theme described the fathers' stress and worry and how they managed to keep a cool head and think rationally in a totally unprepared situation. The second theme described the fathers' need for help and the reassuring feeling provided by contact with health professionals. The third theme described how the birth increased the father's attachment to his partner and baby, while the fourth theme described fathers' feelings of exclusion and their reactions following the birth. CONCLUSION Fathers' perceived lack of expertise and their fear of complications led to stress, worry and anxiety, but support from health personnel provided reassurance and control. Many fathers experienced mastery, pride and joy after the birth, but when arriving at hospital, they felt rejected and wished that maternity care staff had approached them to talk about the experience.
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Affiliation(s)
- Henriette Jarneid
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Kristin Gjestad
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Idun Røseth
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway.,Department of Child and Adolescent Mental Health, Telemark Hospital, Skien, Norway
| | - Bente Dahl
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
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Barthel D, Göbel A, Barkmann C, Helle N, Bindt C. Does Birth-Related Trauma Last? Prevalence and Risk Factors for Posttraumatic Stress in Mothers and Fathers of VLBW Preterm and Term Born Children 5 Years After Birth. Front Psychiatry 2020; 11:575429. [PMID: 33384624 PMCID: PMC7769835 DOI: 10.3389/fpsyt.2020.575429] [Citation(s) in RCA: 12] [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: 06/24/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022] Open
Abstract
Previous research suggests that the birth of a preterm child with very low birth weight (VLBW; <1,500 g) can be traumatic for both parents and lead to short-term consequences like clinical levels of posttraumatic stress symptoms (PTSS) or even to the development of a Posttraumatic Stress Disorder (PTSD). However, little is known about possible mid- and long-term psychological consequences in affected parents. The purpose of this study were (a) to examine the prevalence of parental birth-related PTSS and PTSD in a group of parents with VLBW preterm infants compared to parents of full-term infants 5 years after birth and (b) to investigate potential associations with risk factors for parental PTSS at 5 years postpartum. Perinatal factors (VLBW preterm or term, perceived stress during birth), psychological factors (perceived social support and PTSS 4-6 weeks postpartum, psychiatric lifetime diagnosis) and sociodemographic characteristics (number of children, singleton or multiple birth, socio-economic status), were included in the analysis. The sample consisted of 144 families (77 VLBW, 67 term birth) who participated in the prospective longitudinal cohort study "Hamburg study of VLBW and full-term infant development" (HaFEn-study) and were initially recruited at three perinatal care centers in Hamburg, Germany. PTSD prevalence and PTSS of mothers and fathers were assessed with the Impact of Event Scale-Revised (IES-R), social support with the Questionnaire of Social Support (SOZU-K-22), and lifetime psychiatric diagnoses with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Data were analyzed by hierarchic multiple regression analyses. Results showed that 5 years after birth none of the parents fulfilled the criteria for a birth-related PTSD diagnosis. For mothers, postnatal PTSS and a VLBW preterm birth significantly predicted PTSS 5 years postpartum. For fathers, psychiatric lifetime diagnosis and postnatal PTSS significantly predicted PTSS 5 years after birth. Early identification of parents with higher risk of PTSS, especially after VLBW preterm birth, and their clinical needs seems beneficial to reduce the risk of long-term consequences. More research is needed on the paternal perspective and on potential effects of preterm birth on both parents and their children's mental health outcomes.
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Affiliation(s)
- Dana Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Ouwendijk-Andréa M, Bröring-Starre T, Molderink AC, Laarman CARC, Oostrom KJ, van Dijk-Lokkart EM. Parental emotional distress after discharge from the neonatal intensive care unit: A pilot study. Early Hum Dev 2019; 140:104892. [PMID: 31715521 DOI: 10.1016/j.earlhumdev.2019.104892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Mieke Ouwendijk-Andréa
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands.
| | - Tinka Bröring-Starre
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands
| | - Alice C Molderink
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
| | - Céleste A R C Laarman
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Department of Neonatology, Amsterdam University Medical Centers, the Netherlands
| | - Kim J Oostrom
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
| | - Elisabeth M van Dijk-Lokkart
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
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van Steijn ME, Scheepstra KWF, Zaat TR, van der Post JAM, Olff M, van Pampus MG. Posttraumatic stress disorder in partners following severe postpartum haemorrhage: A prospective cohort study. Women Birth 2019; 33:360-366. [PMID: 31307939 DOI: 10.1016/j.wombi.2019.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/21/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Partners of women are increasingly present during childbirth and may be exposed to a traumatic experience. Since parents' mental health issues (i.e. posttraumatic stress disorder) have been shown to increase the risk of problems in the child's development, it is important to identify these risk factors. Partners often describe severe postpartum haemorrhage as traumatic. AIM Whether witnessing severe postpartum haemorrhage is a risk factor for developing posttraumatic stress disorder in partners. METHODS In this prospective cohort study, we compared partners of women with severe postpartum haemorrhage (≥2000 mL) and partners of women with ≤500 mL of blood loss (controls). Four weeks after birth partners were screened for posttraumatic stress disorder symptoms with a self-report questionnaire. Scores ≥11 were followed by a gold standard clinical interview to diagnose posttraumatic stress disorder. FINDINGS We included 123 severe postpartum haemorrhage partners and 62 control partners. Partners of women with severe postpartum haemorrhage reported higher scores than control partners (median 3.0 (0.0-7.0) vs 2.0 (0.0-4.0), p = 0.04) on symptoms of posttraumatic stress, but no significant difference in probable posttraumatic stress disorder diagnosis according to the self-report questionnaire was found. According to the clinical interview no partners were diagnosed with posttraumatic stress disorder. Severe postpartum haemorrhage was experienced as traumatic by the partners who felt excluded. CONCLUSION None of the partners developed posttraumatic stress disorder, revealing the resilience of young fathers. Because some partners reported severe postpartum haemorrhage as traumatic, we recommend sufficient information and support is provided during childbirth.
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Affiliation(s)
- Minouk E van Steijn
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Karel W F Scheepstra
- Department of Psychiatry, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Tjitske R Zaat
- Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Joris A M van der Post
- Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Miranda Olff
- Department of Psychiatry, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, The Netherlands
| | - Maria G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands
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Current Resources for Evidence-Based Practice, July 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:478-491. [PMID: 31194933 DOI: 10.1016/j.jogn.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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