Ukrainian medical students’ attitudes to parenthood and knowledge of fertility

Objectives: The aim of our study was to investigate Ukrainian medical students’ intentions and attitudes in relation to future parenthood, and their knowledge about fertility. Methods: A classroom survey was carried out of randomly selected groups among 3568 Russian-speaking medical students. The response rate was 88.8%; 858 were female and 407 were male; the mean age was 20.6 (standard deviation [SD] 2.4) years. Results: One in four male and 16% of female respondents did not want to have children, 3.3% had children and 17% wanted one child only. Female respondents wished to have their first child when they were 24.4 (SD 2.4) years of age, and male respondents when they were 26.8 (SD 3.4) years of age. Around 60% of respondents reported there was a pronounced decline in female fertility after the age of 45 years. Conclusions: The desire to have children in the future is not apparent among medical students, especially not among men. Gaps in students’ knowledge about fertility need to be addressed by sexual and reproductive education.     

Couple empathy – the mediator of attachment styles for partners adjusting to parenthood

Objective and Background: Attachment styles and empathy with respect to couples’ functioning during the period of transition to parenthood have rarely been studied. The aim of the present study was to examine the link between attachment security and perceived empathy as well as their role in the adjustment to parenthood. It was hypothesised that secure parents, as opposed to insecure ones, would perceive themselves and their partners as more empathic after the child’s birth and, as a consequence, more effectively adapt to parenthood. Methods: Sixty-seven couples experiencing their first transition to parenthood participated in the study. Their attachment styles were measured before the birth of the child. Empathy (as perceived in oneself and in a partner) and adjustment to parenthood were measured when the child was a few months old. Results: The results indicated that new parents with more secure, less anxious–ambivalent, and less avoidant attachment styles expressed and perceived more empathy in their relationships, and they were better adjusted to parenthood. A partner’s perceived empathy was found to be a mediator between one’s attachment styles and their adjustment to parenthood. In particular, men’s self-assessed empathy and men’s empathy as perceived by their wives was a significant mediator of the relationship between one’s attachment styles and adjustment to parenthood. Conclusion: Attachment styles are associated with the empathy of partners (both declared and perceived), which in turn predicts their better adjustment to parenthood.     

Reflections on having children in the future—interviews with highly educated women and men without children

Background

There is a trend to delay birth of the first child until the age at which female reproductive capacity has started to decrease. The aim of the present study was to explore how highly educated women and men reflected on future parenthood.

Methods

Twenty-two women and 18 men, who had started their professional career, were subjected to individual qualitative semi-structured interviews with qualitative content analysis guiding the analysis.

Results

All informants, except for three women, planned to have children when some important prerequisites were fulfilled. Women and men reflected in much the same way, and prerequisites for parenthood were being of reasonable age and having a partner in the same phase of life. A reasonable age was considered in relation to reproductive capacity, and both women and men expressed awareness of the natural decline in fertility at higher ages. Good living conditions with stable finances were also important. Parenthood was perceived as a challenge and a sacrifice but also as enriching life. Reasons for having children included being part of the future and settling down to build their own family. Many concluded that there would never be a perfect time for having children.

Conclusion

Highly educated women and men reflect on various factors when considering family planning. Being of reasonable age and having good living conditions, in particular a sound personal economy, were important. Given their goals, it is not surprising that many postpone parenthood until ages when female reproductive capacity is decreased.     

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.     

Psychosocial adjustment during the transition to parenthood of Portuguese couples who conceived spontaneously or through assisted reproductive technologies

We examined the psychosocial adjustment of 35 Portuguese couples who conceived through Assisted Reproductive Technologies (ART) and 31 couples with a spontaneous conception during their transition to parenthood (pregnancy and 4 months postpartum). Couples completed self‐report questionnaires regarding their perceptions of pregnancy and parenthood, psychological distress, quality of life, marital relationship, and parenting stress. Compared with parents who conceived spontaneously, parents who conceived through ART perceived pregnancy as being more risky and demanding, reported a decrease in their psychological quality of life, and ART fathers only perceived themselves as being more competent than fathers who conceived spontaneously. Healthcare professionals should be aware of need of couples in their efforts to adapt to the individual and relational challenges associated with the transition to parenthood. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:207–220, 2010     

Service Strategies for Engaging Fathers in the Perinatal Period — What Have we Learned so Far?

The aim of this article is to review the published evidence on the effectiveness of strategies to engage men in psychosocial services during the perinatal period, and to consider anecdotal information from unpublished Australian programs. Thirteen published studies were found that provided some information on the enrolment numbers of men, together with the strategies used in each study. In addition, anecdotal information from nine Australian programs has been reported. Engaging men is more likely to succeed if they are, at least initially, offered a single-session program, rather than multiple sessions, they receive a personal invitation to attend, the initial emphasis is on practical things men can do rather than emotional issues, programs are not scheduled to coincide with televised major sporting fixtures, their partner is already attending the service, and the sessions are scheduled to occur several weeks into a program, not at the start. After-hours services may in some circumstances result in better enrolment by men, and use of plain language by program facilitators is better than counselling ‘jargon’ when engaging and working with men. Perinatal psychosocial services aimed at including men should consider carefully the strategies they employ if they wish to optimise the attendance of fathers or expectant fathers.     

The Relationship Between Parent‐Infant Bed Sharing and Marital Satisfaction for Mothers of Infants

This study investigated the relationship between marital satisfaction and time spent bed sharing with infants in a community sample of 81 bed sharing mothers. Time spent bed sharing did not significantly predict variance in marital satisfaction when considering bed sharers as a whole. Moderation analysis, however, showed the interaction between time spent bed sharing and group classification either as “intentional,” defined as parents who endorse the ideology of bed sharing, or “reactive,” defined as parents who do not plan to bed share but bed share as a reaction to infant nighttime problems, explained a significant increase in variance in marital satisfaction, ΔR² = .075, F(1, 75) = 7.31, p = .008. None of the intended mediator variables (satisfaction with bed sharing, fatigue, and sexual satisfaction) were significantly correlated with time spent bed sharing. Results highlight the importance of recognizing the differences between intentional bed sharers and reactive bed sharers.     

Network support and parenting in mothers and fathers who conceived spontaneously or through assisted reproduction

Background: Little is known about the contribution of other significant relationships beyond the partnership for parental adjustment and care in parents who conceived through Assisted Reproductive Technologies (ART). Objective: This study examined the role of perceived network support on parenting stress and investment in the child in parents who conceived spontaneously or through ART, during their transition to parenthood. Methods: Thirty‐five couples who conceived through ART and 31 couples who conceived spontaneously completed self‐report questionnaires regarding perceived emotional and instrumental support from their social network members (i.e. nuclear and extended family members and friends) during pregnancy (twenty‐fourth week) and regarding parenting stress and investment in the child four months after the partum. Results: Regardless of method‐of‐conception, instrumental support from the nuclear family was positively associated with maternal investment in the child and emotional and instrumental support from the extended family were positively associated with paternal stress while support from friends was negatively associated with it. Conclusion: Results suggest that parents who conceive through ART and spontaneously are alike in that their adjustment to parenthood and the quality of the care they provide to their children depends on perceived support from nuclear and extended family and friends.