Child sleep problems, maternal sleep and self-efficacy: Sleep's complicated role in maternal depression

Depression, poor sleep duration and low self-efficacy are common in mothers of children with sleep problems. However, research rarely extends beyond the postpartum period. This study investigated the multifaceted relationship between child sleep and maternal depression in early motherhood. A confidential survey assessed child sleep problems, maternal sleep duration, parental self-efficacy and depressive symptoms in 477 Australian mothers of children aged 3 months to 5 years. We found no relationship between child age and maternal depression, supporting our decision to look beyond postpartum depression. Robust bootstrapped mediation modelling tested the hypothesis that both maternal sleep duration and parental self-efficacy would mediate child sleep problems as predictors of maternal depression. After controlling for child age, results showed a significant parallel mediation effect, demonstrating that maternal sleep duration and parental self-efficacy both mediate the relationship between child sleep problems on maternal depression. While the total effect of child sleep problems on maternal depression was statistically significant, after partialling out the effects of other variables, child sleep problems no longer predicted maternal depression. Akaike information criterion analyses supported the full model, with both mediators explaining meaningful variance in maternal depression. This study expands our knowledge beyond the postpartum period, and divulges the disparate effects of sleep deprivation and parental self-efficacy on the relationship between child sleep and depression in early motherhood. Maternal sleep duration and self-efficacy are modifiable risk factors of maternal depression, indicating possible efficacious treatments. Parental self-efficacy stands out as a direction for clinical practice and further psychobiological study.

Relational parenthood in addiction recovery

Aims: The purpose of this research was to elicit how parents attending family-focused substance abuse treatment construct their parenthood in relation to other people. Design: Relational parenthood of addiction treatment attendees is scrutinised from seven thematic interviews carried out in a community-based inpatient substance abuse treatment unit in Finland. The core analytical concept of the research is relationality. The data were first content coded via Atlas.ti22 and the relations and codes classified into the five following parenthood types emerging from the data: (1) worn-out; (2) coping; (3) ambivalent; (4) changing; and (5) supported. Content codes and parenthood types were cross-tabulated to ascertain how these types are emphasised in different relationships. Results: Worn-out and coping parenthood types emerged in the closest relationships, mostly with their own children and the other parent. Ambivalent parenthood was present in all relations as expressions of inner conflict, which can lead to changing parenthood. Changing parenthood emerged in relation to interviewees' own children as an empowering experience. It also emerged in relation to other people as readiness to accept help. Supported parenthood was most often found in relation to significant others and professionals, presumably due to the context of the interviews. Conclusion: The parenthood types illustrate how parenting changes over time, which is also an important part of social identity change in recovering from addiction. In treatment, it is extremely important to understand the different sides of parenthood and to use the information to strengthen clients' parenthood.

The midwife's support during transition to motherhood: A modified Delphi study among care providers and childbearing women

OBJECTIVE

To reach consensus between care providers and childbearing women about the midwife's relevant and appropriate domains and elements to support transition to motherhood.

METHODS

A modified web-based Delphi study was conducted in Flanders (Belgium). After performing a systematic literature review, searching the grey literature and an online poll, a set of 79 items was generated. In two rounds, the items were presented to an expert panel of (1) care providers from various disciplines providing services to childbearing women and (2) to pregnant women and postpartum women up to 1-year postpartum. Consensus was defined when 70% or more of the experts scored ≥6, 5% or less scored ≤3, and a standard deviation of ≤1.1.

FINDINGS

In the first Delphi round, 91 experts reached consensus on 24 items. Seventeen round one items that met one or two consensus objectives were included in round two and were scored by 64 panel experts, reaching consensus on three additional items. The final 27 items covered seven domains: attributes, liaison, management of care from a woman-centred perspective, management of care from the midwife's focus, informational support, relational support, and the midwife's competencies.

CONCLUSION

The shared understanding between childbearing women and care providers shows that the midwife's transitional support is multifaceted. Our findings offer midwives a standard of care, criteria, guidance, and advice on how they can support childbearing women during transition to motherhood, beyond the existing recommendations and current provision of transitional care.

[The birthing chair, obstetric bed and gynecological chair in obstetrics and gynecology in Russia of XVIII-XX centuries]

The purpose of the study is to investigate material culture of obstetrics in New and Modern history of Russia. The most important objective of research is to involve into scientific circulation Russian empirical material in order to study transformation of culture of childbirth during transition from traditional to biomedical model of childbirth exemplified by material culture items (maternity beds, chairs, armchairs). The key approaches were those of historical anthropology, social history of medicine, theory of social control and medicalization. The methods of content analysis, narrative and interpretive analysis were applied to analyze empirical data. In the Russian folk tradition included no such special devices as maternity beds and birth chairs that was explained by dominance of vertical maternity pose. The first birth chairs were brought into Russia by foreign midwives. With development of clinical obstetrics horizontal position of woman in labor was approving that was conditioned by convenience of physicians. Since last quarter of the XIX century, Russian physicians began to experiment, inventing most convenient version of maternity beds and gynecological chairs. The Soviet system of obstetrics was mass and publicly accessible, but consolidated technocratic model of childbirth. In maternity wards, the "Rakhmanov obstetric bed" became widespread. The chairs were not used during childbirth, being used exclusively in gynecology. The material culture of Soviet maternity hospitals turned out to be extremely stable and conservative. In modern Russian obstetrics, with transition to holistic model of childbirth and actualization of free positioning of woman in labor, transformer beds and fitballs began to be applied to provide optimal course of birth process. The material culture of obstetrics is closely related to dominant type of maternity culture.

Cumulative Disadvantage or Strained Advantage? Remote Schooling, Paid Work Status, and Parental Mental Health during the COVID-19 Pandemic

During the COVID-19 pandemic, parents experienced difficulties around employment and children's schooling, likely with detrimental mental health implications. We analyze National Longitudinal Survey of Youth 1997 data (N = 2,829) to estimate depressive symptom changes from 2019 to 2021 by paid work status and children's schooling modality, considering partnership status, gender, and race-ethnicity differences. We draw on cumulative disadvantage theory alongside strained advantage theory to test whether mental health declines were steeper for parents with more disadvantaged statuses or for parents with more advantaged statuses. Parents with work disruptions, without paid work, or with children in remote school experienced the greatest increases in depressive symptoms, with steepest increases among single parents without paid work and single parents with children in remote school (cumulative disadvantage), fathers without paid work (strained advantage), and White parents with remote school (strained advantage). We discuss the uneven impacts of the pandemic on mental health and implications for long-term health disparities.

Social contributions to meaning in life: the role of romantic relationship quality, parenting, and gender

Introduction

The present study tests the association between romantic relationship quality and number of children on meaning in life (i.e., sense of purpose, coherence, and significance) and considers interactions between these constructs and gender.

Methods

A survey was conducted approximately one year into the pandemic among 473 individuals in the United States.

Results

Models demonstrated that relationship quality and number of children are positively associated with meaning, though relationship quality was more strongly related to meaning for men than women. We showed that for women there was an equally positive link between relationship quality and meaning regardless of number of children. However, for men, the positive association between relationship quality and meaning was strongest for those with more than one child, decreased in magnitude for those with one child, and was no longer significant for men with more than one child.

Discussion

These findings provide empirical evidence that social relationships benefit meaning in life and underscore the complexity of these associations. Results have implications for theoretical perspectives on meaning in life, as well as for policies that encourage family wellbeing.

Family building and pregnancy experiences of cisgender sexual minority women

BACKGROUND

Although 10% to 20% of cisgender women aged 18 to 40 years have a sexual minority identity (eg, bisexual, lesbian, and queer), there is limited research on the family building and pregnancy experiences of sexual minority cisgender women. Improving our understanding of the family building and pregnancy experiences of cisgender sexual minority women is critical for improving the perinatal health of this population.

OBJECTIVE

This study aimed to compare the mode of family building, past pregnancy experiences, and future pregnancy intentions among cisgender sexual minority women by sexual orientation.

STUDY DESIGN

This is an observational study which was conducted using cross-sectional data collected in 2019 from a national sample of 1369 cisgender sexual minority women aged 18 to 45 years.

RESULTS

Most participants (n=794, 58%) endorsed multiple sexual orientations, most commonly queer (n=641, 47%), lesbian (n=640, 47%), and/or bisexual (n=583, 43%). There were 243 (18%) cisgender sexual minority women who were parents. Pregnancy was used by 74% (181/243) of women to build their families. Among participants who used pregnancy, 60% (108/181) became pregnant through sexual activity with another parent of the child, whereas 27% (64/243) of women used donor sperm. An additional 10% (n=24) became parents through second-parent adoption, 10% (n=25) through adoption, and 14% (n=35) through step-parenting. Bisexual women more often used sexual activity to become parents (61/100, 61%) compared with queer (40/89, 45%) and lesbian women (40/130, 31%). In contrast, lesbian (50/130, 39%) and queer (25/89, 27%) women more often used donor sperm to become parents compared with bisexual women (11/100, 11%). Among the 266 (19%) cisgender sexual minority women who had ever been pregnant, there were 545 pregnancies (mean, 2.05 pregnancies per woman). Among those pregnancies, 59% (n=327) resulted in live birth, 23% (n=126) resulted in miscarriage, 15% (n=83) resulted in abortion, and 2% (n=9) resulted in ectopic pregnancy. A quarter of women had future pregnancy intentions, with no differences by sexual orientation. Overall, few participants (16%) reported that all of their healthcare providers were aware of their sexual orientation.

CONCLUSION

Cisgender sexual minority women primarily built their families through pregnancy and a quarter have future pregnancy desires. In addition, there were important differences in family building methods used by sexual orientation. Providers should be aware of the pregnancy and family-building patterns, plans, and needs of cisgender sexual minority women.

Becoming a father: a qualitative study on the journey to fatherhood

BACKGROUND

The transition to fatherhood represents one of the most significant changes in a man's life and brings many challenges. Despite the great importance of this period, empirical data on it are not abundant, with only a small amount of psychological research on fatherhood available in the Czech Republic; this topic is also rather marginalized abroad. This qualitative study aims to explore men's unique experiences with the process of becoming a father and to understand how paternal identity is shaped.

PARTICIPANTS AND PROCEDURE

Four men who had recently become fathers participated in the research. A semi-structured interview was conducted with each of them.

RESULTS

Using the interpretative phenomenological analysis (IPA) approach, an in-depth analysis of the data identified five significant categories that emerge during the transition to fatherhood: responsibility and commitment to the child, father identity formation, fatherhood and motherhood, changes in the partner relationship and coping with the father role.

CONCLUSIONS

The research suggests that the process of becoming a father is a long-term dynamic process, in which father identity is shaped and consolidated through a variety of situations and experiences. Within this process, paternal identity is also shaped through repeated comparisons and definitions of the role of the mother. Process of becoming a father involves developmental, identity, personality, partnership and family aspects.

["The Nidcap gave me the impression of having a fairer and more objective perception of the child"]

Certified Neonatal Individualized Developmental Care and Assessment Program (Nidcap) childcare worker, Fabienne Grillère first experimented with this practice in the neonatology department before doing so in maternal and child care. Indeed, the principle of Nidcap care can be applied in different professional sectors since they refer to the premature or sick newborn and its observation. Its use brings an undeniable advantage in the support offered to the child and his family.

"What choice do you have knowing your child can't breathe?!": Adaptation to Parenthood for Children Who Have Received a Tracheostomy

Introduction

A growing number of parents are navigating parenthood influenced by medical complexity and technological dependency as the group of children with long-term tracheostomy grows. However, little is known regarding the parental experiences of parenthood for this heterogeneous group of children now surviving through infancy and intensive care.

Objective

This study aimed to analyze how parents of children who have received a tracheostomy adapted to parenthood.

Methods

Interviews were conducted and analyzed following a constructivist grounded theory approach. Ten parents of seven children living with a tracheostomy in Sweden were recruited via the long-term intensive care unit (ICU).

Results

The core variable of parenthood "Stuck in survival" was explained by two categories and six subcategories. The category "Unaddressed previous history" describes the experiences from being in the ICU environment and how the parents are not able, due to insufficient time and resources, to address these stressful experiences. The category "Falling through the cracks of a rigid system" describes how the parents found themselves and their children to be continuously ill-fitted in a medical system impossible to adapt to their needs and situation. Parents placed the starting point of parenthood with the birth of the child, whilst the tracheotomy only constituted a turning point and would lead to the loss of any previously held expectations regarding parenthood.

Conclusion

This study identified a previously undescribed period prior to tracheostomy placement, which may have long-lasting effects on these families. The care provided in ICUs following the birth of a child who will require tracheostomy may not be tailored or adapted to accommodate the needs of these families leading to long-lasting effects on parenthood.

Parenthood during the COVID-19 pandemic: Post-traumatic growth amongst university students

This study sought to investigate a positive dimension of coping with the COVID-19 pandemic, that of post-traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian-Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID-19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post-traumatic growth, in addition to the prevention of COVID-19-related distress.

Selling vs. Supporting Motherhood: How Corporate Sponsors Frame the Parenting Experiences of Elite and Olympic Athletes

Recently, motherhood and pregnancy in elite sport have received increased attention in sport media. Through a comprehensive news media search across Factiva as well as a gray literature search using Google search engine, we analyzed 115 articles using feminist framing analysis. We developed two primary frames: 1) empowerment versus exploitation, and 2) proactivity versus reactivity. Our results show that many pregnant and parenting athletes frame their respective sponsors as exploitative for recognizing and capitalizing upon their unique marketing value, while these same corporate sponsors frame themselves as industry leaders who empower pregnant and parenting athletes. These two frames show that pregnant/parenting elite athletes commonly face discriminatory policies and practices and that there is often a lack of congruence between marketing and actual corporate practices and policies. These findings arguably reflect larger societal issues related to gender equity and highlight the importance of action over rhetoric to ensure motherhood is supported-rather than marketed-for elite athletes.

Intersecting risk factors for physical inactivity among Canadian adults

Background

On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation.

Methods

Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation.

Results

More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity.

Interpretation

Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable.

Reproduction and parenthood among lesbian couples in China: Legal and ethical perspectives

In China, neither reproduction and parenthood by lesbian couples nor their marital status are regulated or protected by law. In 2020, the first legal dispute in China involving a lesbian couple over custody of their joint baby was heard in court. This study examines the legal and ethical issues that lesbian couples confront when they decide to give birth to a child of their own. These challenges begin with regulatory restrictions on their lawful access to assisted reproductive technology and extend to gaps in the legal establishment of parenthood. We found that the lack of access to legitimate reproductive assistance for lesbian couples in China has caused them to make efforts to circumvent laws and regulations to have a child. However, the legislative gaps later led to ethical dilemmas when resolving disputes over parenthood. This study discusses different accounts of establishing and determining natural parenthood in China and concludes by pointing out the urgent need for change in legislative and sociocultural attitudes toward both assisted reproductive technology and same-sex relationships, mapping the way forward for lesbian couples to obtain better protection of procreation and parenthood before their marriage is culturally accepted and finally legalized.

The modern landscape of fertility, pregnancy, and parenthood in people with cystic fibrosis

PURPOSE OF REVIEW

With improved long-term survival and the expanding availability of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies that treat the underlying genetic defect in cystic fibrosis, more people are interested in parenthood. Cystic fibrosis care centers and people with cystic fibrosis need more information to guide decisions related to parenting.

RECENT FINDINGS

Here we present currently available data on fertility, pregnancy, and parenthood in the modern era of cystic fibrosis care. Fertility may be improving in female individuals with cystic fibrosis with the use of CFTR modulator therapies, and there is an associated increase in annual pregnancies. Infertility in male individuals with cystic fibrosis remains approximately 97-98% and is unchanged with CFTR modulators in those already born with cystic fibrosis. As more female individuals with cystic fibrosis experience pregnancy, questions remain about the impact of pregnancy on their health and that of their child. Fortunately, there are multiple routes to becoming a parent; however, more work is needed to understand the impact of pregnancy and parenthood in the context of CF as some previous data suggests potential challenges to the health of parents with cystic fibrosis.

SUMMARY

We encourage cystic fibrosis care teams to have knowledge and resources available to support the reproductive goals of all individuals with cystic fibrosis.

Factoring in Family: Considerations of Parenthood in the Assessment, Enforcement, and Collection of Legal Financial Obligations (LFOs)

Prior research has yet to address how criminal legal system actors take parenthood into account when imposing and enforcing LFOs. Drawing on evidence from 205 semi-structured interviews conducted across four states, this study explores the relationship between monetary punishment and parenthood from the perspectives of court and community corrections professionals. Engaging Kathleen Daly's framework of familial paternalism (1987a, 1987b, 1989a, 1989b), we find that system actors obtain and interpret information about defendant circumstances to (1) consider family complexity, (2) construct deservingness and (3) curb spill-over punishment. Ultimately, we find that system actors consider parental status in relation to LFOs and defendants' ability to pay, though their decisions also hinge on gender and the nature of parental involvement.

An online self-guided cognitive intervention for unwanted intrusive thoughts about harming infants in new parents: initial randomised controlled trial with mediation analysis

Approximately one-fifth of new parents struggle with unwanted intrusive thoughts (UITs) about intentionally harming their child. This study evaluated the initial efficacy, feasibility and acceptability of a novel online self-guided cognitive intervention for new parents with distressing UITs. Self-recruited parents (N = 43, 93% female, age 23-43 years) of children 0-3 years reporting daily distressing and impairing UITs were randomized to the 8-week self-guided online cognitive intervention or to waiting-list. The primary outcome was change on the Parental Thoughts and Behaviour Checklist (PTBC) from baseline to week 8 (post-intervention). The PTBC and negative appraisals (mediator) were assessed at baseline, weekly, post-intervention and at the 1-month follow-up. Results showed that the intervention led to statistically significant reductions in distress and impairment associated with UITs at post-intervention (controlled between-group d = 0.99, 95% CI 0.56 to 1.43), which were maintained at the 1-month follow-up (controlled between-group d = 0.90, 95% CI 0.41 to 1.39). The intervention was deemed to be feasible and acceptable by the participants. Change in negative appraisals mediated reductions in UITs but the model was sensitive to mediator-outcome confounders. We conclude that this novel online self-guided cognitive intervention can potentially reduce the distress and impairment associated with UITs in new parents. Large-scale trials are warranted.Abbreviations: UITs: Unwanted Intrusive Thoughts PTBC: Parental Thoughts and Behaviour Checklist.

[What tools can be used to create a parent-child group in a transcultural situation?]

Welcoming migrant families into an early childhood unit forces professionals to reflect on their clinical practices. When faced with parents with whom the therapeutic alliance is hard to establish and with children with developmental delays, a psychologist and a childcare assistant turn to transcultural psychology to find adapted tools. This text presents the reflections, the set up and the beginning of a parent-child therapeutic group.

Interrelated effects of age and parenthood on whole-brain controllability: protective effects of parenthood in mothers

Background

Controllability is a measure of the brain's ability to orchestrate neural activity which can be quantified in terms of properties of the brain's network connectivity. Evidence from the literature suggests that aging can exert a general effect on whole-brain controllability. Mounting evidence, on the other hand, suggests that parenthood and motherhood in particular lead to long-lasting changes in brain architecture that effectively slow down brain aging. We hypothesize that parenthood might preserve brain controllability properties from aging.

Methods

In a sample of 814 healthy individuals (aged 33.9 ± 12.7 years, 522 females), we estimate whole-brain controllability and compare the aging effects in subjects with vs. those without children. We use diffusion tensor imaging (DTI) to estimate the brain structural connectome. The level of brain control is then calculated from the connectomic properties of the brain structure. Specifically, we measure the network control over many low-energy state transitions (average controllability) and the network control over difficult-to-reach states (modal controllability).

Results and conclusion

In nulliparous females, whole-brain average controllability increases, and modal controllability decreases with age, a trend that we do not observe in parous females. Statistical comparison of the controllability metrics shows that modal controllability is higher and average controllability is lower in parous females compared to nulliparous females. In men, we observed the same trend, but the difference between nulliparous and parous males do not reach statistical significance. Our results provide strong evidence that parenthood contradicts aging effects on brain controllability and the effect is stronger in mothers.

Deconstructing self-fulfilling outcome measures in infertility treatment

The typical outcome measure in infertility treatment is the (cumulative) healthy live birth rate per patient or per cycle. This means that those who end the treatment trajectory with a healthy baby in their arms are considered to be successful and those who do not are considered to have failed. In this article, we argue that by adopting the healthy live birth standard as the outcome measure that defines a successful fertility treatment, it becomes an interpretative self-fulfilling prophecy: those who achieve the goal consider themselves successful and those who do not consider themselves failures. This is regardless of the fact that having children is only one out of many ways to alleviate the suffering related to infertility and that stopping fertility treatment can also be a positive decision to move on to other goals, rather than a form of "giving up," "dropping out," "nonadherence," or failure. We suggest that those seeking fertility treatment would be served better by an alternative outcome measure, which can be equally self-fulfilling, according to which a successful treatment is one in which people leave the clinic released from the suffering that accompanied their status as infertile when they first entered the clinic. This new outcome measure still implies that walking out with a healthy baby is a positive outcome. What changes is that walking out without a baby can also be a positive outcome, rather than being marked exclusively as a failure.

Reimbursement of elective egg freezing from health care systems: Beyond simplistic claims

France is the first country to offer elective egg freezing for nonmedical reasons under public health coverage. However, this decision deserves in‐depth scrutiny in the future because the cost‐beneficial profile is yet unknown.

Cohort effects of women's mid-life binge drinking and alcohol use disorder symptoms in the United States: Impacts of changes in timing of parenthood

BACKGROUND AND AIMS

Alcohol use is increasing among women in mid-life concurrently with societal changes in timing of parenthood and changing cultural norms, which may influence alcohol use. The aim of this study was to determine if age of first parenting was associated with excessive drinking [i.e. past 2-week binge drinking and past 5-year alcohol use disorder (AUD) symptoms] among women during mid-life in the United States and to determine if there were pronounced cohort effects influencing these relationships.

DESIGN

This was a retrospective cohort, longitudinal study.

SETTING, PARTICIPANTS AND MEASUREMENTS

Data were drawn from the Monitoring the Future survey, an annual ongoing survey of high school students' substance use behaviors in the United States. Participants were women who completed the age 35 survey between 1993 and 2019, corresponding to high school senior years 1976-2002 (n = 9988). Past 2-week binge drinking and past 5-year AUD symptoms were self-reported. Age of first parenting was self-reported.

FINDINGS

Binge drinking and AUD symptoms were higher among women in recent than in older cohorts. Women from the 2018-19 cohort had increased odds of binge drinking [odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.41-2.12] and AUD symptoms (OR = 1.51, CI = 1.27-1.80) relative to women from the 1993-97 cohort. Throughout cohorts, there was an inverse association between transition to parenthood and excessive drinking outcomes (e.g. range for ORs for binge drinking among those without children compared with those who had had children between the ages of 18 and 24: 1.22-1.55). Simultaneously, there was a population shift towards delaying parenting in recent cohorts (i.e. 54% of women in the 1993-97 cohort had children before age 30 compared with 39% in the two recent cohorts), increasing the size of the group at highest risk for excessive drinking.

CONCLUSIONS

In the United States, subgroups of women at highest risk of excessive drinking appear to be expanding, probably supported in part by a trend towards delayed parenting.

[Meeting your baby and becoming a father]

The birth, the moment when the father physically discovers his baby, is essential in the development of fatherhood. Accompanying this encounter during the stay in the postnatal unit leads to a greater commitment to care on the part of the father over the following three months. It therefore seems essential to support him during these first moments, by offering him skin-to-skin contact, for example, or by showing him in practical terms how to provide nursing care for his newborn. Encouraging the development of the father-baby relationship is beneficial for the family alliance that is being built around the cradle.

A conditional process analysis of suicidal thoughts and behaviors in outpatient parents: Examining the Narrative Crisis Model by parenthood status

No study to date has examined the moderating effect of parenthood on suicidal states and outcomes using a conditional process model. The Narrative Crisis Model, a multi-stage model from interpersonal distress to suicidal outcomes mediated by Suicide Crisis Syndrome severity, was assessed (H1). The present study tested whether (H2) parenthood moderates the indirect association between interpersonal distress and suicidality to reduce suicide risk. Psychiatric outpatients (N = 466) completed measures assessing the severity of interpersonal distress and Suicide Crisis Syndrome, as well as a clinical interview of suicidal thoughts and behaviors. The sample was predominantly female (65.7%), with ages ranging from 18 to 84 years. Mediation was conducted on the total sample (H1) and a conditional process analysis compared parents (n = 170) and non-parents (H2). Suicide Crisis Syndrome severity mediated the relationship between interpersonal distress and suicidal outcomes. Parenthood moderated the indirect relationship between interpersonal distress and suicidal outcomes through Suicide Crisis Syndrome such that parents had a significantly higher suicide risk than non-parents (index = 0.058; 95% CI [0.005, 0.139]). In the context of an outpatient population, parents appear to be more at risk for developing a suicidal crisis and engaging in suicidal thoughts and behaviors than non-parents. Parenthood may act as a pile-up stressor for this population, outweighing the protective effects of having children. In this way, the Narrative Crisis Model is a theoretical model suitable for the examination of complex factors impacting risk for near-term suicidal thoughts and behaviors.

The genesis of perinatal clinical psychology and its contemporary issues

The main aim of French clinical psychology is to explain the psychic processes of transformation, to which the subject is central. In this context, transformations in the perinatal period open an innovating field in perinatal clinical psychology focused on the conscious/subconscious, subjective/inter-subjective psychic reality of a subject who is in the process of becoming (or becoming once again) a parent and being born a human.

In it Together: Relationship Transitions and Couple Concordance in Health and Well-Being

Events that change the family system have the potential to impact couple dynamics such as concordance, that is, partner similarity in health and well-being. This project analyzes longitudinal data (≥ two decades) from both partners of up to 3,501 German and 1,842 Australian couples to investigate how couple concordance in life satisfaction, self-rated health, mental health, and physical health might change with transitioning to parenthood and an empty nest. Results revealed couple concordance in intercepts (averaged r = .52), linear trajectories (averaged r = .55), and wave-specific fluctuations around trajectories (averaged r = .21). Concordance in linear trajectories was stronger after transitions (averaged r = .81) than before transitions (averaged r = .43), whereas no systematic transition-related change in concordance of wave-specific fluctuations was found. Findings emphasize that shared transitions represent windows of change capable of sending couples onto mutual upward or downward trajectories in health and well-being.

'The law is very, very outdated and not keeping up with the technology': novel forms of assisted gestation, legal challenges, and perspectives of reproductive rights advocates in England and Wales

A growing body of literature examines the ethico-legal challenges resulting from novel forms of assisted gestation like uterus transplantation and artificial placentas (also known as 'artificial wombs'). However, there has not yet been consideration of reproductive rights organizations/advocates' understandings of novel forms of assisted gestation and their challenges. These perspectives provide critical insight into how novel procreative practices are understood and the problems and pressures that might arise from their use. This is the first legal article to engage with reproductive rights organizations/advocates and thus it provides important contextual grounding to existing scholarship about assisted gestation. Focus group discussion epitomized the need for legal reform in key areas surrounding reproduction. Themes were constructed that exemplify what participants highlighted as critical: the need to re-evaluate the fundamentals of legal parenthood, consideration of how novel technologies could further enable the policing of gestation, and the space and time needed for law-making.

Parental burnout, depression and emotional development of the preschoolers

Introduction

Parental burnout is becoming more and more prevalent in the world, mainly incultures with high demands towards parents. Parental burnout is distinctive from depression and might have its unique influence on child development, which isunder current international research. This work contributes to the understanding of parental burnout, maternal depression and child emotional development(specifically emotion comprehension) interrelations. Additionally, we explored whether there are differences in the effects of parental burnout and depressionon boys and girls.

Methods

To analyse the emotional development of the preschoolers, the Russian version of the Test of Emotional Comprehension (TEC) was used. We used the Russian version of the Parental Burnout Inventory (PBI) to analyse the level of PB and the Russian version of Beck depression Inventory (BDI) to assess participants' depression level.

Results

Parental burnout positively correlates with child emotional comprehension skills, specifically understanding of external causes (B = 0.20, CI: 0.03; 0.37) and mental causes of emotions (B = 0.22, CI: 0.05; 0.40). This effect is gender dependent and is significantlyhigher for girls (B = 0.54, CI: 0.09; 0.98). The effect of maternal depression on emotion comprehension skills is also gender dependent: total scores on emotioncomprehension tasks are significantly higher for daughters of mothers with depression (B = 0.59, CI: 0.001; 1.18).

Discussion

Maternal depression and parental burnout might provoke development of extra sensitivity and self-regulation strategies in girls.

Desire for genetically related children among transgender and gender-diverse patients seeking gender-affirming hormones

Objective

To assess predictors of desire for genetically related children among a national cohort of reproductive-age transgender and gender-diverse patients aged 18 to 44 years initiating gender-affirming hormone therapy for the first time.

Design

Cross-sectional study.

Setting

National telehealth clinic.

Patients

A cohort of patients from 33 US states initiating gender-affirming hormone therapy. A total of 10,270 unique transgender and gender-diverse patients-aged 18 to 44 years (median age 24 years), with no prior use of gender-affirming hormone therapy-completed clinical intake forms between September 1, 2020, and January 1, 2022.

Interventions

Patient sex assigned at birth, insurance status, age, and geographic location.

Main Outcome Measures

Self-reported desire for children using own genetic material.

Results

Transgender and gender-diverse patients seeking gender-affirming medical treatments who are open to having genetically related children are an important population to identify and appropriately counsel. Over one quarter of the study population reported being interested in or unsure about having genetically related children, with 17.8% reporting yes and 8.4% unsure. Male-sex-assigned-at-birth patients had 1.37 (95% confidence interval: 1.25, 1.41) times higher odds of being open to having genetically related children compared with female-sex-assigned-at-birth patients. Those with private insurance had 1.13 (95% confidence interval: 1.02, 1.37) times higher odds of being open to having genetically related children compared with those without insurance.

Conclusions

These findings represent the largest source of self-reported data on the desire for genetically related children among reproductive-age adult transgender and gender-diverse patients seeking gender-affirming hormones. Guidelines recommend that providers offer fertility-related counseling. These results indicate that transgender and gender-diverse patients, particularly male-sex-assigned-at-birth individuals and patients with private insurance, could benefit from counseling regarding the impacts of gender-affirming hormone therapy and gender-affirming surgeries on fertility.

Assessing knowledge regarding fertility and attitude and intentions towards future parenthood among undergraduate medical students in Karachi

This study aimed to assess the knowledge regarding female fertility, infertility treatments and the attitudes regarding parenthood of medical students in Pakistan. Delayed childbirth among medical trainees due to extended years of medical education and training puts this population at a higher risk for involuntary childlessness later in life due to age-related decline in female fertility. A knowledge, attitude and practice study was carried out among medical students in Karachi in July 2021 using the English version of the Swedish Fertility Awareness questionnaire, which has been used in similar studies. Most participants wished to have children at some point in the future. However, a majority of students did not have sufficient knowledge regarding age-related decline in female fertility and overestimated the efficacy of infertility treatments. The results of this study indicate that despite planning to have children and placing great importance on parenthood, medical students severely overestimate female fertility and plan to start having children at an age at which female fecundity has begun to decline. These findings highlight a need for better provisions regarding fertility knowledge in the curriculum for medical students, as they are an at-risk group for involuntary childlessness due to age-related fertility decline.

Desire for biological parenthood and patient counseling on the risk of infertility among adolescents and adults with hemoglobinopathies

BACKGROUND

Both diagnosis and treatment of hemoglobinopathies have been associated with an increased risk of fertility impairment. German guidelines recommend annual monitoring of fertility parameters to enable early detection of fertility impairment and/or to offer fertility preservation (FP) when indicated. We explored the general desire for parenthood, the frequency of recalling fertility counseling and testing, and the utilization of FP in adolescents and adults with hemoglobinopathies.

PROCEDURE

In a cross-sectional study, patients aged 12-50 years, treated in Germany, Austria, or Switzerland, were surveyed on fertility-related aspects. Medical data, including fertility testing results, were collected from patient records.

RESULTS

Overall, 116/121 eligible patients, diagnosed with sickle cell disease (70.7%), thalassemia (27.6%), or other hemoglobinopathy (1.7%), participated in our study (57.8% female, median age 17.0 years, range 12-50 years). All participants required treatment of the underlying hemoglobinopathy: 68.1% received hydroxyurea, 25.9% required regular blood transfusions, and 6.0% underwent hematopoietic stem cell transplantation (HSCT). Most patients (82/108, 75.9%) stated a considerable to strong desire for (future) parenthood, independent of sex, education, diagnosis, or subjective health status. Fertility counseling was only recalled by 32/111 patients (28.8%) and least frequently by younger patients (12-16 years) or those treated with regular blood transfusions or hydroxyurea. While fertility testing was documented for 59.5% (69/116) in medical records, only 11.6% (13/112) recalled previous assessments. FP was only used by 5.4% (6/111) of patients.

CONCLUSION

Most patients with hemoglobinopathies wish to have biological children, yet only few recalled fertility counseling and testing. Adequate patient counseling should be offered to all patients at risk for infertility.

Paternal Leave Entitlement and Workplace Culture: A Key Challenge to Paternal Mental Health

Paternal mental health continues to be a health concern in the UK. Paternal leave entitlement and workplace cultures have failed to support fathers in navigating the complexity of fatherhood, which has an impact on fathers' wellbeing. Interviewing twenty fathers in the York area, this study seeks to explore the impact of parental leave entitlements and workplace cultures on fathers' mental health. The findings demonstrate that the influence of gendered norms and hegemonic masculinity perceptions are ingrained in the current leave entitlement and workplace cultures. While fathers are entitled to take leave, the leave is significantly insufficient to allow them to forge a meaningful bond with a newborn or adapt to the change in routine brought about by the birth of a baby. Furthermore, workplace cultures fail to recognise the responsibilities that come with fatherhood and provide insufficient support for fathers. The COVID-19 lockdown presented fathers with a unique opportunity to be available and take on more family responsibilities. Fathers felt they did not have to navigate gendered and hegemonic perceptions to spend more time with the family. This paper challenges structural and cultural barriers that prevent fathers from taking leave and impacting negatively on fathers' mental health. The paper suggests a review of the current paternal leave entitlement and cultural change in the workplace.

Work-Family Conflict and Family Role Performance Among Collegiate Athletic Trainers

CONTEXT

Work-life balance continues to be a focal point of athletic training research, particularly due to the job challenges and demands of health care providers. Despite a large body of literature, much is still unexplored, especially in the area of family role performance (FRP).

OBJECTIVE

To examine the relationships between work-family conflict (WFC), FRP, and various demographic variables among athletic trainers employed in the collegiate setting.

DESIGN

Cross-sectional online survey.

SETTING

Collegiate setting.

PATIENTS OR OTHER PARTICIPANTS

A total of 586 collegiate athletic trainers (females = 374, males = 210, sex variant or nonconforming = 1, preferred not to answer = 1).

MAIN OUTCOME MEASURE(S)

Data were collected through an online survey (Qualtrics) in which participants responded to demographic questions and previously validated WFC and FRP scales. Demographic data were reported and analyzed for descriptive information and frequencies. Mann-Whitney U tests were performed to identify differences among groups.

RESULTS

Participants' mean scores were 28.19 ± 6.01 and 45.86 ± 11.55 for the FRP and WFC scales, respectively. Mann-Whitney U tests revealed differences between men and women for WFC scores (U = 344 667, P = .021). The FRP score was moderately negatively correlated with the WFC total score (rs[584] = -0.497, P < .001) and predicted the WFC score (b = 72.02, t582 = -13.30, P = .001). The Mann-Whitney U test demonstrated that married athletic trainers (47.20 ± 11.92) had higher WFC scores than those who were not married (43.48 ± 11.78; U = 19847.00, P = .003). Mann-Whitney U analysis (U = 32 096.00, P = .001) also revealed a difference between collegiate athletic trainers with children (48.16 ± 12.44) and those without children (44.68 ± 10.90).

CONCLUSIONS

Collegiate athletic trainers experienced more WFC with marriage and having children. We propose that the time required to raise a family and build relationships may cause WFC due to time incongruencies. Athletic trainers want to be able to spend time with their families; however, when such time is highly limited, then WFC increases.

Changes, differences, and factors of parenthood in high-risk pregnant women and their partners in Japan

Background

Various stressors exists for pregnant women worldwide, especially negative social and environmental influences that can increase the number of high-risk pregnant women. These may cause a difficult transition to parenthood for women and their partners. However, limited studies have focused on and examined parenthood. Therefore, this study aimed to identify the changes in parenthood from pregnancy to post-discharge after childbirth among high-risk pregnant women and their partners, as well as the presence or absence of gender differences and the factors associated with parenthood.

Methods

This longitudinal quantitative study used a self-administered anonymous questionnaire distributed among 127 pregnant women and their partners who visited a high-risk pregnant outpatient clinic. The Scale of Early Childrearing Parenthood (SECP; three subareas, 33 items) was administered thrice: during pregnancy (T1), after childbirth (T2), and after discharge (T3).

Results

The analysis included 85 T1 (37 fathers and 48 mothers), 36 T2 (13 fathers and 23 mothers), and 31 T3 (11 fathers and 20 mothers) responses. There was a significant increase in the SECP scores for both parents from T1 to T3. Mothers had a greater increase in the SECP scores from T1 to T2 than fathers. In addition, fathers’ mean SECP scores at T1 and T2 were higher compared with those of the mothers. Mothers’ and fathers’ SECP scores at each time point showed no significant differences.

At all time points, the SECP scores were commonly and significantly associated with infertility treatment, physical and mental condition, postpartum depression at T2, and parenting stress at T3.

Conclusions

Because parenthood in the infertility treatment group was significantly higher throughout the series, we need to support such couples so that childbirth does not become their main goal. We suggest interventions for factors that impede parenthood development, understand the various backgrounds of the parents, and support the couple individually while also considering them as a unit.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-023-05519-3.

[Consequences of domestic violence on toddler development and parenting]

The climate of domestic violence is a major risk factor for the health and development of children from an early age, as well as for parenthood. The role of health professionals is essential in addressing this issue. Training on this subject is necessary because it allows them to feel more comfortable in dealing with these issues and to work in an interdisciplinary manner.

From Housewives to Employees, the Mental Benefits of Employment across Women with Different Gender Role Attitudes and Parenthood Status

Previous studies suggest that paid employment can improve workers' mental health status by offering a series of manifest and latent benefits (i.e., income, self-achievement and social engagement), which motivates policymakers' ongoing promotion of labour force participation as an approach to protect women's mental health status. This study extends the literature by investigating the mental health consequences of housewives' transition into paid employment across different gender role attitude groups. In addition, the study also tests the potential moderating role of the presence of children in relationships. This study yields two major findings by using nationally representative data (N = 1222) from the United Kingdom Longitudinal Household Study (2010-2014) and OLS regressions. First, from the first wave to the next, housewives who transitioned into paid employment reported better mental health status than those who remained housewives. Second, the presence of children can moderate such associations, but only among housewives with more traditional gender role attitudes. Specifically, among the traditional group, the mental benefits of transition into paid employment are more pronounced among those without children. Therefore, policymakers should develop more innovative approaches to promote housewives' mental health by considering a more gender-role-attitudes-sensitive design of future labour market policies.

"Find ways to work parenting into cystic fibrosis": A PhotoVoice exploration of being a parent and having CF

BACKGROUND

As more people with cystic fibrosis (CF) consider their reproductive futures, the impact of parenthood on CF must be better understood. In the context of chronic disease, deciding if, when, and how to become a parent is complex. Little research has investigated how parents with CF balance their role as parents with its associated health impacts and demands of CF.

METHODS

PhotoVoice is a research methodology that utilizes photography to generate discussion about community issues. We recruited parents with CF with at least 1 child <10 years old and divided them into three cohorts. Each cohort met five times. Cohorts developed photography prompts, took photographs between sessions, and reflected on the photos at subsequent meetings. At the final meeting, participants selected 2-3 pictures, wrote captions, and as a group organized the photographs into thematic groups. Secondary thematic analysis identified metathemes.

RESULTS

Participants (n = 18) generated a total of 202 photographs. Each cohort identified 3-4 themes (n = 10) which secondary analysis grouped into 3 metathemes: (1) It is important for parents with CF to pay attention to the joyful aspects of parenting and to cultivate positive experiences; (2) Parenting with CF requires balancing your own needs with those of your child, and creativity and flexibility can be key; (3) Parenting with CF consists of competing priorities and expectations often with no clear "correct" choice.

CONCLUSIONS

Parents with CF identified unique challenges to their existence as both parents and patients as well as ways in which parenting has enhanced their lives.

Fast Track intervention effects on family formation

The present study examines whether the Fast Track (FT) intervention, a 10-year randomized controlled trial with children at risk for conduct problems, affects family formation in adulthood, as indexed by partnerships, parenthood, and family structure, and whether the intervention effect differs across participants' gender and race/ethnicity. Participants included 891 children (intervention n = 445; control n = 446; 69% male; 51% Black, 47% White) who were recruited in kindergarten and followed to age 32 or 34 (80% participation of still-living participants), when they reported on their romantic partnerships, parenthood, and family structure. Controlling for numerous covariates that are related to family formation, intervention participants were more likely than those in the control group to be married rather than single and to have a larger number of children; the intervention and control groups did not differ on cohabitation status, age at first marriage, whether they had ever been divorced, their likelihood of being a parent, the age at which they first became a parent, the spacing of births, family structure (partnered or not, with or without children), or in whether they were residentially independent of their parents and grandparents. Intervention effects were not moderated by gender, but race/ethnicity moderated the effect of the intervention on the probability of having any children and the number of children. These findings suggest that several elements of family formation may remain unchanged by an intervention that changes many other behavioral and psychological trajectories of participants. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Right to Sexuality, Reproductive Health, and Found a Family for People with Intellectual Disability: A Systematic Review

Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo's eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.

Social, Community, and Cultural Factors Associated with Parental Stress in Fathers and Mothers

Parenting stress is a key factor in predicting the quality of parent−child relationships and child development outcomes. Previous research tends to focus on examining individual factors contributing to parental stress, with minimal attention to other important contextual factors that may affect parenting. This study examines the issue from a broader ecological perspective by investigating social, cultural, and community factors associated with parental stress in a community sample of economically active fathers and mothers in Hong Kong. A secondary analysis was conducted using the data from the 2017 Family Survey, a territory-wide household survey conducted in Hong Kong. The data of the current study included a sub-sample of 736 working-class parents (48.4% males and 51.6% females). The mean age of fathers and mothers was 50.99 (SD = 11.2) and 48.68 (SD = 10.34) years, respectively. Mothers reported significantly higher levels of parental stress than fathers, t = −4.241, p < 0.001. Different social, cultural, and community factors were associated with parental stress for fathers and mothers. Strong endorsement of traditional family values (B = −0.23, p = 0.032) and frequent practice of filial piety (B = −0.005, p = 0.019) reduced parental stress in fathers. Additionally, fathers who perceived formal support as effective scored higher levels of parental stress, B = 0.20, p < 0.001. For mothers, informal social support from family members was the only social predictor for reduced parental stress (B = −0.14, p < 0.001) among all the other contextual variables. Community support to reduce parental stress in working parents should address the respective risk factors for fathers and mothers.

Bad mommies: socio-cognitive judgments of single mothers with alcohol use disorder

Gender disparity persists in the United States; women are still paid less than men and are also subject to discrimination in the workplace based on the fact that they may become mothers. Further, there is evidence to indicate that single mothers are judged more harshly than their married mother counterparts and single fathers. As a form of amelioration, some women self medicate with alcohol and according to the CDC), alcohol use disorder (AUD) is on the rise for women. Although there is research on gender disparity, the motherhood penalty, and AUD, there are no experiments testing socio-cognitive judgments on those combined factors and specifically examining what we term "the single motherhood penalty". Therefore, in two experiments using between-participants designs, participants rated a picture of a person (female or male) paired with a brief description where marital status (single or married) and type of ailment (alcohol or physical) was manipulated. In Experiment 1, a passive AUD manipulation did not show a clear single motherhood penalty. In Experiment 2, the results of an active AUD manipulation supported the predicted single motherhood penalty (Experiment 2a), but did not show an analogous single fatherhood penalty (Experiment 2 b). These findings are the first to offer empirical evidence that socio-cognitive judgments might perpetuate the interplay of the single motherhood penalty and AUD.

LGBTQ+ Persons' Experiences of Parenthood in the Context of Maternal and Child Health Care: A Meta-ethnography

This study aims to integrate and synthesize knowledge of lesbian, gay, bisexual, transgender and queer (LGBTQ+) persons' experiences of parenthood in the context of maternal and child health care. For nurses to provide optimal care for LGBTQ+ parents, we need to derive knowledge from their perspectives. An interpretive meta-synthesis approach, meta-ethnography, was chosen for this study. A lines-of-argument synthesis based on four themes was developed: (1) Entering the world of LGBTQ+ parenthood; (2) The emotional journey in LGBTQ+ parenthood; (3) Struggling with the system as a LGBTQ+ parent and (4) A need to expand the knowledge horizon of LGBTQ+ parenthood. The overarching metaphor, "To be recognised as parents, unique and good enough, like everybody else," reflects how recognition and inclusion may support LGBTQ+ persons in their parenthood and broaden the understanding of parenthood. Knowledge of the LGBTQ+ family needs to be given greater attention in maternity and child health care settings, and in education and health policies.

Parental stress and life satisfaction: A comparative study of social services users and nonusers from a gender perspective

The psychometric properties of the Spanish version of the Parental Stress Scale (PSS) scale have not been verified on the Spanish population. Similarly, the literature on gender differences and parental stress is inconclusive, and there is little evidence of their relationship with life satisfaction. To analyze the psychometric properties of the Spanish version of the PSS scale, (2) to examine possible gender differences, and (3) to study the relationship between parental stress (PS) and parental rewards (PR) and satisfaction with life (SWL) attending to the possible moderating effect of gender. These objectives were examined in samples comprising Social Services Users (SSU) (N = 525; 78.3% female; Mage  = 38.3) and non-SSU users (N = 421; 41.1% male; Mage  = 37.08). A CFA corroborated a two-factor structure: PS and PR. In the SSU sample, mothers showed higher PS and lower PR. However, PR was also higher in mothers from the non-SSU sample compared to fathers. PR and PS were directly related to SWL in the SSU sample. However, gender moderated the relationship between PR and SWL in the non-SSU sample in the case of mothers. The results are discussed considering gender roles and the characteristics of both samples.

Parenthood and changes in physical activity from early adulthood to mid-life among Finnish adults

This study examined longitudinal associations between parenthood-related factors and physical activity from young adulthood to midlife over a 19-year follow-up period. Participants (n = 761) at the ongoing Cardiovascular Risk in Young Finns Study responded to a self-report questionnaire in their adulthood (in 1992, 2001, 2007, and 2011). Participants were classified as meeting or not meeting an aerobic physical activity recommendation. Parenthood-related factors included the age of having their first child and the number and age of the children. Analyses of generalized estimation equations were performed and adjusted for several demographic and health-related covariates. Both mothers and fathers with children under 6 years were less likely to be involved in physical activity than participants without children. However, meeting the aerobic physical activity recommendations did not differ between parents with a youngest child who was 6 years old or older as compared to the childless participants. The older the youngest child was, the more likely the parents were to be physically active. Participants who became a parent relatively late, at the age of 30 or older, seemed less likely to meet the aerobic physical activity recommendation during follow-up than those who had their first child at the age of 26-29. The results indicate that parenthood does not seem to have a long-lasting negative impact on adults' physical activity, and the individuals reached a similar level of physical activity in midlife than they had before parenthood.

Pre-natal testing, excessive parenting and care ethics

This article explores the current parenting culture, particularly the promotion of competitive and excessive parenting, as an important background issue against which the debates around pre-natal testing take place. It offers an alternative vision of parenting, relying on care ethics, which sees parenting as a relationship, rather than a job. A relationship that should change a parent's understanding of what is valuable in life. Parenting should not be about moulding the 'perfect child' but being open to being profoundly changed. The parent-child with a disability relationship offers particular opportunities to find new meanings and values in life. This analysis is offered as another dimension to the debates over pre-natal testing. It is not intended as an argument against such testing, but rather raises concerns about some of the broader attitudes around it.

[Risks and opportunities of reproduction with HIV]

As the human immunodeficiency virus (HIV) infection has become a chronic disease, the question of becoming a parent arises for HIV-positive people. There are several answers to this question, depending on the situation. Here is an overview of the risks and possibilities of procreation with HIV.

Effect of Marriage on Burnout among Healthcare Workers during the COVID-19 Pandemic

Since the onset of the COVID-19 pandemic, burnout symptoms have been prevalent among healthcare workers. Living with spouses can be complex and was associated with an increased burnout risk during the COVID-19 pandemic. This study investigated the relationship between living with spouses and burnout among healthcare workers during the COVID-19 pandemic. We distributed questionnaires to participants working in a hospital affiliated with a medical university in Taiwan. The questionnaires were the Copenhagen Burnout Inventory, which comprises personal burnout (PB), work-related burnout (WB), and client burnout subscales; the Nordic Musculoskeletal Questionnaire; and information on basic demographic variables, family factors, living habits, work-related factors, and physical health factors. Multiple linear regression and mediation analysis were used. We obtained 1615 (63.81%) valid questionnaires. After analysis revealed that marriage was an independent risk factor for PB; however, the effect of marriage on WB was nonsignificant after controlling for risk factors. Parenthood, less alcohol use, reported sleep duration less than six hours, less overtime, less shift work, and participation in leisure activities with family and friends were found to be mediators between marriage and a lower WB level. In addition, chronic diseases, frequent neck pain, and shoulder pain were suppression factors. In summary, marriage was associated with an increased risk of PB. Married individuals sustain a high WB level because of changes in family roles, living conditions, and work conditions. Overall, helping healthcare workers to maintain well-being in marriage or family living may be effective in decreasing burnout during the COVID-19 pandemic.

Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict

Background

Pregnant teenagers usually experience psychosocial challenges such as a great amount of stress when they have to deal with an unwanted pregnancy, unpreparedness for parenthood and a lack of income as well as labour and birth complications. These are further complicated by the stigma from their families, friends and community. Unaddressed psychosocial challenges during teenage pregnancy can adversely affect the health outcomes of both mother and the child.

Aim

This study explores and describes the psychosocial challenges faced by pregnant teenagers in the Ditsobotla subdistrict.

Setting

The study was conducted in three health centres in the Ditsobotla subdistrict.

Methods

A qualitative-exploratory-descriptive and contextual research design was used. Non-probability purposive and convenience sampling techniques were used to select the participants. Semistructured individual interviews through WhatsApp video calls were used to collect data, which were analysed using conventional content analysis.

Results

Three themes emerged from the findings of the study, namely psychological challenges, social challenges and suggestions to address psychosocial challenges faced by pregnant teenagers.

Conclusion

The findings established that pregnant teenagers in the Ditsobotla subdistrict are faced with psychosocial challenges which negatively impact their psychological health and social life. Suggestions made in this study have the potential to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict if implemented.

Contributions

The findings of this study provide important information that may be used to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict.

The role of motherhood schemas and life transitions in reproductive intention formation

OBJECTIVE

This study provides a theory-based snapshot of the processes involved in women's fertility intention formation and decisions regarding the timing of motherhood.

BACKGROUND

The trend to defer childbearing is linked with both empowering and challenging outcomes for women. The cognitive-social (C-S) model suggests that deliberative thinking regarding reproduction occurs following fertility-relevant life transitions, which results in fluctuations in motherhood schemas and fertility intentions. This framework was applied to explore fertility intention formation.

METHODS

Semi-structured interviews were conducted with twelve women who either had children or desired children.

RESULTS

Two overarching themes central to the C-S model are discussed: (a) passive expectations and (b) deliberative intentions. Women's motherhood schemas were often underpinned by schematic structures (e.g. group norms and scripts) and material structures (e.g. observational influences). Life transitions and personal experiences tended to prompt deliberative thinking about motherhood plans.

CONCLUSION

The results were generally consistent with the C-S model, but highlight complexities to consider when investigating fertility expectations and intentions.

Pregnancy During Surgical Training: Are Residency Programs Truly Supporting Their Trainees?

OBJECTIVE

Despite recent national improvements in family leave policies, there has been little focus on program-level support for surgical trainees. Trainees who may require clinical duty adjustments during pregnancy, who experience pregnancy loss, or who struggle with balancing work obligations with the demands of a new infant may face stigma when seeking schedule accommodations. The aim of this study was to describe program and colleague support of surgical trainees for pregnancy-related and postpartum health needs.

DESIGN

Survey questionnaire. Participants responded to multiple-choice questions about their history of pregnancy loss, their experience with reduction of clinical duties during pregnancy, and their breastfeeding experience. Those who took time off after miscarriages or reduced their clinical duties during pregnancy were asked whether they perceived their colleagues and/or program leadership to be supportive using a 4-point Likert scale (1-strongly agree, 4-strongly disagree) which was dichotomized to agree/disagree.

SETTING

Electronically distributed through social media and surgical societies from November 2020 to January 2021.

PARTICIPANTS

Female surgical residents and fellows.

RESULTS

258 female surgical residents and fellows were included. Median age was 32 (IQR 30-35) years and 76.74% were white. Of the 52 respondents (20.2%) who reported a miscarriage, 38 (73.1%) took no time off after pregnancy loss, including 5 of 10 women (50%) whose loss occurred after 10 weeks' gestation. Of the 14 residents who took time off after a miscarriage, 4 (28.6%) disagreed their colleagues and/or leadership were supportive of time away from work. Among trainees who reported at least 1 live birth, only 18/114 (15.8%) reduced their work schedule during pregnancy. Of these, 11 (61.1%) described stigma and resentment from colleagues and 14 (77.8%) reported feeling guilty about burdening their colleagues. 100% of respondents reported a desire to breastfeed their infants, but nearly half (46.0%) were unable to reach their breastfeeding goals. 46 (80.7%) cited a lack of time to express breastmilk and 23 (40.4%) cited inadequate lactation facilities as barriers to achieving their breastfeeding goals.

CONCLUSIONS

A minority of female trainees takes time off or reduces their clinical duties for pregnancy or postpartum health needs. National parental leave policies are insufficient without complementary program-level strategies that support schedule adjustments for pregnant trainees without engendering a sense of resentment or guilt for doing so. Surgical program leaders should initiate open dialogue, proactively offer clinical duty reductions, and ensure time and space for lactation needs to safeguard maternal-fetal health and improve the working environment for pregnant residents.