The transition to parenthood: perspectives of relationship science theories and methods

Prevalence and risk factors of intimate partner violence during the COVID-19 pandemic: Results from the population-based study DREAMCORONA

OBJECTIVES

This study examines the 12-month prevalence rates of intimate partner violence (IPV) victimization, including psychological, physical, and sexual forms, in women and men. It also aims to identify changes in IPV victimization during the COVID-19 pandemic and to explore factors associated with the occurrence of any IPV victimization during this period.

METHODS

Data from the DREAMCORONA study in Germany collected from May 2020 to February 2021 included 737 participants, i.e., (expectant) mothers (64%) and fathers (36%). The Revised Conflict Tactics Scale (CTS2S) short form was used to assess the 12-month IPV victimization. Prevalence of IPV victimization as well as changes in IPV victimization during the pandemic were analyzed descriptively, with results stratified by sex. Multiple logistic regression was employed to identify risk factors for IPV.

RESULTS

Psychological IPV was found to be the most prevalent form of violence, with the occurrence of any psychological IPV affecting 48.5% of women and 39.4% of men, while 2.6% of women and 3.3% of men reported the occurrence of any physical IPV victimization, and 2.8% of women and 1.5% of men reported the occurrence of any sexual IPV victimization. Of those who experienced the occurrence of any IPV in the last 12 months, 89.7% of women and 89.8% of men were victimized by one single act of violence. The majority of affected participants reported no change in psychological and physical IPV victimization during the pandemic. Nevertheless, for certain IPV behaviors on the psychological and physical IPV victimization subscales, both affected women and men also reported higher frequencies during the COVID-19 pandemic. Multiple logistic regression revealed that higher levels of relationship satisfaction were negatively associated with the occurrence of any IPV victimization for women and men, whereas greater levels of own anger-hostility symptoms were positively associated with the occurrence of any IPV victimization.

CONCLUSIONS

Psychological IPV was present in almost every second (expectant) couple. The majority of affected women and men reported no change in their psychological and physical IPV victimization, suggesting that they continued to experience IPV during the pandemic. This underlines the importance of promoting healthier relationship dynamics, coping strategies, and emotional well-being to reduce the risk of IPV, even in times of crisis. Our study sheds light on the early stages of the pandemic and highlights the ongoing need for research into the temporal dynamics of IPV.

Birth expectations, birth experiences and childbirth-related post-traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis

OBJECTIVES

During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth-related post-traumatic stress symptoms (CB-PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB-PTSS.

DESIGN

Dyadic longitudinal data from the Self-Hypnosis IntraPartum Trial.

METHODS

Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post-partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post-partum) and CB-PTSS (6 weeks post-partum).

RESULTS

Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB-PTSS. Birth experiences related to CB-PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB-PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB-PTSS.

CONCLUSIONS

Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB-PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB-PTSS. The impact of birth experiences on CB-PTSS highlights the importance of respectful and supportive maternity care.

Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research

BACKGROUND

Research suggests 1 in 3 births are experienced as psychologically traumatic and about 4% of women and 1% of their partners develop post-traumatic stress disorder (PTSD) as a result.

AIM

To provide expert consensus recommendations for practice, policy, and research and theory.

METHOD

Two consultations (n = 65 and n = 43) with an international group of expert researchers and clinicians from 33 countries involved in COST Action CA18211; three meetings with CA18211 group leaders and stakeholders; followed by review and feedback from people with lived experience and CA18211 members (n = 238).

FINDINGS

Recommendations for practice include that care for women and birth partners must be given in ways that minimise negative birth experiences. This includes respecting women's rights before, during, and after childbirth; and preventing maltreatment and obstetric violence. Principles of trauma-informed care need to be integrated across maternity settings. Recommendations for policy include that national and international guidelines are needed to increase awareness of perinatal mental health problems, including traumatic birth and childbirth-related PTSD, and outline evidence-based, practical strategies for detection, prevention, and treatment. Recommendations for research and theory include that birth needs to be understood through a neuro-biopsychosocial framework. Longitudinal studies with representative and global samples are warranted; and research on prevention, intervention and cost to society is essential.

CONCLUSION

Implementation of these recommendations could potentially reduce traumatic births and childbirth-related PTSD worldwide and improve outcomes for women and families. Recommendations should ideally be incorporated into a comprehensive, holistic approach to mental health support for all involved in the childbirth process.

Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health

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.

[Fathers and peripartum mental illness: the neglected parent?]

Fathers also play an important role during pregnancy and the postpartum period, both for the partner and for the child. With changes in society and increasing early involvement in the care of infants, the father-child relationship has become increasingly more important in recent years. There is growing evidence that fathers can also suffer from mental illnesses during their partner's pregnancy and especially after the birth of a child. As the transition to the role of a father is a major change in a man's life, the birth of a child can be a life event that contributes to a first time mental illness or triggers a new episode of an already existing illness. For example, birth complications can also traumatize the attendant fathers and result in trauma sequelae. Peripartum anxiety disorders and depression probably affect approximately 5% of all men and can among other things have a negative impact on the development of exposed children. Specific screening or even treatment services for affected men are still very rare and little research has been performed. Much less is known about the prevalence, risk factors, and treatment of other mental illnesses in fathers, and there is still a great need for research in this respect.

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

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.

Romantic Relationships from Adolescence to Established Adulthood

This 15-year longitudinal study investigated with follow-up data how romantic patterns from ages 16 to 24 are associated with romantic involvement and turnover (ages 25-30), romantic dispositions (age 30) and romantic relationships characteristics (age 30). A sample of 255 individuals (60.8% women) identified all their romantic partners between the ages of 16 and 24. Between ages 25 and 30, participants identified all their romantic partners and the length of each relationship. At age 30, they also completed a series of questionnaires regarding romantic dispositions and if it applied, characteristics of their current romantic relationship. Results indicated continuity in the romantic sphere from adolescence to established adulthood. At age 30, romantic patterns were associated with: avoidance of intimacy, jealousy, global romantic satisfaction, relationship status and the duration of the current romantic relationship. Together, these results bring new information on romantic development from adolescence to established adulthood.

Dyadic approach to maturity to parenthood: multilevel study on attachment in expectant and non-expectant couples

OBJECTIVE

This study examined links between attachment styles and maturity to parenthood and its dimensions across different age groups of childless young adult couples. The role of developmental factors (age, assuming parental role) for maturity to parenthood was also investigated.

BACKGROUND

Relational and individual factors have both been confirmed to be crucial for the transition to parenthood. The concept of maturity to parenthood has been linked to individual values, personality traits, and close relationships. However, the question arises whether maturity to parenthood is related to one of the most crucial concepts in family psychology - attachment.

METHOD

Three hundred heterosexual young adult couples aged 20-35 years (M_age  = 26.20; SD  = 3.63) took part. Couples were divided into three groups: 1) 110 couples aged 20-25 (emerging adulthood); 2) 90 couples aged 26-35 (young adulthood); and 3) 100 couples aged 20-35 expecting their first child (third trimester of pregnancy). The main questionnaires used were the Maturity to Parenthood Scale and Close Relationship Experience Scale.

RESULTS

The results indicated that the more avoidant couples had lower maturity to parenthood. A moderation effect of group (pregnancy) was also observed - the effect of attachment-related avoidance was weaker in expectant couples. Women presented higher overall and behavioural maturity to parenthood than men. Furthermore, higher life satisfaction were associated with greater maturity to parenthood.

CONCLUSION

Maturity to parenthood is also created in the dyadic context. When related to lower attachment avoidance, it might greatly facilitate transition to parenthood and future parent - child relations.

Partner support and relationship quality as potential resources for childbirth and the transition to parenthood

BACKGROUND

The aim of the present paper was to explore the role of partners for the stressful life events of birth and the transition to parenthood.

METHODS

In a first prospective longitudinal study (N = 304 dyads) we tested whether relationship quality positively predicted fewer interventions during labor and birth, a more positive birth experience, and better well-being during the first six weeks after birth. In a second study we surveyed mothers (N = 980; retrospective quasi-experimental design) who had given birth during the first lockdown of the COVID-19 pandemic in spring 2020 - some in the absence of their partners - to test the assumption that regardless of relationship quality, the presence of the partner was positively related to low-intervention births and the birth experience.

RESULTS

The results of the longitudinal study (Study 1) could be integrated into a Single Indicator model. They revealed that a high relationship quality assessed between week 5 and week 25 of pregnancy had a positive effect on birth experience for the mother and on psychological well-being during the transition to parenthood for both mothers and fathers. Results of the retrospective quasi-experimental field study (Study 2) revealed that the continuous presence of the partner was associated with a higher probability of a low-intervention birth and a more positive birth experience. Presence of a partner for only part of the birth did not positively predict labor and birth, but did positively predict the birth experience. The effects were independent of relationship quality.

CONCLUSION

The results of both studies highlight the importance of partners for psychological well-being during labor and birth and the transition to parenthood.

The impact of postpartum obsessive-compulsive symptoms on child development and the mediating role of the parent-child relationship: A prospective longitudinal study

BACKGROUND

The first 2 years of life are a particularly sensitive period for the parent-child relationship as well as a healthy, age-appropriate child development. Both have been shown to be linked to postpartum depressive and anxiety symptoms, while the role of obsessive-compulsive symptoms, which are also common, is still largely understudied. In addition, fathers have been neglected in this area of research. This study, which includes both mothers and fathers, aims to investigate the longitudinal associations between postpartum obsessive-compulsive symptoms and different domains of child development, as well as the mediating role of the parent-child relationship.

METHODS

Data were drawn from the prospective longitudinal study DREAM, with 674 mothers and 442 fathers from the general population completing self-report questionnaires at four measurement points. Longitudinal associations between parental postpartum obsessive-compulsive symptoms 8 weeks postpartum, the parent-child relationship 14 months postpartum, and child development 24 months postpartum were investigated using regression and mediation analyses. A number of potential confounding variables were considered, i.e., age, academic degree, postpartum depressive and anxiety symptoms of the parents, preterm birth and temperament of the child, as well as COVID-19 pandemic-driven adversities.

RESULTS

When adjusting for confounders, neither maternal nor paternal postpartum obsessive-compulsive symptoms had adverse effects on the respective parent-child relationship and child development. Further, no mediating role of the parent-child relationship between parental postpartum obsessive-compulsive symptoms and child development could be confirmed. Instead, we found that the mother- and father-child relationship were differentially related to specific child developmental domains. For mothers, a poorer mother-child relationship was prospectively related to poorer fine motor development. For fathers, a poorer father-child relationship prospectively predicted a poorer overall development as well as poorer gross motor, fine motor, problem-solving, and personal-social development.

CONCLUSION

Our results suggest that negative effects on the parent-child relationship and child development may only become apparent in full-blown postpartum obsessive-compulsive disorder. Given the differential impact on specific developmental domains, our findings also suggest that it is crucial to consider both parents in clinical practice as well as in future research, rather than focusing only on the mother-child dyad.