Relationship With the Father of the Baby and Perceived Stress Among Black Women

A Mixed Methods Approach to Understand Mother-Father Relationship and Perceived Stress Among Black Pregnant Women

BACKGROUND

Black women in the United States report moderate to high levels of perceived stress during pregnancy. Though lower levels of involvement and support from father of the baby (FOB) and higher levels of conflict have been associated with higher levels of maternal perceived stress, it is not clear how Black pregnant women experience the mother-father relationship and its influence on perceived stress.

PURPOSE

To examine and describe the mother-father relationship and its role in experiences of perceived stress from the perspective of Black pregnant women.

METHODS

Using a convergent, mixed methods approach with ideal-type analysis, we conducted a secondary analysis of data among 60 Black pregnant women enrolled in the Biosocial Impact on Black Births study. Women completed online self-report questionnaires and participated in a semi-structured interview by telephone.

RESULTS

Participants who reported more conflict with FOB also reported higher levels of perceived stress (ρ(47) = .431, P= .002). Themes (importance, communication, support, conflict, satisfaction, and stress) emerged from the data. Five distinct mother-father relationship typologies were identified following an ideal-type analysis of the combined dataset: Cared For; Managing Expectations; Just Friends, For the Kids; It's Complicated; and Can't be Bothered.

CONCLUSIONS

These findings are an innovative exemplar of ideal-type analysis and provide a deeper understanding of the nuance and dynamics within the mother-father relationship and how it influences perceived stress among Black pregnant women.

IMPLICATIONS

Clinicians must recognize the significance of the mother-father relationship and, when appropriate, encourage paternal involvement or intervene if there is conflict during pregnancy.

Perinatal Mental Health: Father Inclusion At The Local, State, And National Levels

Fathers occupy a dual role in the realm of perinatal mental health: partner and parent. In fathers' role as partners, their support for mothers during pregnancy and postpartum is associated with improved maternal mental health. In their role as parents, fathers themselves are vulnerable to perinatal mood and anxiety disorder. This article aims to advance awareness of paternal perinatal mental health issues and impacts on families. We first review the evidence on paternal perinatal mental health. This evidence includes the critical role played by fathers in maternal perinatal mental health, the prevalence of paternal perinatal mood and anxiety disorder, the impact of paternal mental health on child and family well-being, and screening and treatment approaches. Next, we offer recommendations for more inclusive approaches at the local, state, and national levels aimed at improving parental mental health and health outcomes for fathers, mothers, and babies.

Mother-Father Relationship and Depressive Symptoms Among Pregnant Black Women

BACKGROUND

Black women report higher levels of depressive symptoms during pregnancy than white women. A supportive relationship with the father of the baby may be protective and decrease depressive symptoms.

OBJECTIVE

We sought to examine the association between mother-father relationship and depressive symptoms among pregnant black women.

METHODS

Using a cross-sectional design, we conducted a secondary data analysis from a subsample of 405 pregnant black women who participated in the Biosocial Impact on Black Births study, a prospective cohort study. Participants completed questionnaires at 19- to 29-week gestation, including 6 measures of their relationship with the father of the baby: (1) contact, (2) involvement, (3) overall relationship, (4) change in relationship from prior to pregnancy to during pregnancy, (5) support, and (6) conflict. Latent class analysis was used to identify and classify the relationship construct. The Center for Epidemiologic Studies-Depression (CES-D) scale was used, with scores ≥23 considered high levels of depressive symptoms. Data were analyzed with logistic regression.

RESULTS

Following adjustment for maternal sociodemographic characteristics, comorbid conditions, and health behaviors, women in a conflictual relationship had higher odds of having depressive symptom scores ≥23 (adjusted odds ratio: 3.50, 95% confidence interval: 2.00, 6.12) than those having no relationship (adjusted odds ratio: 2.81, 95% confidence interval: 1.43, 5.52), when compared with those with a good relationship.

CONCLUSIONS

These findings suggest that having either a conflictual or no relationship with the father of the baby during pregnancy increases the odds for higher maternal depressive symptoms (CES-D scores ≥ 23) among pregnant black women.

Fathers Matter: Black Fathers' Relationships with their Partners during Pregnancy and Postpartum

PURPOSE

To describe the characteristics of participants in the Fathers Matter study for a better understanding of fathers of the baby who engage in pregnancy research involving primarily Black couples and their relationships with their partners.

STUDY DESIGN AND METHODS

The Fathers Matter Study uses a prospective design, identifying father-mother dyads during pregnancy and following them until birth as part of the Biosocial Impacts on Black Births Study. Participants completed prenatal and postpartum questionnaires.

RESULTS

Our analyses are based on 111 fathers. Nearly all ( n = 101, 91.1%) of fathers identified as Black and 51.4% ( n = 57) had a high school diploma, graduate equivalency diploma, or higher. About half ( n = 57, 51.4%) reported annual incomes of $10,000 or less. Most reported that relationships with the mother were very close both before ( n = 100, 89.9%) and during ( n = 85, 76.6%) pregnancy. However, substantial variability was found in relationship satisfaction, involvement in the pregnancy, financial support provided, and scales of conflict and support.

CLINICAL IMPLICATIONS

We found homogeneity in sociodemographic and basic relationship measures. Complex measures of the father-mother relationships demonstrated considerable variability. Data from fathers may identify their contributions to successful birth outcomes. Understanding relationships between fathers and mothers could identify risk or protective characteristics to be addressed at the family or community levels.

Black fathers' contributions to maternal mental health

This mixed-methods research study aimed to assess the contribution of interparental relationship quality and paternal support for mothers to maternal mental health among Black parents in a metro area characterized by severe racial disparities. We also explored Black parents' understanding of meaningful paternal support for mothers. Using survey data collected from Black mothers (N = 75), we examined correlations among the study variables, then conducted mediation and moderation analyses to examine whether relationship quality would mediate the association between paternal support and maternal mental health and to test whether relationship quality would moderate the association between paternal support and maternal self-reported overall health. We used inductive thematic analysis to analyze data from focus groups with Black parents (N = 15). We found that mothers' mental health was positively correlated with relationship quality, mothers' subjective health was positively correlated with paternal support, and relationship quality significantly mediates the relationship between paternal support and maternal mental health while controlling for relationship status. Our thematic analysis yielded four themes to characterize meaningful paternal support for mothers and a high quality interparental relationship: (1) Teammates; (2) Multidimensional, everyday support; (3) Communication is key; and (4) Challenge racism and disrupt intergenerational trauma. Findings suggest that paternal support and interparental relationship quality can play a protective role, promoting maternal mental health and wellbeing. Providers of perinatal services should support Black parents to support one another, including as advocates in confronting racism.

The Impact of a Father's Adverse Childhood Experiences (ACEs) on the Relationship He Has with the Mother of His Baby

The relationship between the father and mother during pregnancy has been linked to pregnancy outcomes. However, factors that influence this relationship have not been studied in depth. Adverse childhood experiences (ACEs) of the father have been associated with poor health and functioning in adulthood, and may be important factors that impact the prenatal relationship between the parents. We recruited 117 fathers from a study that examined the risk of preterm birth in pregnant Black women. Of the fathers recruited, 113 completed questionnaires and provided survey data to determine behavioral, health, psychosocial, social, and sociodemographic characteristics. The mean ACEs score represents 107 fathers with 6 missing. The fathers' ACEs scores were measured using a 10-item self-report survey assessing whether each of the presented ACEs were experienced by the participant prior to the age of 18 years. Perceived conflict in the relationship between the father of the baby and mother of the baby was measured using a 5-item questionnaire scored on the 5-point Likert scale. For the Likert scale, 112 fathers provided data with 1 missing. A t-test was then used to compare the average score on the conflict scale with the mean ACEs of 67 fathers with 2 or fewer ACEs, and 40 fathers with 3 or more ACEs (6 missing). This study hypothesized that fathers with higher rates of exposure to ACEs would have higher scores on the conflict scale, indicating more conflict with the mother. The average score on the conflict scale was significantly higher (difference in means, 2.20 points, p=0.023) for fathers with an ACEs of 3 or more (mean± standard deviation: 12.2±4.6) relative to those with an ACEs of 2 or lower. (mean± standard deviation:14.4±5.0).

Family involvement in pregnancy and psychological health among pregnant Black women

Social determinants of health influence psychological health in pregnancy and contribute to health inequities in birth outcomes. This study examines the association between family involvement during pregnancy and psychological health among Black women. Pregnant women in Detroit, MI and Columbus, OH were recruited between 8 and 29 weeks' gestation (n = 203). Higher family involvement was associated with lower depressive symptoms (CES-D; β = -1.3, p < 0.001), perceived stress (β = -0.8, p < 0.001), and anxiety (β = -0.39, p < 0.01), and higher levels of psychological well-being (β = 2.2, p < 0.001). Family involvement may be a protective factor for pregnant Black women.