Predictors of maternal role adaptation in Iranian women: a cross-sectional study

Background

Numerous factors play a role in maternal identity formation and function. Recognizing the aspects related to adaptation to the mother role can effectively provide a solution to help mothers construct maternal roles. Consequently, this study aimed to determine the predictors of adaptation to the maternal role in Iranian women.

Methods

This cross-sectional study was performed on 564 women who gave birth within one to four months after delivery with a record in Tabriz-Iran health centers, 2020–21. Participants were selected by cluster sampling. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, Birth Satisfaction Scale-Revised (BSS-R), Lipz Maternal Self-Confidence Scale (LMSCS), and maternal role adaptation questionnaire. The general linear model was used to estimate the effect of each of the independent variables (socio-demographic and obstetrics characteristics, childbirth satisfaction, and self-confidence) on the dependent variable (maternal role adaptation).

Results

The mean (± SD) total scores of adaptation to the maternal role, childbirth satisfaction, and maternal self-confidence were 77.4 (± 15.2) (score range: 33–165), 17.0 (± 5.9) (score range: 0–40), and 65.1 (± 13.5) (score range: 24–144), respectively. Based on the Pearson correlation test, there was a significant direct correlation between the overall score of adaptation to the maternal role with childbirth satisfaction (r = 0.462, P < 0.001) and maternal self-confidence (r = 0.652, P < 0.001). Based on the adjusted general linear model, the variables of maternal self-confidence, childbirth satisfaction, adequacy of household income, and spouse support were predictors of adaptation to the mother role. They explained 50.6% of the variance in the adaptation to the mother role score.

Conclusions

Concerning the study results, adaptation to the maternal role is related to childbirth satisfaction and some socio-demographic variables. Therefore, considering the impact of maternal role on other aspects of women's life and child care, healthcare providers' and policymakers' critical role is to create positive childbirth experiences and strengthen mothers' self-confidence.

The Effect of Paternal Skin-to-Skin Care: A Systematic Review and Meta-analysis of Randomized Control Trials

BACKGROUND

Research about skin-to-skin care (SSC) experiences in early period after birth has focused on mothers and infants.

PURPOSE

The purpose of this study was to determine the outcomes of paternal skin-to-skin care (P-SSC) in both fathers and infants.

METHODS

The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed/MEDLINE, Embase, CINAHL, PsycInfo, Airiti Library, and Google Scholar were searched for randomized controlled trials (RCTs) that reported outcomes of P-SSC in both fathers and infants. We calculated pooled mean differences (MDs) and 95% confidence intervals (CIs) using RevMan 5.3 for the meta-analysis [PROSPERO: CRD42018106790].

RESULTS

Seven RCTs including a total of 552 participants were eligible for inclusion. Compared to the maternal skin-to-skin care (M-SSC), fathers in the P-SSC exhibited no significant differences in salivary oxytocin levels (MD: -0.35 pg/mL; 95% CI: -0.75, 0.05), salivary cortisol levels (MD: 0.25 μg/dL; 95% CI: -0.82, 1.33), or anxiety scores (MD: -0.17; 95% CI: -0.57, 0.22) during the period of SSC. Similarly, there were no significant differences in the salivary cortisol levels (MD: -0.11 μg/dL; 95% CI: -0.05, 0.28) among preterm infants between the 2 groups. However, the crying time was less among full-term infants in the P-SSC group compared with infants in the incubator care or cot care groups.

IMPLICATIONS FOR PRACTICE AND RESEARCH

P-SSC had similar effects as M-SSC on stress-related outcomes during and after SSC among fathers and infants in the early stages after birth. We recommend that P-SSC be implemented in the early stages after birth. Further RCTs with a longitudinal design and large samples are needed to better understand the long-term effects of P-SSC on fathers and infants.

First-time fathers' experiences during their transition to parenthood: A study of Korean fathers

Purpose

This study was conducted to explore first-time fathers' experiences during their transition to parenthood in South Korea.

Methods

Data were collected from September 2019 to February 2020 through in-depth interviews that were conducted individually with 12 participants. First-time fathers with children under 2 months of age were recruited. Verbatim transcripts were analyzed using Colaizzi's phenomenological method.

Results

Four theme clusters were identified: Preparing to become a father, challenges of becoming a father, motivation to foster familial bonds, and acknowledgement of fatherhood.

Conclusion

These findings suggest that Korean first-time fathers prepared to practice parenthood through prenatal education, taegyo, and feeling bonds with their new baby. They recognized their identity as fathers and experienced self-growth. These results would be beneficial for health professionals in developing perinatal care programs, and the results provide basic data for studies on fathers and families during the transition to parenthood.

Prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period

BACKGROUND

The changes experienced during the transition to first-time or subsequent fatherhood are mainly positive; however, fathers can also experience adverse mental health outcomes such as stress, anxiety, and depression. The aim of this study was to investigate the prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period.

METHODS

A quantitative, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising of the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale.

RESULTS

A total of 336 fathers were included in the study. The prevalence rates were 41.1% (n = 138) for moderate/high stress symptoms, 20.8% (n = 70) for state anxiety symptoms, 25.9% (n = 87) for trait anxiety symptoms, and 13.4% (n = 45) for depression symptoms. In the multivariable analysis, several factors were associated with increased stress, anxiety, and depression symptoms including being a subsequent father (p = 0.009), not living in a house (p = 0.009), having a history of adverse mental health (p = 0.008), and having a partner with a history of anxiety (p = 0.040).

CONCLUSION

The findings suggest that fathers are at risk of adverse mental health in the early postnatal period which is a pivotal time for fathers in terms of bonding with their infant and redefining their relationship with their partner.

Predictors of postpartum depression among Chinese mothers and fathers in the early postnatal period: A cross-sectional study

OBJECTIVE

Postpartum depression is a serious mental health problem in early parenthood. The prevalence of postpartum depression is currently increasing. However, no studies have yet examined and compared maternal and paternal psychological health during the early postpartum period. The objectives of this study were therefore to explore the prevalence of postpartum depression and identify its predictors among Chinese mothers and fathers in the early postpartum period.

DESIGN

A cross-sectional study was conducted from September 24, 2020 to April 7, 2021 in Guangzhou, China.

SETTING

A regional teaching hospital in Guangzhou, China, with approximately 3000 births per year.

PARTICIPANTS

Four hundred and fifty-four married couples in the 2, 3 days postpartum period following a singleton, full-term birth.

MEASUREMENTS AND FINDINGS

Participants completed the Edinburgh Postnatal Depression Scale, Parenting Satisfaction Subscale and Parenting Efficacy Subscale, Social Support Rating Scale, and the demographic and obstetric datasheet. The prevalence of depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 13) was 13.0% and 7.5% in mothers and fathers, respectively, in the early postpartum period. The predictors of maternal depression were maternal parenting satisfaction, paternal depression, maternal social support and maternal relationship with mother-in-law (adjusted R²= 0.34, F = 58.40, df = [4, 449], P < 0.001). While the predictors of paternal depression were paternal parenting satisfaction and self-efficacy, maternal depression and whether the pregnancy was planned (adjusted R²= 0.28, F = 44.85, df = [4, 449], P < 0.001).

KEY CONCLUSIONS

Maternal and paternal depression were positively correlated and were predictive factors for one another.

IMPLICATIONS FOR PRACTICE

Healthcare professionals should screen both mothers and fathers for depression in the early postpartum period and provide targeted support during time in hospital following birth. In addition, the focus of future interventions should be on both parents rather than just mothers.

Process evaluation of couple-based psychoeducation program for first-time parents

RATIONALE

Postpartum depression is a worldwide public health issue that can have long-term impact on the family. It is crucial to evaluate intervention program to help new parents cope with the stress of parenthood to reduce the risk of postpartum depression. The aim of this study was to explore the perceived benefits of the couple-based psychoeducation to first-time Hong Kong Chinese parents, and the crucial factors influencing the effectiveness of this program underpinned by the concept of process evaluation.

METHOD

Using an exploratory qualitative design, a purposeful sample of 27 couples who had participated in the program were interviewed at 1-3 months postpartum. Data were collected using semi-structured interviews and analysed by thematic analysis.

FINDINGS

The findings showed that the parents perceived the program to be useful in enhancing their parenting skills and emotional control, and increasing their sense of support. The effectiveness of the program was facilitated by (a) the predisposing factors such as couple-based approach to enhance mutual expectation and shared decision making when experiencing and managing challenges, and telephone follow-up calls to sustain the continuity of care from hospital to the community, (b) the enabling factor for instance, the time of intervention arranged in non-working hour, and (c) reinforcing factor namely involvement of midwives during program implementation and telephone follow-up consultation.

CONCLUSIONS

The results of this study suggest the potential of the couple-based psychoeducation to support first-time parents in taking care of their children and controlling their emotions in this critical transition. The program could be integrated into maternal and child care services on a regular basis, and thus accessible to all first-time parents.

Placing myself in a new normalized life: The process of becoming a first-time father. A grounded theory study

Becoming a first-time father is an important transition period in men's lives that is frequently accompanied by joy and happiness. Engaging fathers has a broader impact on family and community and on fathers' own well-being. This study explores the process of men becoming first-time fathers and the experiences and challenges involved. Seventeen interviews with men in different stages of pregnancy, childbirth, and the postpartum period were conducted. Through a grounded theory design, a novel four-stage theoretical model emerged that represents the journey to first-time fatherhood. These stages are beginning the journey, fatherhood in limbo, facing reality, and settling down. Participants suggested that achieving a new normality was the final stage where they finally felt located with a sense of mastery in their journey to fatherhood. The novel theoretical approach of addressing the process of men's transition allowed more complete access to their perspectives. Men's needs are different at every phase of the transition to fatherhood, and the use of these findings can help care providers in caring for every man according to the stage he is facing.

Stress, Marital Relationship and Quality of Life of Couples Across the Perinatal Period

OBJECTIVES

Transition to parenthood is characterized by a high level of stress, which can affect couples' relationship and quality of life. Limited research compares the relationships and trends in stress, marital relationship and quality of life between both couples across the perinatal period. This study examined the associations, changes over time and gender differences in the stress, marital relationship and quality of life of Chinese couples during the perinatal period.

METHODS

A convenience sample of 130 couples participated in this longitudinal study. Data on the assessment of stress, marital relationship and quality of life were collected by validated measures during the second or third trimester of pregnancy and at 6 weeks, 6 months and 12 months postpartum.

RESULTS

Both couples experienced an increased level of stress at 6 weeks postpartum and a gradual decline in marital relationship from pregnancy to 1 year postpartum. The mental component of women's quality of life declined sharply at 6 weeks postpartum and recovered at 6 months postpartum. The physical component of quality of life showed gradual improvements from pregnancy to 1 year postpartum for the women, but a decline for the men. The women showed more stress and poorer marital relationship and quality of life than their partners, and the women's levels of stress, marital relationship and mental component of quality of life were closely related to those of their partners' across the perinatal period. Stress was related negatively to marital relationship and quality of life, and a positive marital relationship was associated with better quality of life during the perinatal period.

CONCLUSION

The study highlights the need to adopt couple-based approaches in clinical practice directed at helping partners develop realistic expectations and manage stress, which are essential to promoting marital relationships and quality of life during the transition to parenthood.

Fatherhood group sessions: A descriptive and summative qualitative study

The aim of this qualitative study of fatherhood group sessions offered as part of child health care services for new parents was to examine the activities, roles, and topics initiated by the leader and describe fathers' participation. Eight new fathers took part in three audio‐ and video‐recorded sessions led by a male leader. Three qualitative content analysis approaches were used to analyze the data. The analysis showed that the group leader took on four leadership roles, mainly that of discussion leader, but also expert, friend, and organizer. When the group leader acted as discussion leader, fathers participated by discussing challenges and changes in their new situation. Challenges were related to raising the child, partner relationships, everyday life, and gender equality. Fathers also discussed changes in their partner relationships and an increased focus on practicalities in daily life. Fatherhood groups can help new fathers form social networks and can create space for fathers to work through challenging topics, such as gender equality in parenting. The discussion leader's choice of role is crucial to creating the space for such discussions.