'To be able to support her, I must feel calm and safe': pregnant women's partners perceptions of professional support during pregnancy

A survey on the perceptions of midwives, women, and support persons on the introduction of a support person information resource

INTRODUCTION

Midwives in an Australian birth unit undertook a project to develop a resource for women and their support person. The aim of this study was to explore how the women, support persons and midwives viewed the introduction of this resource designed to guide and support women in their choice of support person.

METHODS

A quantitative survey study was used to explore how three participant groups viewed the introduction of a support person information resource. A hospital designed survey was developed for women, support people and midwives. Data were analyzed using SPSS, version 26 and Braun and Clarke's guide for thematic analysis.

RESULTS

More than half (55%) of the midwives believed that the information resource presented influenced women's choice of support people during labor. Almost three-quarters (72%) of the women did not change their choice of number of support people that they wanted during their labor. The majority (83%) of women would recommend the support person brochure to other women. The majority (83%) of support people stayed the entire duration of labor. Four themes were generated from open-ended questions: value of the information sheet, knowing how to be a support person, connecting midwives with being woman-centered, and choosing the support person.

CONCLUSIONS

The availability of an information resource was of benefit for women, support people and midwives, contributing to women feeling more informed in choosing their support person. Midwives felt they had evidence to support conversations with women, contributing to the feeling of being woman-centered. Support people had increased confidence.

Preferences of support and barriers and facilitators to help-seeking in pregnant women with severe fear of childbirth in Sweden: a mixed-method study

BACKGROUND

There are few support interventions for women with fear of childbirth tailored towards type of fears and parity. To inform the future development of an acceptable and relevant intervention for women with severe fear of childbirth, primary objectives were to examine: (1) pregnant women's experiences of and preferences for support and (2) barriers and facilitators to help-seeking. Secondary objectives were to examine if there are any differences based on pregnant women's parity.

METHODS

Pregnant women with a severe fear of childbirth in Sweden completed an online cross-sectional survey between February and September 2022. Severe fear of childbirth was measured using the fear of childbirth scale. Quantitative data were analysed using descriptive and inferential statistics and free answers were analysed using manifest content analysis. A contiguous approach to integration was adopted with qualitative and quantitative findings reported separately.

RESULTS

In total, 609 participants, 364 nulliparous and 245 parous women, had severe fear of childbirth. The main category "A twisting road to walk towards receiving support for fear of childbirth" was explored and described by the generic categories: Longing for support, Struggling to ask for support, and Facilitating aspects of seeking support. Over half (63.5%), of pregnant women without planned or ongoing treatment, wanted support for fear of childbirth. Most (60.2%) pregnant women with ongoing or completed fear of childbirth treatment regarded the treatment as less helpful or not at all helpful. If fear of childbirth treatment was not planned, 35.8% of women would have liked to have received treatment. Barriers to help seeking included stigma surrounding fear of childbirth, previous negative experiences with healthcare contacts, fear of not being believed, fear of not being listened to, and discomfort of having to face their fears. Facilitators to help seeking included receiving respectful professional support that was easily available, flexible, and close to home.

CONCLUSIONS

Most pregnant women with severe fear of childbirth felt unsupported during pregnancy. Findings emphasise the need to develop individual and easily accessible psychological support for women with severe fear of childbirth, delivered by trained professionals with an empathetic and respectful attitude.

"We decided together": a qualitative study about women with HIV navigating infant-feeding decisions with the father of their children

BACKGROUND

The World Health Organization (WHO) recommends that women with HIV breastfeed for a minimum of one year. In contrast, United Kingdom (UK) guidelines encourage formula feeding, but breastfeeding can be supported under certain circumstances. Infant-feeding decisions often involve personal and social networks. Currently, little research addresses how individuals with HIV in high-income countries navigate infant-feeding decisions with the father of their children.

METHODS

Semi-structured remote interviews were conducted with UK-based individuals with a confirmed HIV positive diagnosis who were pregnant or one-year postpartum, and two partners. Using purposive sampling, pregnant and postpartum participants were recruited through HIV NHS clinics and community-based organisations, and where possible, fathers were recruited via them. Data were analysed using thematic analysis and organised using NVivo 12.

RESULTS

Of the 36 women interviewed, 28 were postpartum. The majority were of Black African descent (n = 22) and born outside the UK. The key factors in women navigating HIV and infant-feeding discussions with respect to their baby's father were the latter's: (1) awareness of woman's HIV status; (2) relationship with the woman; (3) confidence in infant-feeding decision; (4) support and opinion about woman's infant-feeding intentions. Most women made a joint decision with biological fathers when in a long-term (> one year) relationship with them. Single women tended not to discuss their infant-feeding decision with the father of their child, often for safety reasons.

CONCLUSION

Women in ongoing relationships with the father of their child valued their support and opinions regarding infant-feeding. In contrast, single women chose not to involve the father for reasons of privacy and safety. Clinical teams and community-based organisations should support mothers in discussing infant-feeding decisions regardless of relationship status. When appropriate, they should also support discussions with their partners, but remain sensitive to circumstances where this may put women at risk.

Engaging culturally diverse fathers in maternal and family healthcare: Experiences and perspectives of healthcare professionals

ISSUE ADDRESSED

Australian maternal, family and child services increasingly espouse the value of being 'father-inclusive'. However, fathers report feeling excluded or marginalised during healthcare visits with their partners/infants, and experience barriers to engaging in perinatal healthcare at the community, individual and healthcare service level. These barriers may be amplified in men who are members of minority groups, such as those from culturally and linguistically diverse (CALD) backgrounds.

METHODS

This research investigated healthcare professionals' perceptions and experiences of providing perinatal health services to families from CALD backgrounds. Semi-structured interviews were held with healthcare professionals from multiple disciplinary backgrounds providing services to families in the perinatal period. Interviews were audio recorded, transcribed and analysed thematically to identify key themes and sub-themes.

RESULTS

Ten healthcare professionals were interviewed. Participants acknowledged that inclusion of fathers in care is important as involvement enables fathers to support their pregnant partners and children, manage their own mental health, and helps to transform harmful gender roles.

CONCLUSIONS

Overall, healthcare professionals are willing to include culturally diverse fathers. However, the ability of culturally diverse families to engage with healthcare services is impacted by the cultural competency of the services. So what? Healthcare delivered during pregnancy, childbirth and postpartum year may be improved by adopting a whole-family approach, which considers the needs and perspectives of fathers and partners. However, particular attention is needed to ensure healthcare policies and practices are culturally competent to meet the needs of fathers from culturally diverse backgrounds.

Paternal pregnancy-related anxiety: Systematic review of men's concerns and experiences during their partners' pregnancies

BACKGROUND

Up to 25 % of expectant parents experience anxiety symptoms. Pregnancy-related anxiety is characterised by concerns and worries specific to pregnancy, childbirth, and the transition to parenthood. While pregnancy-related anxiety is well-researched in women, the exact nature of this construct in men is unclear. The purpose of the current review was to examine men's concerns, worries, and fears during pregnancy and gain an understanding of their experiences during pregnancy.

METHODS

An integrative review design was adopted, using thematic content analysis to synthesise findings from quantitative and qualitative studies. Quality appraisal of the quantitative studies used the AXIS appraisal tool. The Critical Appraisal Skills Program (CASP) checklist was used for the qualitative studies.

RESULTS

A comprehensive search of nine databases led to inclusion of 14 quantitative and 41 qualitative studies. Ten dimensions of paternal pregnancy-related anxiety were identified: childbirth concerns, attitudes towards childbirth, baby concerns, acceptance of pregnancy, partner concerns, relationship concerns, worry about self, transition to parenthood, attitudes towards health care professionals, and practical and financial concerns. The pregnancy transition was characterised by mixed emotions and conflicted experiences for fathers.

LIMITATIONS

Generalizability of review findings was limited by poor reporting of demographic information by many included studies, exclusion of studies not published in English, and focus on heterosexual relationships.

CONCLUSIONS

Expectant fathers may experience anxiety symptoms characterised by excessive worry across multiple domains of pregnancy-related concerns. Clinicians play an important role in identifying and supporting fathers with pregnancy-related anxiety and addressing the sense of exclusion often experienced by them.

Fathers' Educational Needs Assessment in Relation to Their Participation in Perinatal Care: A Systematic Review

Even though they are crucial for a positive pregnancy experience, many fathers may not be aware of the significance of their role in perinatal care. As it is important to identify the needs of the target population in the initial phases of a health plan in order to ensure success, the current systematic review is the first one to address the reported needs for men's antenatal education.

METHODS

All studies written in English and published between 1997 and 2021 relevant to the theme were included in the review. The electronic databases of various mainstream journals were used to evaluate 87 studies.

RESULTS

In total, the validity of 17 studies was determined based on their compliance with the inclusion criteria. According to the review, men's participation in antenatal education can significantly influence pregnancy, childbirth, parenting, couple's relationship, and overall family functioning.

CONCLUSION

Providing face-to-face antenatal education to men by doctors or midwives is emphasized as an important component of perinatal care preparation because it leads to positive outcomes.

Male partners’ experiences of early pregnancy ultrasound scans in Soweto, South Africa: The Healthy Pregnancy, Healthy Baby randomised trial

Background. Despite international evidence highlighting the benefits of male partners attending antenatal visits, including pregnancy ultrasound scans, it is unusual for South African (SA) men to attend such visits, and little is known about their experiences if they do. Objectives. To explore the experiences and antenatal attachment among male partners who attend early pregnancy ultrasound examinations in Soweto, SA. Methods. Pregnant women attending ultrasound examinations were invited to bring their partners with them. Both completed individual questionnaires, including the antenatal attachment scale. The results are based on a descriptive analysis of 102 mother-partner pairs. Results. The mean age of partners was 35 years. Only 32% of men were living with their pregnant partner. Before the ultrasound scan, 64% of men reported feeling very anxious, while 54% also felt anxious after the procedure. The ultrasound examination had a positive effect on men and their thoughts regarding their developing baby, with 30% stating that they were ready or excited to be a father. Twenty-eight percent believed their relationship with the mother was stronger as a result of participating in antenatal care. Conclusions. We found that prenatal ultrasound scans had a positive effect on male partners and their thoughts about the pregnancy, their forthcoming child and their relationship with and support for their partner. Health services in SA should accommodate partners/ fathers and encourage them to attend antenatal care, including pregnancy ultrasound scans. Interventions are needed to encourage more men to be involved – from conception – potentially addressing individual, familial, societal and structural barriers to involvement of the father in long-term maternal and child care.

Effects of health literacy education on adaptation to pregnancy, self-efficacy, fear of childbirth and health literacy in Turkish pregnant women: A randomized, controlled trial

This research aims to evaluate the effects of health literacy (HL) education on Turkish pregnant women's adaptations to pregnancy, self-efficacy, fear of childbirth and HL levels. This was a randomised, controlled trial. The research was carried out in the Marmara region of Turkey between July 2018 and April 2019. This research was conducted with three groups including one control (n = 73) and two intervention (n = 109) groups. One of the intervention groups was given antenatal education (AE) for improving HL (HL-AE) (n = 53), and the other was provided AE (n = 56) only. A Pregnancy Information Form, Prenatal Self-Evaluation Questionnaire, Fear of Childbirth and The Postpartum Period Scale, General Self-Efficacy Scale and Turkey Health Literacy Scale-32 were used for data collection. Results show that adaptation to pregnancy, general self-efficacy and HL levels significantly improved while fear of childbirth decreased in the group that was provided HL-AE intervention group. Additional when the pre-education and post-education scale scores were compared in the AE group, it was found that there was a significant difference in other scale scores, but not for fear of childbirth.

The concept, importance and values of support during childbearing and breastfeeding - A discourse paper

BACKGROUND

Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing.

AIM

The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites.

DESIGN

Discourse paper.

METHODS

This discourse paper is based on our own experiences and is supported by literature and theory.

RESULTS

Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered.

Parents' Perceptions About Future Digital Parental Support-A Phenomenographic Interview Study

Background: Parents use digital sources (such as the internet or online forums and applications) during pregnancy and after childbirth to receive informative support. Research shows that there is further need for innovation development in digital parental support despite informative support available in digital form. Purpose: To explore parents' perceptions of future digital parental support concerning pregnancy and the first 18 months of parenthood. Method: A phenomenographic interview study with an inductive approach including 15 semi-structured interviews was conducted. Results: The analysis process resulted in three descriptive categories: Opportunities for virtual and in-person meetings, Individualized digital parental support, and Professional knowledge and trustworthiness concerning future digital parental support. Conclusion: The results broaden the knowledge about how future digital parental support can be designed to facilitate the functional, interactive, and critical digital health literacy of new and would-be parents. To succeed, healthcare organizations should allow healthcare professionals to assume an active role in developing digital parental support, both as health educators (i.e., providing parents with knowledge) and facilitators (i.e., facilitating parents' use of digital parental support). However, parents perceived that future digital parental support should complement standard care instead of replacing in-person meetings with healthcare professionals.

Parental-couple separation during the transition to parenthood

AIM

To evaluate factors associated with parental separation during the parenthood transition.

DESIGN

Prospective, longitudinal and explorative.

METHODS

This is a quantitative longitudinal study of N784 subjects throughout the pregnancy journey with multivariate regression analysis of survey data derived from three validated measurement scales; the Sense of Coherence scale, the Multidimensional Scale of Perceived Social Support and the Perceived Quality of the Dyadic Relationship scale conducted 2014-2016.

RESULTS

N17 participants separated at 2 years. Parental separation was significantly greater for those women and partners with low or changing sense of coherence, perceived social support and perceived quality of the parental-couple relationship indexes. Partners with a change in sense of coherence (p: .003) and perceived quality of the parental-couple relationship (p: .020) between 1 week and 2 years were at greater risk for separation. Attending professional preparatory support with a partner for women (p: .013) and attending the "Inspirational Lecture" for partners (p: .046) were, to a lesser extent, associated with a risk of parental separation.

Parents' Experiences of Receiving Professional Support Through Extended Home Visits During Pregnancy and Early Childhood-A Phenomenographic Study

Background: While becoming a parent can be challenging for all, it can particularly be challenging for those parents and children who are in a vulnerable situation—e.g., in families whose members have problems related to health, relationships, or socioeconomic status. It is essential for health care professionals to identify the more vulnerable families at an early stage. Home visits are one cost-effective way of identifying and supporting such families. This study describes the parental experiences of an intervention that involves professional support in the form of extended home visits. The aim of the study is to describe the parents' understanding of their experiences of receiving professional support through extended home visits both during pregnancy and the first 15 months of their child's life.

Methods/Design: A phenomenographic approach was used. Semi-structured interviews were conducted with 12 parents who had received the intervention. The interviews were analyzed using the seven-step phenomenography model described by Sjöström and Dahlgren.

Results: The following three descriptive categories emerged from the analysis: (1) conceptions concerning the meaning of the physical environment, (2) conceptions concerning extended home visits promoting feelings of self-confidence in the parental role, and (3) conceptions concerning extended home visits promoting parental participation and relations.

Conclusion and Clinical Implications: Extended home visits as a form of professional support appear to promote parental self-confidence in parenting ability, giving parents a feeling of security that facilitates conversation with professionals. Children and their entire families had natural roles during home visits, which allowed the children to behave more characteristically. Furthermore, the home visits were understood to facilitate social support through social activities at the child health center as well as integration into Swedish society for migrant parents. Professional support should be adjusted to the unique individual needs of parents, which demands a variety of supportive interventions—for example, reorganizing one or two of the regular clinical visits currently being scheduled as home visits instead.

An Overview of Guidelines for Supplemental Feeding of Infants in Swedish Maternity Clinics

This study aims to describe the local guidelines for the supplemental feeding of infants of Swedish women's clinics with maternity wards. Purposeful sampling was used during a four-week data collection time in 2019. Guidelines from 41 of the 43 Swedish women's clinics with maternity wards were analysed using qualitative and quantitative content analysis. The information provided, and length of the guidelines varied widely in 38 guidelines. Feeding methods were included in 28 guidelines, but 10 provided no information about feeding methods. The most common feeding methods were cup feeding and feeding probes. Suggestions for supplemental feeding included infant formula (32), breast milk (27) and no suggestions (6). The methods to support breastfeeding were skin-to-skin contact (25), breastfeeding freely (22), a caring plan (18), extra supervision (3), optimising the caring environment (2), supplying a breast pump (1) and breastfeeding observation (1). Twenty-two guidelines included information about how long formula should be given and that the feeding should be phased out gradually. We conclude that a national guideline for the supplemental feeding of infants is needed to ensure equal best practice care for infant safety and the support of parents to increase the breastfeeding rate. More national guidelines are needed in general because it is easier to update only one set of guidelines.

Female and male perspectives on male partner roles in expanded carrier screening

PURPOSE

To explore facilitators and barriers for male partner follow through carrier screening (CS) after their female partners were identified as carriers, from both male and female perspectives.

METHODS

Participants were either females identified as a carrier through CS (512 participants) or males who had CS (125 participants). Participants were recruited via e-mails with survey links. The survey explored factors surrounding decisions to pursue CS or not.

RESULTS

Males who attended the females' CS appointment were more likely to have CS (OR: 2.07). More male partners of females identified as carriers of severe or profound conditions pursued CS (82.0%) than male partners of females who were carriers for moderate conditions (50.0%). Logistic factors were more impactful for males who pursued CS. Females whose male partners did not test endorsed personal belief factors as most impactful, reporting the perceived low risk (75.0%) and his low concern for the specific condition (65.5%) were the top reasons their partners did not test.

CONCLUSION

Many factors impact how male partners appraise reproductive risk from CS and make decisions regarding their own screening. Advising that male partners attend CS appointments may increase the likelihood of follow through CS. Thorough and repeated risk counseling is indicated.

First-time fathers' experiences and needs during childbirth: A systematic review

OBJECTIVE

Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and children. However, childbirth is a life event that parents may experience differently. First-time fathers' experiences have been barely studied and may differ from those of fathers who have already had a child. In order to adapt support and care during childbirth to the needs of first-time fathers, a deeper insight must be gained into their experiences and needs during childbirth.

DESIGN

A systematic review of qualitative studies was conducted using PubMed, Embase and CINAHL as well as the snowball method. Quality appraisal was performed and evaluated using the Critical Appraisal Skills Programme. A thematic best evidence synthesis was performed.

FINDINGS

Of 821 articles, eight qualitative studies and the qualitative data of one mixed methods study were included. amongst other feelings, fathers experience a lack of knowledge and a need to be better prepared. First-time fathers want to be more involved and need guidance, information and honest answers to help them fulfil a supportive role. Fathers disregard their own needs to focus on the needs of the mother. Meeting the baby for the first time changes the focus from the mother to the child, and fathers need time and privacy for this special moment.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

To adapt support and care during childbirth to the needs of first-time fathers, professionals must be aware of their needs. Professionals must realise the significant influence of their professional behaviour on first-time fathers' experiences. Care for first-time fathers should be formalised. Follow-up research must be conducted on integrating the preparation of first-time fathers into prenatal care. Education and training of professionals must be improved.

Midwives' Experiences of Providing the "Inspirational Lecture" as a Care Intervention for Expectant Parents-A Qualitative Study

Background: In most Western countries, ordinary parental classes exist and have become a well-established form of professional support within midwifery care, even though some of these classes lack evidence of benefits for the parents. A Swedish randomized controlled trial including an intervention as a pilot study, revealed that a type of parental preparatory professional support provided for expectant parents, the “inspirational lecture,” showed a tendency to be beneficial for parents' birth experience, and their perceived quality of parental couple relationship. However, there is no previous research on the midwives' experiences from providing the inspirational lecture. Carrying out research on midwives' experiences from providing the lecture, could bring future opportunities to provide a work-integrated learning (WIL) related to professionals' skills, and the pedagogic used.

Aim: To elucidate midwives' experiences about providing the inspirational lecture as a care intervention for expectant parents.

Methods: Midwives were interviewed and data were analyzed using qualitative content analysis.

Results: The midwives strived to put childbirth into a comprehensive and manageable context for the expectant parents, during the inspirational lecture. For this, different approaches were used to make expectant parents understand how the parents themselves can be engaged participants in their own birth.

Conclusion and Clinical Implications: The midwives used the inspirational lecture to provide the expectant parents with knowledge about how they, as a parental couple, could cooperate and feel safe in relation to the upcoming birth. This could be understood as if the midwives were striving to facilitate the integrative power of the parental couple, which is the couples' ability to gather their joint power. These results can assist midwives and serve as a reference for providing parental classes for expectant parents with a focus on promoting both the parents' individual as well as mutual skills.

Individual parental conversations with non-birthing parents

AIM

The aim of this study was to describe Child Health Service (CHS) nurses' experiences with conducting individual parental conversations (IPCs) with non-birthing parents.

BACKGROUND

CHS nurses in Sweden mainly focus on monitoring a child's physical and mental development and the mothers' health in order to support their parenthood. The assignment of the CHS includes identifying dysfunctional social relationships in a family and strengthening responsive parenting. An imbalance arises within the family when someone in the family suffers from illness, which could have a negative effect on the whole family's health and well-being.

METHODS

An inductive, descriptive qualitative study design was used to describe and to gain an understanding of the CHS nurses' experiences. Data were collected in 13 interviews, and a qualitative content analysis was performed.

FINDINGS

The analysis of interviews with CHS nurses resulted in two main categories, each with three subcategories. The main categories are: working for equality and applying a family focus, and dealing with challenges in the developing assignment. The IPCs stimulate the CHS nurses to work for more equality and to apply a family focus, which can be a way of strengthening the families' health and the children's upbringing. Developing the CHS nurses' assignment can be a challenge that appears to entail positive outcomes for CHS nurses, while also generating the need for CHS nurses to receive supervision to find ways to improve their approach and practice.

Effects of the "Inspirational Lecture" in Combination With "Ordinary Antenatal Parental Classes" as Professional Support for Expectant Parents: A Pilot Study as a Randomized Controlled Trial

Background: Both expectant mothers and their partners describe weaknesses in ordinary parental preparatory professional support provided internationally and nationally within Sweden. Therefore, it is necessary to develop the parental preparatory professional support provided by midwives for expectant parents within Sweden. This study will evaluate the effects on expectant parents of receiving a combination of an “inspirational lecture” and “ordinary antenatal parental classes” compared with only “ordinary antenatal parental classes.”

Methods/Design: This block randomized controlled trial included an intervention as a pilot study, in which expectant parents were randomized for (1) the inspirational lecture and ordinary antenatal parental classes (intervention group [IG]) (n = 66) or (2) ordinary antenatal parental classes (control group [CG]) (n = 60). Data collection with repeated questionnaires was conducted in the first week and 6 months after birth. Statistical analyses were conducted for participant characteristics, differences between parents within IG and CG, effects of the intervention, intention to treat, and internal consistency of the included measurements.

Results: The intervention showed a tendency to be gainful for one out of four outcomes related to birth experience, and parents' perceived quality of parental couple relationship consensus and sexuality and manageability. These results were more prominent for the partners. Parents within both the intervention and control groups reported decreased social support in the first 6 months after birth.

Conclusion and Clinical Implications: Overall, the concept of the inspirational lecture in combination with ordinary antenatal parental classes as parental preparatory professional support seems to be a valuable care intervention. However, this study was a pilot study and the results should therefore be interpreted with caution. More research is needed since childbirth and transition to parenthood are complex processes in need of comprehension.

First-Time Mothers' Enjoyment of Breastfeeding Correlates with Duration of Breastfeeding, Sense of Coherence, and Parental Couple and Child Relation: A Longitudinal Swedish Cohort Study

Objectives

Many women do not reach their own breastfeeding goals regarding duration of breastfeeding. Different factors influence breastfeeding, and to learn more about breastfeeding within a multidimensional and longitudinal perspective, further research is needed. Therefore, the aim of the present study was to investigate diverse factors correlated with first-time mothers' enjoyment of breastfeeding and breastfeeding duration, between childbirth and two years after birth.

Methods

In a prospective longitudinal cohort study, 324 newly become mothers were followed. The Spearman correlation test was used to investigate factors correlated with the degree to which mothers enjoy breastfeeding and the duration of breastfeeding. The Mann–Whitney test was conducted for comparisons of demographic characteristics between mothers who did or did not breastfeed.

Results

Among the mothers, 99.2% initiated breastfeeding after birth. Frequencies of breastfeeding were 54.8% at six months, 9.1% at one year, and 1.0% at two years. The degree to which the mother enjoyed breastfeeding was correlated positively with (1) the duration of breastfeeding, (2) more positive feelings for and relation to the child, (3) the partner's perceived relation to the child, (4) a higher sense of coherence, and (5) stronger perceived parental couple's relationship. Longer breastfeeding duration was correlated positively with (1) a higher degree of enjoyment of breastfeeding, (2) more positive relation to the child, and (3) stronger perceived parental couple's relationship. Additionally, breastfeeding during the first two hours after birth, more positive feelings for and relation to the child, and a higher degree of enjoyment of breastfeeding were more frequently reported among breastfeeding mothers, in comparison with not breastfeeding mothers.

Conclusion

Mothers' subjective experience from breastfeeding, sense of coherence, and couple relationship with partner and relationship with the child are valuable factors in regard to breastfeeding.

Effects of providing nursing care with web-based program on maternal self-efficacy and infant health

OBJECTIVE

The study was conducted to examine the efficacy of a web-based program, informed by Pender's Health Promotion Model, given to primiparous women on the growth and development of infant, infants' health, and women's self-efficacy level.

METHODS

This randomized controlled study with a posttest design was conducted in three primary care clinics. The study group comprised 71 primiparous women and their infants (intervention group: N = 35; control group: N = 36). The women who are at the 33-37th gestational week in the intervention group participated in the web-based program. They completed four education modules. Women in the control group received routine care in clinics. Data forms were completed in the first week and first, second, and third months postpartum. Breastfeeding status, weight, head circumference, development of infants and women's self-efficacy were evaluated in the postnatal period up to 3 months.

RESULTS

In the intervention group, the ratio of infants who were exclusively breastfed was higher compared to the control group. The mean scores for the LATCH instrument which measures breastfeeding status and Parental Self-Efficacy Scale, were significantly higher in the intervention compared to the control group (p < .05).

CONCLUSION

The women who participated in the web-based program demonstrated better self-efficacy and their infants demonstrated better scores on measures of growth, development, and health than those in the control group.

Investigating the effect of group counseling on family stress and anxiety of primiparous mothers during delivery

Background

Family is considered as the first source of care and support for the mother. Family stress and anxiety can be transmitted to the pregnant mother and have negative effects on pregnancy, childbirth, postpartum, and even their fetus. Given that one of the policies of the World Health Organization is to emphasize “safe family is safe with mother” this study was aimed to determine the effect of group counseling on family stress and anxiety of primiparous mothers during delivery.

Methods

This quasi-experimental study was conducted in 2016 on 72 family members of pregnant women who were referred to midwifery clinics in two health centers in Saveh-Iran. In this research, two members of each family (husband and other family of the pregnant woman) were selected using convenience sampling and were randomly divided into two groups of 36 families. At the beginning of the third trimester of pregnancy, standard questionnaires of Cohen’s Perceived Stress and Cattell Anxiety scale were completed by both groups. For the intervention group, six sessions of cognitive group counseling were held weekly and the control group did not receive the intervention. Then, at the time of hospitalizing pregnant women for childbirth, the questionnaires were completed again by the family of both groups and the two groups were compared in terms of stress and anxiety before and after the intervention. Data were analyzed by SPSS software version 16 using appropriate statistical tests.

Findings

The findings showed that there was no significant difference between mean scores of stress, anxiety, hidden anxiety and obvious anxiety before intervention in both intervention and control groups. In the intervention group, Perceived stress score (p < 0.001), anxiety score (p < 0.001), hidden anxiety score (p = 0.003) and obvious anxiety score (p < 0.001) after intervention, with a statistically significant difference were lower than the control group.

Conclusion

Group counseling can reduce the stress and anxiety of the family of primiparous mothers.

Electronic supplementary material

The online version of this article (10.1186/s13030-019-0148-1) contains supplementary material, which is available to authorized users.

Mothers' and fathers' sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review

Background

From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents’ experiences of their sense of security associated with pregnancy, childbirth and the postnatal period.

Methods

A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers’ and fathers’ experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings.

Results

Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security.

Conclusions

The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers’ sense of security is lacking. Further research focused on the experiences of security from the parents’ perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.