Relationship in Japan between maternal grandmothers' perinatal support and their self-esteem

Mothers with depressed mood: help-seeking from husbands and child-rearing behaviors

BACKGROUND

Mothers with depressed mood tend not to seek help or support from others. Yet, there is no research providing a detailed examination of the processes that mothers with depressed mood undergo while seeking child-rearing support from their husbands. This study aimed to clarify the processes that mothers with depressed mood go through in seeking child-rearing support from their husbands and performing child-rearing duties.

METHODS

The participants were 10 mothers living in Japan who had given birth within the past three years and were suspected of having depression after screening using the Edinburgh Postnatal Depression Scale. Semi-structured interview data were analyzed based on the grounded theory.

RESULTS

The responses revealed that the mothers felt as though they had insufficient time for themselves, which impelled them to seek support from their husbands, consequently leading them to conclude either that child-rearing and housework are difficult or that child-rearing can be managed some way or another.

CONCLUSION

When the husbands fully cooperated in child-rearing or demonstrated their willingness to cooperate in child-rearing, despite difficulty, the wives accepted their child-rearing support. On the other hand, if the husbands did not recognize their wives' efforts, the wives did not accept their support, even if they had helped with child-rearing. In this way, the wives re-evaluated their relationship with the husbands based on their husbands' attitudes toward child-rearing.

Mothers susceptible to child maltreatment and requiring public health nurses' continuous support

OBJECTIVE

This study aimed to identify the characteristics of mothers who are at a high risk for future child maltreatment and therefore, require continuous support from public health nurses (PHNs) to prevent child maltreatment and those who do not require it.

DESIGN AND SAMPLES

This retrospective cross-sectional study included women who were registered in 2018 for being at risk for future child maltreatment and required help with childrearing in City A within the Tokyo metropolis.

MEASUREMENTS

Public health nurses registered data pertaining to each mother, including demographic data, family-related variables, assessment by PHNs, use of maternal and child healthcare services, and continuity of support from PHNs.

RESULTS

Of the 206 cases, the discontinued group-comprising those who no longer needed PHNs' support-included 83 cases (40.3%) and the continuing group-comprising those needed continuing support-included 123 cases (59.7%). Logistic regression analysis showed that those with marital conflicts, maternal mental instability, lack of parenting skills, and not moving out of the city were more likely to require continuous PHNs' support.

CONCLUSIONS

By identifying these factors, PHNs can identify new mothers who need continuous support and provide more concentrated care for them. Thus, support from PHNs can help prevent child maltreatment.

Characteristics of Pregnant Women and New Mothers Identified as Being At-Risk for Child Maltreatment in Early Pregnancy

Pregnant women and new mothers who have risk factors of child maltreatment are “at high risk for future child maltreatment.” Early detection of them is crucial to prevent it. This community-based, retrospective, cross-sectional, observational study aimed to identify the characteristics of pregnant women, and those in their postpartum period, identified as at-risk cases for child maltreatment. We used data from the municipal pregnancy registration system in City A and analyzed 206 cases identified as “at-risk for child maltreatment” from 1 April 2017 to 31 March 2018. They were categorized into two groups: a pregnancy group (131 cases, 63.6%) and a postpartum group (75 cases, 36.4%). Logistic regression analysis revealed that women who reported having poor relationships with their parents and participated in the interview in their early stages of their pregnancy were less likely to be registered as at-risk cases for child maltreatment after delivery. The results suggest that public health nurses (PHNs) can conduct interviews with pregnant women during the early stages of pregnancy to prevent child maltreatment in community settings. Additionally, to ensure safe delivery and childrearing environments, PHNs need to assess the family support capacity of each registered case and provide assistance to those without parental support.

Pregnant women's experiences of non-invasive prenatal testing (NIPT) in Japan: A qualitative study

In Japan, prenatal testing does not include a publicly insured routine health check-up for pregnant women. Hence, taking advantage of such prenatal testing procedures is still not an option for a majority of Japanese women. However, social support systems for children and adults with disabilities have been developed with the assumption that people with disabilities will continue receiving support from their family members, especially their mothers. In this study, we described pregnant women's experiences regarding noninvasive prenatal testing (NIPT) within the context of their physical experiences during the NIPT process, Japanese society, and their medical circumstances. Women with no family history of genetic diseases or fetal disabilities and who had also received negative results after the NIPT explanation were recruited. Altogether, 15 women participated in the biographical narrative interview. The data were subjected to reflexive thematic analysis and signified advanced age for pregnancy as a trigger for both the women's consideration regarding receiving NIPT and interventions from their families and social group members. Participants considered themselves as the main caretaker for the older adults and individuals with disabilities and thus were afraid of the multiple responsibilities inherent in this reality. They were also concerned about the impact on any other siblings if the baby had disabilities. In addition, participants encounter physical and mental changes during the timeframe of the NIPT processes. Hence, as their fetuses mature, the psychological bonds the women develop with them are constantly evolving, and participants with histories of miscarriages or possible miscarriages expressed concerned not only about the results of NIPT but also about the specific possibility of losing their child in any way. In conclusion, the continuous support of these women throughout the NIPT process and social efforts for the improvement of the welfare system for people with disabilities are required to utilize NIPT effectively.

'No Austrian Mother Does This to Sleep Without a Baby!' Postnatal Acculturative Stress and 'Doing the Month' Among East Asian Women in Austria: Revisiting Acculturation Theories From a Qualitative Perspective

Acculturative stress is a phenomenon describing negative emotions experienced by immigrants in their socio-cultural and psychological adaptation process to the host society’s dominant culture and its population. Acculturative stress is assumed to be one the reasons for higher prevalence of postnatal depression among immigrant women compared to non-immigrant women. Theories and models of acculturation and coping strategies suggest that certain cultural orientations or behaviors could mitigate acculturative stress and postnatal depression. Nevertheless, quantitative studies applying these theories have so far revealed inconsistent results. Given this background, we ask: what can a qualitative study of immigrant women’s postnatal experiences tell us about the interrelationships between immigrant mothers’ acculturation behaviors or cultural orientations, and maternal psychological health? Particularly, we explore the postnatal experiences of Chinese and Japanese women who gave birth in Austria, focusing on their experiences and behaviors influenced by their heritage culture’s postnatal practices (zuò yuè zi and satogaeri). Theoretically, we apply Berry’s acculturation model through a focus on what we call ‘Postnatal Acculturative Stress’ (PAS). By doing so, we identify factors that prevent or mitigate PAS. Another aim of this article is to critically reassess Berry’s model in the context of postnatal care and maternal psychological health. Data were analyzed using a combination of deductive and inductive method through the application of directed content analysis and phenomenological approach. Women’s postnatal experiences were summarized as an ‘unexpected solitary struggle in the midst of dual identity change’ in four specific domains: postnatal rest and diet, social support, feelings toward significant others and identity. Preventive and mitigating factors against PAS included trust (in self and one’s health beliefs) and mutual respectful relationships with and between the significant others. The application of Berry’s acculturation model provided a useful framework of analysis. Nevertheless, the multifarious complexity involved in the process of acculturation as well as different power dynamics in the family and healthcare settings makes it difficult to draw causal relationships between certain acculturation behaviors or cultural orientations with specific health outcomes. Health professionals should be aware of the complex psychosocial processes, contexts as well as social environment that shape immigrants’ acculturative behaviors.

The Effect of Grandmothers' Presence on the Provision of Multidisciplinary Perinatal Support for Pregnant and Postpartum Women with Psychosocial Problems

Background

Pregnant and postpartum women with psychosocial problems are prone to face limited or absent perinatal functional support from biological grandmothers due to familial dysfunction. The study aimed to investigate whether the involvement and presence of biological maternal grandmothers providing practical support for their pre/postnatal daughters (ie, pregnant women) during the perinatal period may influence the number of support services provided by multidisciplinary agencies, including child consultation centers and municipal offices.

Participants and methods

This is a retrospective cohort study based on the medical records of all pregnant women with psychosocial problems that visited, gave birth, and received intervention from the hospital-based child protection unit at the Chiba University Hospital between February 2018 to March 2019. The primary outcome was to identify whether there was a difference in the number of multidisciplinary agencies providing perinatal support between pregnant women with and without the presence of functional support from biological maternal grandmothers during the perinatal period.

Results

We identified 114 pregnant and postpartum women with psychosocial problems. Seventy-six of these participants (66.7%) had functional support from their biological maternal grandmothers during the perinatal period, and 38 participants (33.3%) did not. The number of agencies involved with participants who lacked functional support was significantly higher than participants with functional support (t(55.14) = 2.98, p < 0.01). This finding was consistent among pregnant and postpartum primipara participants (n = 70) (t(68) = 3.87, p < 0.001), but not multipara (n = 44).

Conclusion

The findings indicate that the presence and functional support of biological maternal grandmothers influence the support that is needed from multidisciplinary perinatal support systems by pregnant and postpartum women with psychosocial problems. Primipara mothers without support from their own mothers may need greater multidisciplinary support.

Factors associated with psychological resilience in left-behind children in southwest China

Psychological resilience of Chinese left-behind children (LBC) remains under-studied. In this cross-sectional survey, we intended to analyze factors associated with resilience in a large group of LBC. One-stage random cluster sampling was used to select 2898 LBC aged between 10 and 17 years in Yunnan province of southwestern China. Face-to-face interview was used to collect relevant information from the participants. Resilience was measured by the Resilience Scale for Chinese Adolescents (RSCA). Multivariate logistic regression models revealed that having a better educated mother, feeling closer to people living in the same residence, and having more close friends were associated with higher psychological resilience in LBC. LBC who felt less close to people living in the same residence were consistently lower in all five dimensions of resilience. Compared with LBC with 2 or less close friends, LBC with more close friends had significantly greater resilience in goal concentration, family support, and interpersonal assistance. Higher mother's education level was related to higher resilience in emotion regulation, family support, and interpersonal assistance. Our findings suggest that dimension-specific intervention measures should be developed and implemented to improve psychological resilience of LBC.

Parents' experiences of their teenage children's parenthood: An interview study

In this study, we described and analyzed parents' experiences of teenage parenthood and the provision of support to their teenage children who had recently have become parents. A qualitative method was used. In-depth interviews with 24 participants were conducted, all parents of teenage parents. Data were analyzed using content analysis; four themes and 11 subthemes were identified. The results show that parents' norms and values were strongly influenced by their religious beliefs. The participants had mixed emotions and reactions to their teenage children's parenthood. Also participants were sources of support to the teenage parents and assisted them in their transition to parenthood. However, the participants also expressed the importance that their teenage children continue their education and avoid repeated pregnancies. This study highlights how emotional, instrumental, and informational support provided by parents to their teenagers can assist the latter in their transition to parenthood. In their work with teenage parents, healthcare providers can benefit from teenage parent's own parents involvement and experiences.

Attitudes and Expectations in the Intergenerational Transmission of Breastfeeding: A Phenomenological Study

BACKGROUND

The socially constructed meanings of breastfeeding that have been passed from generation to generation by grandmothers produce continuities and discontinuities in the practices of breastfeeding. Research aim: The aim of this study is to explore the objectives and positioning of women today with respect to their role as future grandmothers, based on their experiences with breastfeeding. That is, what role do future grandmothers wish to have in the lives of their breastfeeding daughters and grandchildren?

METHODS

A qualitative study with interpretative phenomenological analysis was conducted based on the philosophy of Martin Heidegger, using a sample of unstructured interviews from 20 women in Madrid. The data were analyzed using the steps of interpretative phenomenological analysis.

RESULTS

Among the women who desired to have a supportive role for their future breastfeeding daughters and daughters-in-law, three emergent themes were identified that aimed at being supportive but remaining flexible and respecting their autonomy: "I'll give you what I didn't have," "the well-being of my daughter/daughter-in-law," and "seeking professional help." Two additional themes were identified that show the desire of these women to be present during this stage of family development and the lifecycle: "my role in the family" and "continuing to share."

CONCLUSION

Future grandmothers desire to be involved in their daughters and daughters-in-law breastfeeding experience through flexibility and support and with the use of specialized and personalized professional help. In addition, future grandmothers desire to be valued and included in the vital process of breastfeeding.