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Journey from Pregnancy to Early Parenthood: Perceived Needs of Support, Fathers’ Involvement, Depressive Symptoms and Stress
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aim was to describe the perceived needs for support and fathers’ involvement among expectant parents, and to examine depressive symptoms and parental stress in early parenthood among mothers and fathers.

Methods: Two qualitative studies using focus groups and individual interviews, and three quantitative comparative studies using three questionnaires were conducted.

Results: The expectant parents had different needs and suggestions for health-care improvement. One improvement of these was better involvement of expectant fathers, as fathers were described as the mothers’ best means of support and also had needs of their own. The fathers used different strategies to get involved during the pregnancy, but sometimes found it difficult to know what was expected of them. The mothers perceived more depressive symptoms and parental stress than the fathers. The mothers also perceived higher dyadic consensus than the fathers. Parents with depressive symptoms reported lower consensus than those without. There was a negative correlation between dyadic consensus and depressive symptoms in both mothers and fathers. Mothers perceived higher parental stress than fathers in the sub-areas ‘Incompetence regarding parenthood’, ‘Role restriction’, ‘Spouse relationship problems’, and ‘Health problems’, and overall. In contrast, fathers perceived higher stress than mothers in the sub-area ‘Social isolation’. Low education, lack of a role model and poor sense of coherence promoted more stress in mothers in the sub-areas ‘Social isolation’ and ‘Spouse relationship problems’, while lack of a role model and low sense of coherence promoted stress in fathers in the sub-area ‘Social isolation’.

Conclusions and clinical implications: The expectant parents’ needs of support were not consistent with the support offered from health care services. These services need to become more client-centred, for example by offering customized individual support and peer support in groups. Further, they should also meet the needs of expectant fathers which can benefit the whole family. To promote parents’ health and family stability, health professionals should consider depressive symptoms and parental stress. They should also take gender norms into account so that parents become prepared for parenthood and get adequate support during early parenthood.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. , 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1057
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-237088ISBN: 978-91-554-9119-2 (print)OAI: oai:DiVA.org:uu-237088DiVA: diva2:766329
Public defence
2015-01-28, Samlingssalen, Ingång 29, Västmanlands sjukhus, Västerås, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2014-12-18 Created: 2014-11-26 Last updated: 2015-02-03
List of papers
1. Support Needs of Expectant Mothers and Fathers: a Qulitative Study
Open this publication in new window or tab >>Support Needs of Expectant Mothers and Fathers: a Qulitative Study
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2012 (English)In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 1, 36-44 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to describe expectant mothers’ and fathers’ perceived needs of support during pregnancy. Twenty-two women and 10 men were interviewed in four focus groups and 13 individual interviews. Systematic text condensation was performed. Parents described a broad spectrum of social support needs but also needs of psychological and physical support. They also requested to share experiences with others.  The foci of care and parents’ needs of support are more harmonized with medical than with psychological and emotional support. Mother’s needs were dominant in the health-services but father’s often felt “invisible”. Antenatal-services might offer more customized individual support and emphasize peer support in groups; the challenge is to involve both parents through communication and encouragement so they can support each other.

Keyword
fathers, mothers, midwifery, support needs
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-155047 (URN)10.1891/1058-1243.21.1.36 (DOI)23277729 (PubMedID)
Available from: 2011-06-15 Created: 2011-06-15 Last updated: 2017-01-24Bibliographically approved
2. The association between perceived relationship discord at childbirth and parental postpartum depressive symptoms: a comparison of mothers and fathers in Sweden
Open this publication in new window or tab >>The association between perceived relationship discord at childbirth and parental postpartum depressive symptoms: a comparison of mothers and fathers in Sweden
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2012 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 117, no 4, 430-438 p.Article in journal (Refereed) Published
Abstract [en]

Aim

To examine whether mothers' and fathers' levels of perceived relationship discord at childbirth were associated with postpartum depressive symptoms when the child was 3 months old. Another aim was to examine parents' levels of self-reported depressive symptoms. The hypothesis was that parents with high levels of perceived relationship discord have higher levels of postpartum depressive symptoms than parents with low levels of perceived relationship discord.

Method

One week after childbirth, 305 couples' perceived level of relationship discord was measured using the Dyadic Consensus Subscale (DCS) of the Dyadic Adjustment Scale (DAS). At 3 months postpartum, the same couples answered the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. The relations between perceived level of relationship discord and postpartum depressive symptoms were analysed using standard non-parametric statistical methods.

Results

The mothers and fathers partly differed regarding which areas of their relationship they perceived that they disagreed with their partners about. Furthermore, 16.5% of the mothers and 8.7% of the fathers reported postpartum depressive symptoms, and there was a moderate level of correlation between the DCS and EPDS scores.

Conclusion

These results may be useful for professionals in antenatal care and child health centres as well as for family caregivers who need to be aware that mothers and fathers may have different views on relationship discord and of the high level of depressive symptoms in recent parents. Further research is needed to examine perceived relationship discord and the development of depressive symptoms postpartum over a longer term.

Keyword
Depression postpartum, Family, Family relations, Fathers, Mothers
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-186016 (URN)10.3109/03009734.2012.684805 (DOI)000310372800011 ()
Available from: 2012-11-28 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
3. Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden
Open this publication in new window or tab >>Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden
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2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, 689-699 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Parental stress can negatively affect the parent-child relationship and reduce the well-being of the whole family. Family disagreement is associated with parental divorce and with psychological problems in children.

AIMS: The aim was to examine perceived parental stress and draw comparisons among mothers and among fathers, in relation to educational level, parental experience, existence of a parental role model and sense of coherence. The aim was also to examine perceived dyadic consensus and its association with perceived parental stress within couples.

METHODS: Questionnaires were completed by 320 mothers and 315 fathers at 1 week and 18 months post-partum. The Swedish Parenthood Stress Questionnaire, the Sense of Coherence Scale and the Dyadic Consensus Subscale were used.

RESULTS: Low education, lack of a role model and poor sense of coherence promoted stress in mothers in the subareas social isolation and spouse relationship problems, while lack of a role model and poor sense of coherence promoted stress in fathers in the subarea social isolation. Furthermore, parental experiences promoted stress among mothers in the subarea incompetence while this was not seen among fathers. Mothers perceived a higher level of dyadic consensus than fathers in the items recreational activities, friends, aims and life goals, time spent together, and decisions regarding career and personal development. Household tasks was the only item where fathers perceived a higher level of dyadic consensus than mothers. Additionally, there were associations between perceived parental stress and dyadic consensus in several items and in the total score.

CONCLUSIONS: To promote parents' health and family stability, health professionals should consider factors affecting stress and stress reactions, and take gender roles into account.

National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-229883 (URN)10.1111/scs.12096 (DOI)000345314000008 ()24215595 (PubMedID)
Available from: 2014-08-15 Created: 2014-08-15 Last updated: 2017-12-05Bibliographically approved
4. Parental stress in early parenthood among mothers and fathers in Sweden
Open this publication in new window or tab >>Parental stress in early parenthood among mothers and fathers in Sweden
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2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, 839-847 p.Article in journal (Refereed) Published
Abstract [en]

Background

Parental stress affects parenting behaviour and the quality of dyadic parent–child interactions. Mothers generally show higher parental stress than fathers.

Aims

Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence.

Methods

In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3.

Results

Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas.

Conclusions

Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress.

National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-207916 (URN)10.1111/j.1471-6712.2012.01088.x (DOI)000328140200008 ()23067055 (PubMedID)
Available from: 2013-09-20 Created: 2013-09-20 Last updated: 2017-12-06Bibliographically approved
5. “Paddling upstream”: Fathers' involvement during pregnancy as described by expectant fathers and mothers
Open this publication in new window or tab >>“Paddling upstream”: Fathers' involvement during pregnancy as described by expectant fathers and mothers
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2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 7-8, 77 p.1059-1068 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To describe the perspectives of expectant mothers and fathers on fathers' involvement during pregnancy.

Background

Becoming a father is a major life event and paternal involvement during pregnancy has a positive influence on the family. However, research into both expectant mothers' and fathers' perspectives on fathers' involvement during pregnancy is relatively scarce.

Design

A descriptive qualitative study was used.

Methods

Thirty expectant parents (20 women and 10 men) were interviewed either as part of one of four focus groups or in an individual interview. Qualitative content analysis was performed on the interview transcripts.

Results

A theme of 'Paddling upstream' emerged as an expression of the latent content of the interviews concerning perspectives on fathers' involvement. Five sub-themes described the manifest content: trying to participate, trying to be understanding, trying to learn, trying to be a calming influence and trying to find a balanced life. Expectant parents suggested several ways to improve fathers' involvement and to meet parents' need for shared involvement.

Conclusion

Expectant mothers and fathers wanted the father to be more involved in the pregnancy. Although fathers attempted different strategies, they did not always perceive what was expected of them and encountered many barriers as they tried to navigate through this unique experience. The best support for the father was the mother. Expectant parents wanted their healthcare to include the father more thoroughly and to focus on the whole family.

Relevance to clinical practice

Prenatal care professionals can overcome barriers that prevent paternal involvement. Although fathers are not able to engage in the pregnancy on the same level as the mother, we suggest that their specific needs also be recognised through an increased awareness of gender norms in healthcare.

Publisher
77 p.
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-237058 (URN)10.1111/jocn.12784 (DOI)000351633800017 ()25662781 (PubMedID)
Available from: 2014-11-26 Created: 2014-11-26 Last updated: 2017-12-05

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