A Study of Father and Nurse Support During Labor

ABSTRACT: Support behaviors directed to the woman during childbirth are documented, along with the identity of the providers in this study of 40 primiparous women. A time-sampling method was used during labor observations to record kinds and frequencies of support behaviors provided by different individuals. In addition, a postpartum interview with mother and father included maternal recall of the support behaviors and her evaluation of the helpfulness of these activities. The data show husbands were an important source of support. Of special interest was amount of touching. Fathers were 5 times as likely to touch their wives as were nurses to touch their patients. Mothers’postpartum reports centered on the husbands’behavior, indicating that the most helpful thing was the husbands’presence. Other postpartum maternal reports are discussed.     

Fathers’Birth Attendance,Early Extended Contact,and Father-Infant Interaction at Five Months Postpartum

ABSTRACT: Forty couples and their 5-month old infants were observed in their homes in a study of the relationships between fathers’birth attendance, early extended contact, and involvement with their babies at five months postpartum. Fathers who were excluded from the birth were more involved with their babies, in the presence of their wives, than were fathers who attended births. The three aspects of early extended contact that were found to be significantly associated with fathers’caregiving and social involvement at five months were time of first contact, length of first contact, and total hours fathers spent with children in the hospital. The implications for research and for policy concerning early father-infant contact are discussed.     

Differences between husbands' and wives' approach to infertility affect marital communication and adjustment

Objective: To test a theoretical model of the effect on marital communication and adjustment of men’s and women’s approach to infertility.

Design: A cross-sectional research design involving interviews, questionnaires, and a marital discussion task.

Setting: Volunteers from practices of fertility specialists.

Patient(s): Forty-eight couples currently seeking infertility treatment.

Intervention(s): None.

Main Outcome Measure(s): Quality of marital communication during a marital discussion task and effect of infertility on the marriage.

Result(s): Having children was more important to wives than husbands; wives were more involved in trying to have a baby, wanted to talk with their partner more about trying to have a baby, and experienced a greater loss of self-esteem than did their husbands. To the extent that husbands saw having children as important, were involved in trying to have a baby, or wanted to talk with their wives about trying to have a baby, the quality of marital communication when discussing infertility was less negative, and in turn, wives perceived a more positive effect of infertility on their marriage.

Conclusion(s): Increases in husbands’ interest and involvement in fertility treatment may lead to positive changes in couple communication about infertility and to a more positive effect of infertility on the marriage.     

Fathers' Coping Style,Antenatal Preparation,and Experiences of Labor and the Postpartum

Background: In recent years the trend for fathers in Western postindustrial countries to attend childbirth has increased. This study examined the interaction between fathers' information‐seeking coping predispositions and their level of attendance at antenatal classes with respect to their experiences of attending childbirth. Associations between fathers' childbirth experiences, their relationship with their baby, and level of depressive symptomatology at 6 weeks postpartum were also examined. Methods: A quantitative methodology was employed in which 78 fathers completed several questionnaires, some within 6 days of childbirth and others at 6 weeks postpartum. Results: Fathers who were characterized as high blunters (avoiders) of threat information, from antenatal classes reported that experiencing childbirth was less fulfilling than fathers with similar coping styles who did not attend classes. Fathers' reports of fulfillment and delight while attending childbirth were negatively related to their level of depressive symptomatology at 6 weeks postpartum. Levels of distress were associated with subsequent depressive symptoms, but their effect was removed when preexisting depressive symptoms were partialled out. Fathers whose children were born by cesarean delivery used significantly more negative adjectives to describe their baby at 6 weeks postpartum compared with those born by vaginal delivery. More married fathers attended antenatal classes and reported lower levels of depressive symptomatology than unmarried fathers. Conclusions: Although fathers' attendance at antenatal classes may have positive consequences for them and their partner, for some fathers, attendance at classes may be associated with less positive reports of experiencing childbirth. The way in which men experience childbirth may have some influence on their subsequent emotional well‐being.     

The Adjustment of Fathers to their First Baby: The Roles of Parenting Groups and Marital Relationship

ABSTRACT: Forty-seven first-time fathers from Lamaze classes were studied by means of self-reports of their feelings of well-being, sense of competence as parents, views of their babies’temperaments, marital relationships and social support systems. These self-reports were recorded at 2–3 months, 5–6 months and 9–10 months after childbirth. Twenty of the fathers were attending parenting groups during this period, while 27 fathers expressed interest but did not attend. Fathers participated more in baby care and felt more comfortable as parents as their babies become older, but they reported a slight decrease in marital satisfaction. Although fathers who attended parenting groups showed the same pattern of adjustment as did fathers who did not participate in the groups, they reported significantly lower feelings of relaxation and health for themselves, and more fussy moods in their babies at each of the three points during the first year. The quality of the marital relationship and attendance at parenting groups were associated with positive over-all adjustment to the baby at 9–10 months.     

Families created through ovum donation: A preliminary investigation of obstetrical outcome and psychosocial adjustment

Purpose This study attempted to obtain preliminary followup information regarding obstetrical outcomes and the psychosocial well-being of families created through ovum donation. There is presently very little known about this population with respect to obstetrical care, health status of offspring, family and marital relationships of recipient couples, or how couples feel about having chosen ovum donation as a family-building option.Results Fifty-nine couples were initially surveyed and, ultimately, extensive information was obtained for 30 husbands, 31 wives, and 51 offspring. There was a very high percentage of cesarean section deliveries (81.6%), and although a few children experienced health problems at birth, they are all now in good health and developmental milestones are within normal limits. Information was also obtained about breast-feeding experiences, choice of donor (known) [sister] or anonymous), reasons for choosing ovum donation over other parenting options, and the impact of this choice on marital and family relationships. Demographic data were also obtained.Conclusions For many infertile couples, the long struggle to become parents culminated in a successful birth, and the experience of pregnancy seemed to meet a need to be both biological and psychosocial parents. In general, subjects were extremely cooperative with the investigation and they indicated a desire to learn as much as possible about the psychosocial status of families created through ovum donation. As the assisted reproductive technologies move rapidly into the 21st century, it now seems imperative that health and mental health professionals gain more knowledge about the impact of third party reproduction and the psychosocial adjustment and well-being of families created by this medical technology.Presented at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, April 3–7, 1995, Vienna, Austria.     

Husbands' experiences of supporting their wives during childbirth in Nepal

Background

the husband’s presence at childbirth is universally accepted in industrialised nations, but the concept is still new within the cultural values and norms of Nepalese society. Understanding the cultural context surrounding the feelings and needs of Nepalese husbands will help to initiate realistic maternity education programmes.

Objective

to explore husbands’ experiences of supporting their wives during childbirth.

Method

semi-structured interviews were conducted, and the data were analysed using thematic analysis.

Setting

the Maternity and Neonatal Service Centre, a midwife-run birthing centre within a public maternity hospital in the capital of Nepal.

Participants

twelve first-time expectant Nepalese fathers who had supported their wives during childbirth were interviewed in July 2009, within seven days of the birth.

Findings

six themes were identified to explain the mixed experiences of the husbands in the labour or delivery room: (1) being positive towards attendance; (2) hesitation; (3) poor emotional reactions; (4) being able to support; (5) the need to be mentally prepared and (6) enlightenment. Husbands reflected on their experiences positively, despite profound hesitation and overwhelming emotions.

Conclusions

the husbands’ experiences revealed that Nepalese husbands tend to experience overwhelming emotional feelings in the labour or delivery room if they are allowed to attend the birth without prior preparation.

Implications for practice

counselling for couples and education from the start of the pregnancy may reduce negative emotional experiences and improve satisfaction with the childbirth experience for both husbands and wives.     

Impact of First Childbirth on Changes in Women’s Preference for Mode of Delivery: Follow‐up of a Longitudinal Observational Study

ABSTRACT: Background: A woman’s childbirth experience has an influence on her future preferred mode of delivery. This study aimed to identify determinants for women who changed from preferring a planned vaginal birth to an elective cesarean section after their first childbirth. Methods: This prospective longitudinal observational study involved two units that provide obstetric care in Hong Kong. A mail survey was sent to 259 women 6 months after their first childbirth. These women had participated in a longitudinal cohort study that examined their preference for elective cesarean section in the antenatal period of their first pregnancies. Univariate and multivariate analyses were performed to identify determinants for women who changed from preferring vaginal birth to elective cesarean section. Results: Twenty‐four percent (23.8%, 95% CI 18.4–29.3) of women changed from preferring vaginal birth to elective cesarean section after their first childbirth. Determinants found to be positively associated with this change included actual delivery by elective cesarean section (OR 106.3, 95% CI 14.7–767.4) intrauterine growth restriction (OR 19.5, 95% CI 1.1–353.6), actual delivery by emergency cesarean section (OR 8.4, 95% CI 3.4–20.6), higher family income (OR 3.2, 95% CI 1.1–8.8), use of epidural analgesia (OR 2.6, 95% CI 1.0–6.8), and higher trait anxiety score (OR 1.1, 95% CI 1.0–1.3). The most important reason for women who changed from preferring vaginal birth to elective cesarean section was fear of vaginal birth (24.4%). Conclusions: A significant proportion of women changed their preferred mode of delivery after their first childbirth. Apart from reducing the number of cesarean sections in nulliparous women, prompt provision of education to women who had complications and investigations into fear factors during vaginal birth might help in reducing women’s wish to change to elective cesarean section. (BIRTH 35:2 June 2008)     

Women’s postnatal psychological functioning: the role of satisfaction with intrapartum care and the birth experience

Objective: To investigate the relationship between women’s postnatal psychological well-being and retrospective, self-reported satisfaction with intrapartum care and the birth experience. Background: The period immediately following childbirth can be marked by various problems that can affect a woman’s happiness and functioning. Previous research has suggested that aspects of the maternal experience of childbirth may act as predictors for specific indicators of women’s postnatal functioning. This study aimed to determine the relationship between satisfaction with labour and birth care and the general childbirth experience and a broad, comprehensive measure of subsequent psychological functioning. Methods: Data for this study was taken from relevant items in the Having a Baby in Queensland 2009 Pilot Survey. Researchers assessed maternal socio-demographic characteristics, perceptions of labour and birth care, satisfaction with labour and birth care, and perceived positivity of the birth experience. A dichotomous, composite measure of postnatal psychological functioning was derived from women’s responses to five separate survey items. Results: The multivariate logistic regression analysis showed that women who felt they were looked after ‘very well’ and women who rated their birth experience as ‘very positive’ were significantly more likely to experience high postnatal functioning than women who did not rate their intrapartum care and birth experience as highly. Conclusions: Reducing the risk factors for dissatisfaction is critical in order to improve the likelihood of high maternal postnatal functioning. The findings of this study emphasise the importance of intrapartum care in the development of positive functioning in women who have recently given birth.     

First-time mothers’ experiences of preparing for childbirth at advanced maternal age

ObjectiveTo explore the lived experiences of preparing for childbirth for nulliparous women aged 35–44 and determine how mature first-time mothers’ can be better supported regarding childbirth preparation.DesignThe research study comprised a cross-sectional qualitative design utilising Interpretative Phenomenological Analysis to provide a deep exploration into the experience of mature age women.SettingParticipants resided in South Australia and Victoria, Australia, in regional, suburban and inner-city locations.ParticipantsFourteen nulliparous women aged 35–44 were recruited in their third trimester of pregnancy using purposeful sampling.MethodData were collected by conducting in-depth semi-structured interviews during 28–36 weeks of pregnancy. Data were transcribed and analysed using Interpretative Phenomenological Analysis to identify themes of mature first-time mothers’ preparations for childbirth.FindingsThe super ordinate theme “Building confidence for childbirth” describes mature first-time mothers’ experience of preparing for childbirth. This process appears to influence women's information seeking behaviour, expectations of healthcare providers, and reflections on birth planning.ConclusionsParticipants sought various support and interactions with healthcare providers, both helpful and unhelpful, with nulliparous women of advanced maternal age undertaking various preparations with the intention of a positive childbirth experience. Participants were seeking support from friends, along with conducting their own independent research and activities.Implications for practiceIt is evident that more and more women in developed countries are delaying having children into their late thirties and over, and these women report various levels of support from health practitioners. Healthcare professionals have the potential to foster more trustful relationships and empowering interactions with women, provide various resources regarding childbirth preparation, and sensitive birth planning assistance that supports women's agency along with managing risk. Guidelines based on this and other research in managing the antenatal care of women of advanced maternal age would ensure consistency, particularly in terms of risk management and childbirth.     

Becoming a father First-time fathers' experience of labor and delivery

In this study, ethnographic interviews were used to identify first-time fathers' experiences of the birth of their first child. Fourteen fathers were interviewed, and prenatal expectations of the experience are compared with the fathers' perceptions after the birth. Although the fathers expected to be treated as part of a laboring couple, they found that they were relegated to a supporting role. Initially the fathers were confident of their ability to support their wives, but they found that labor was more work than they had anticipated. They became fearful of the outcome, but hid these fears from their partners. Later, they found that their focus moved from their wives to their babies at the time of birth. The men all completed the experience with an enhanced respect for their wives. Fathers should be included in labor management plans and need support for their role as coach, particularly when their wives experience pain. They also need to be encouraged to eat and take a break from their wives' labor when appropriate.     

Becoming a Father: First-Time Fathers' Experience of Labor and Delivery

In this study, ethnographic interviews were used to identify first-time fathers' experiences of the birth of their first child. Fourteen fathers were interviewed, and prenatal expectations of the experience are compared with the fathers' perceptions after the birth. Although the fathers expected to be treated as part of a laboring couple, they found that they were relegated to a supporting role. Initially the fathers were confident of their ability to support their wives, but they found that labor was more work than they had anticipated. They became fearful of the outcome, but hid these fears from their partners. Later, they found that their focus moved from their wives to their babies at the time of birth. The men all completed the experience with an enhanced respect for their wives. Fathers should be included in labor management plans and need support for their role as coach, particularly when their wives experience pain. They also need to be encouraged to eat and take a break from their wives' labor when appropriate.     

Introducing Birth Plans in Mexico: An Exploratory Study in a Hospital Serving Low‐Income Mexicans

ABSTRACT: Background: Increased medicalization of childbirth in Mexico has not always translated into more satisfactory childbirth experiences for women. In developed countries, pregnant women often prepare written birth plans, outlining how they would like their childbirth experiences to proceed. The notion of expressing childbirth desires with a birth plan is novel in the developing world. We conducted an exploratory study to assess the feasibility and acceptability of introducing birth plans in a hospital serving low–socioeconomic status Mexicans and to document women’s and health practitioners’ perspectives on the advantages and barriers in implementing a birth plan program. Methods: We invited 9 pregnant women to prepare birth plans during their antenatal care visits. The women also participated in interviews before and after childbirth. We also conducted in‐depth interviews with 4 women who had given birth in the past year, and with 2 nurses, 2 social workers, and 1 physician to learn about their perspectives on the benefits and challenges of implementing a birth plan program. Results: All 9 women who completed a birth plan found the experience highly satisfying, despite the fact that in some cases, their childbirths did not proceed as they had specified in their plans. Interviewed practitioners believed that birth plans could improve the childbirth experience for women and health care practitioners, but facilities often lacked space and financial incentives for birth plan programs. Conclusions: Our findings suggest that birth plans are acceptable and feasible in this study population. Facility administrators would need to commit to provide the physical space and financial incentives necessary to ensure successful implementation. (BIRTH 34:1 March 2007)     

Marital stability and quality in families created by assisted reproduction techniques: a follow-up study

An increasing number of children are being born with the use of assisted reproduction techniques such as donor insemination, egg donation and surrogacy. There have been concerns that the use of these third-party reproduction techniques may have a negative effect on the quality of the relationship between the mother and father. Marital stability and quality was examined in a UK sample of donor insemination, egg donation and surrogacy families and families in which children were naturally conceived. Interview and questionnaire assessments of marital stability and quality were collected from mothers and fathers over five time points, when the children in the families were aged 1, 2, 3, 7 and 10. Of those families who participated when children were 10 years old, a minority of couples in each family type had divorced/separated and few differences emerged between the different family types in terms of mothers’ or fathers’ marital quality. Despite concerns, couples in families created by donor insemination, egg donation and surrogacy were found to be functioning well.An increasing number of children are being born with the use of assisted reproduction techniques such as donor insemination, egg donation and surrogacy. There have been concerns that the use of these third-party reproduction techniques may have a negative effect on the quality of the relationship between the mother and father. Marital stability and quality was examined in a UK sample of donor insemination, egg donation, and surrogacy families and families in which children were naturally conceived. Interview and questionnaire assessments of marital stability and quality were collected from mothers and fathers over five time points, when the children in the families were aged 1, 2, 3, 7 and 10. Of those families who participated when children were 10 years old, a minority of couples in each family type had divorced/separated and few differences emerged between the different family types in terms of mothers’ or fathers’ marital quality. Despite concerns, couples in families created by donor insemination, egg donation and surrogacy were found to be functioning well.     

What’s on the mind of IVF consumers?

During economic downturns demographers note that birth rates often decline as couples are more concerned with job security than providing for an additional child. The effects of economic conditions are likely to be amplified in infertile couples because there is often the need to pay for treatment. To try and understand changes in public interest in IVF over time, this study explored publicly available data (Google? Insights) that reports changes in internet search activity relative to baseline volumes for search queries entered into Google search engines. Using the USA and the UK as case studies, it was observed that interest in internet searches using the term ‘IVF’ relative to searches within the infertility category remained relatively unchanged in the USA, with a small decrease observed in the UK. Internet searches using the combined terms ‘IVF cost’ and ‘cost of IVF’ have increased over the past 2 years relative to the infertility category. Additionally, inclusion of the term ‘cost’ appears concentrated in US states without insurance mandates compared with states with mandated insurance coverage. The extent to which Google internet search queries reflect public interest, and more importantly interest from infertile couples, is difficult to know for certain; however, there appears to be increased interest in the cost of treatment.     

Why Do Some Women Change Their Opinion About Childbirth Over Time?

Abstract: Background : The current investigation is a follow‐up of a study on women's memory of childbirth, which showed that 60 percent made the same assessment of their overall birth experience at 1 year after delivery as they did at 2 months postpartum, and 24 percent had became more negative and 16 percent more positive. The study purpose was to gain some understanding of what factors make some women change their assessment over time. Methods : Data from a longitudinal cohort study of 2,428 women who completed questionnaires in early pregnancy, at 2 months, and at 1 year after birth were analyzed. Two subsamples were studied: 1,451 women who said childbirth was a positive experience at 2 months and 151 who said it was a negative experience. Comparisons were made, within each sample, between those who made the same assessment at 1 year and those who had changed their view, with respect to psychosocial background, labor outcomes, infant health outcomes during first year, and experiences of intrapartum care. Results : Changing the assessment from positive to less positive, mostly to “mixed feelings,” was associated with difficult childbirth, such as painful labor and cesarean section; dissatisfaction with intrapartum care; and psychosocial problems, such as single status, depressive symptoms, and worry about the birth in early pregnancy. Changing the assessment from negative to less negative was associated with less worry about the birth in early pregnancy and a more positive experience of support by the birth‐attending midwife. Conclusions : This study supported the view that measures of satisfaction with childbirth soon after delivery may be colored by relief that labor is over and the happy birth of a baby. More negative aspects may take longer to integrate. Supportive care may have long‐term effects and may protect some women from a long‐lasting negative experience.     

Exploring couple attributes and attitudes and marital violence in Vietnam

Using a couple-centered approach, this study focuses on the relative attributes and attitudes of spouses as predictors of marital violence. Analysis of data from Vietnam showed that 37% of married women have ever been hit by their husbands. Regression results found that husbands with lower resources or status than their wives were more likely to have abused. Results also found that the association between husbands' gender attitudes and marital violence depends on the level of equity of wives'attitudes. The decline in violence among couples in which husbands expressed gender equitable attitudes was greater when wives also expressed equitable attitudes.