Preparing parents for parenthood: protocol for a randomized controlled trial of a preventative parenting intervention for expectant parents

What are antenatal maternity care needs of women who conceived through fertility treatment?: a mixed methods systematic review

BACKGROUND

Existing research indicates that pregnant women who conceived through fertility treatment might experience more stress and anxiety compared to women who conceived spontaneously. Therefore, these women might have additional antenatal care needs.

METHODS

A search for both quantitative and qualitative studies was performed in PubMed, PsycINFO, CINAHL and MEDLINE through May 2021, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. 21 articles met the inclusion criteria. After methodological quality appraisal using the Mixed Methods Appraising Tool, 15 studies were included in the review.

RESULTS

Analysis of the studies identified behavioral, relational/social, emotional, and cognitive needs and women's preference about maternity care. Women who conceived through fertility treatment reported lower social and physical functioning scores and elevated levels of anxiety and depression compared to women who conceived spontaneously. They reported difficulties adjusting to pregnancy and experienced a care gap between discharge from the fertility clinic and going to local maternity care services for their first consultation, and a care gap postpartum.

CONCLUSIONS

Women who conceived through fertility treatment have additional antenatal care needs. We recommend to offer these women more frequent check-ins, and to pay attention to the impact of their infertility and treatment on their pregnancy.

Efficacy of a school-based intervention to influence attitudes about future parenting among Swedish youth with intellectual disability: An RCT study

BACKGROUND

The study aim was to investigate the efficacy of an intervention designed to provide a basis for informed choices about future parenthood to special upper secondary school students with intellectual disabilities.

METHODS

A randomised trial with a waiting list control group was used. In total, 108 special upper secondary school students with mild or moderate intellectual disabilities, age 16-21 years, provided informed consent and participated. The intervention included education using the Parenting Toolkit and a Real Care Baby simulator. The analyses included 91 students (intervention group n = 46, 24F/22M; control group n = 45, 26F/19M).

RESULTS

The result showed that intervention group changed their attitudes to future parenting, from 'do not know' to 'know', significantly more than control group. The intervention increased knowledge levels in the intervention group.

CONCLUSIONS

The intervention group showed increased ability to make informed choices and decisions about parenthood.

Motherhood: Female Perspectives and Experiences of Being a Parent with ASC

Little is known about the emotional pressures and practical management of daily challenges and, intra and interpersonal demands of raising a child as a parent with a diagnosis of Autistic Spectrum Conditions. The present study utilised a qualitative approach to understand perceptions of females diagnosed on the autistic spectrum of ‘being a parent’. Eight semi-structured interviews were analysed using Interpretative Phenomenological Analysis. Benefits and challenges of being a parent were highlighted alongside population-specific skill and characteristics associated with strength and resilience, love, nurture, routine and sensory considerations. Findings identify the need for population-specific specialist parenting support, provide direction for professionals in clinical settings and expand the paucity of research in this area.

"Crippling and unfamiliar": Analysing the concept of perinatal anxiety; definition, recognition and implications for psychological care provision for women during pregnancy and early motherhood

AIM

To clarify how perinatal anxiety is characterised within the current evidence base and discuss how a clearer definition and understanding of this condition may contribute to improving care provision by midwives and other healthcare professionals.

BACKGROUND

Perinatal anxiety is common, occurs more frequently than depression and carries significant morbidity for mother and infant. The concept of perinatal anxiety is ill-defined; this can pose a barrier to understanding, identification and appropriate treatment of the condition.

DESIGN

Concept Analysis paper.

METHOD

Rodgers' Evolutionary Model of Concept Analysis, with review based on PRISMA principles (see Supplementary File-1).

FINDINGS

While somatic presentation of perinatal anxiety shares characteristics with general anxiety, anxiety is a unique condition within the context of the perinatal period. The precursors to perinatal anxiety are grounded in biopsychosocial factors and the sequelae can be significant for mother, foetus, newborn and older child. Due to the unique nature of perinatal anxiety, questions arise about presentation and diagnosis within the context of adjustment to motherhood, whether services meet women's needs and how midwives and other health professionals contribute to this. Most current evidence explores screening tools with little examination of the lived experience of perinatal anxiety.

CONCLUSION

Examination of the lived experience of perinatal anxiety is needed to address the gap in evidence and further understand this condition. Service provision should account for the unique nature of the perinatal period and be adapted to meet women's psychological needs at this time, even in cases of mild or moderate distress.

A pilot longitudinal sleep education intervention from early pregnancy and its effect on optimizing sleep and minimizing depressive symptoms

OBJECTIVES

Investigate the efficacy of a pilot longitudinal sleep education program for optimizing sleep and minimizing depressive symptoms in nulliparous pregnant women.

DESIGN

Early and longitudinal sleep education intervention pilot study.

SETTING

Community-based convenience sample of New Zealand women.

PARTICIPANTS

15 nulliparous women who were involved in a pilot of a longitudinal sleep education intervention during pregnancy (N = 15) were compared to a comparison group (n = 76) from another observational study with the same time points. Groups were matched on depression history and parity.

INTERVENTION

A longitudinal sleep education program was developed. Women in the intervention group participated in three individualized and trimester specific education sessions designed to increase sleep knowledge and improve sleep practices. The comparison group received no sleep education.

MEASUREMENTS

Self-reports of depressive symptoms and five dimensions of sleep (duration, quality, continuity, latency, daytime sleepiness) were compared between groups using linear mixed model analysis of variance.

RESULTS

At the conclusion of the intervention, the intervention group had fewer depressive symptoms with none experiencing clinically significant depressive symptoms, while 21% of the comparison group were considered to have clinically significant depressive symptoms. The intervention group also had better sleep quality, sleep initiation and sleep continuity than the comparison group at late pregnancy.

CONCLUSIONS

Findings suggest that a longitudinal sleep education intervention commencing early in pregnancy may be effective in optimizing sleep and minimizing depressive symptoms for nulliparous women with a history of depression. Further investigation of sleep education interventions to improve maternal mental health in pregnancy and postnatally is warranted.