[Creation of an early parenthood support system by the CCAS in Le Havre]. / Création d'un dispositif de soutien à la parentalité précoce par le CCAS du Havre.

The phenomenon of early motherhood, although marginal, is slightly higher in Le Havre than the national average. This observation, combined with a worrying socio-economic context, prompted a reflection on the need for specific support for these pregnancies: it led to the creation of a coordination system for early parenthood, piloted by Le Havre's Centre communal d'action sociale (CCAS). This article reports on the experience.

Women's expectations, preferences and needs in midwifery care - results from the qualitative Midwifery Care (MiCa) study: Childbirth and early parenthood.

OBJECTIVE: The main goals of our study were (I) the investigation of expectations and preferences as well as (II) the determination of needs of women in regard to midwifery care. DESIGN: Descriptive phenomenology was used to investigate the ways in which women experienced childbirth and early parenthood. A descriptive qualitative research design was chosen, using focus groups. SETTING: ix online focus groups were carried out with 19 women for this part of the Midwifery Care (MiCa) study, mainly from the north of Germany. PARTICIPANTS: Women shortly after birth, in puerperium and the first year after childbirth were recruited in Germany. A purposeful strategy according to maximum variation sampling was applied to reach diversity in the sample regarding age and previous children. Data were analysed using qualitative content analysis, according to Mayring, with support of the qualitative data analysis software MAXQDA 2022. FINDINGS: Six main categories were derived for both childbirth and early parenthood: (a) involvement of family, (b) need for information, (c) physical and psychological aspects and (d) orientation in the healthcare system. In each group, one main category about provision of healthcare was developed: (e) care around childbirth and (f) midwifery care in early parenthood. Women attached great importance to the communication with midwives and favoured the involvement of their partners in the childbirth process and during parenting. Based on different experiences and inconsistency of information, women would prefer consistency in staff and communication as well as standardised information. CONCLUSIONS: From the user's perspective, midwifery care is crucial during childbirth and the child's first year of life. Current health care during and after childbirth and early parenthood lacks individualised care models, emotional support, adequate and professional communication between different health care providers, and consistency in midwifery care. Our findings should be translated into health care delivery with effective interprofessional teamwork within the continuity of midwifery care. Further quantitative research should analyse the individual healthcare situations of women in the reproductive phase of their life as well as of the applied healthcare models in order to personalise care and to improve healthcare quality.

Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development.

Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the postpartum and early parenthood periods on child behavioral problems at the mean age of 2.25 years. The Edinburgh postnatal depression scale and Beck depression Inventory were used to assess postpartum and early parenthood depression, respectively. The Child Behavior Checklist was used to examine child's behavioral problems. The regression analysis showed statistically significant associations between child behavioral problems and maternal depression during early parenthood and no significant associations with postpartum depression. Four maternal depressive symptoms' trajectories were identified: consistently low, consistently high, decreased, and increased. The children of mothers with consistently high depressive symptoms at both research stages had the most significant total, internalizing, and externalizing problems. Children of mothers whose depressive symptoms decreased over time had the lowest scores in all three domains of behavioral problems. It is extremely important to implement programs for screening and early intervention for maternal mental health problems that could greatly influence the well-being of women and their children's development.

Preventing Teen Pregnancy: A Qualitative Study of the Perspectives of Parenting and Expecting Latino Adolescents.

STUDY OBJECTIVE: Latino youths in the United States experience disproportionately high rates of teen pregnancy. The aim of this study was to obtain expecting and parenting Latino adolescents' perspectives regarding factors contributing to teen pregnancy and pregnancy prevention. METHODS: Expecting/parenting Latino adolescents were recruited from high schools with high proportions of Latino youths and teen pregnancy. Participants completed a questionnaire on sociodemographic and background characteristics. Focus groups were stratified by age and gender and audio recorded. Grounded theory was used to identify themes from the transcribed audio recordings. RESULTS: Thirty-two expecting/parenting Latino adolescents (20 females, 12 males) 14-19 years old participated in four focus groups. Quantitative results revealed that two-thirds of participants at birth had adolescent mothers. Over three-quarters of participants reported that their pregnancies had occurred too soon. Qualitative themes for factors contributing to teen pregnancy included lack of contraceptive knowledge/access, belief of invincibility, influence within relationships, male decisions on contraceptive use, desire to belong among peers, lack of parental support for contraceptive use, lack of parental attention, rebellion, normalization of adolescent parenthood in Latino culture, and media. Themes for pregnancy prevention included time alone with physicians, parenting teens as mentors, reproductive health education, and community pregnancy-prevention programs. CONCLUSION: Multiple factors contribute to teen pregnancy in Latino youth, including influences from Latino culture, family, peers, partners, and social determinants of health. Pregnancy prevention should incorporate interventions to address these aspects, including disseminating culturally sensitive education materials, providing parenting teens as peer mentors, encouraging time alone with health care providers, and addressing various social determinants of health.

Understanding the use of telehealth in the context of the Family Nurse Partnership and other early years home visiting programmes: A rapid review.

Overview: This rapid review sought to understand the use of telehealth in early parenthood programmes sharing similarities with the Family Nurse Partnership. Methods: A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline, Cochrane Library, and CINAHL databases were searched. Inclusion criteria were developed using population, intervention, comparator, outcome, study design, and timeframe components. Two reviewers searched, screened, and extracted data. AMSTAR was used for critical appraisal. Results were synthesised narratively. Results: Searches yielded 18 studies out of 881 for inclusion. Findings were identified across seven domains: acceptability and accessibility; therapeutic relationships; flexibility offered by telehealth; participation and engagement; confidentiality and privacy; equipment and technical considerations; and training and support. Conclusion: Telehealth provides unique opportunities to improve access to early years health services for young mothers. However, considerable accessibility barriers remain in the form of connectivity issues, access to appropriate technology, and the acceptability of remote healthcare delivery. This review presents a timely overview of the opportunities and challenges associated with the use of telehealth in early parenthood and family-based programmes.

How to support fathers of preterm infants in early parenthood - An integrative review.

PROBLEM: Preterm birth is a stressful event. Paternal experiences of having a preterm infant indicate a need for tailored support. However, it is unclear which interventions work best. This review presents the evidence on existing healthcare interventions to support fathers of preterm infants in early parenthood, how effective they are and paternal experiences with the interventions. ELIGIBILITY CRITERIA: The integrative review process of Whittemore and Knafl was used to guide the study. A structured and comprehensive literature search was conducted in PubMed (MEDLINE), Embase, CINAHL, PsycInfo, Cochrane, Scopus, Web of Science, SweMed+, and Proquest Dissertation & Thesis Global. SAMPLE: A total of 18 qualitative and quantitative studies were included in the review. The Mixed Methods Appraisal Tool was used to assess quality. RESULTS: Three overall themes were identified in the analysis: 1) Skin-to-skin contact supported interaction between infant and father, 2) information impacted paternal experiences of stress, anxiety, and development of fatherhood, 3) fathers' relationships with the nurses oscillated between conflict and assistance. CONCLUSIONS: Our findings show that targeted interventions could support father-infant interaction and reduce stress among fathers of preterm infants. IMPLICATIONS: Fathers of preterm infants rely on nurses to support their engagement in early parenthood, while nurses facilitate the interventions that engage the fathers. It is also essential to develop a culture within the neonatal intensive care unit that encourages the presence of fathers and enhances educational nursing strategies for supporting fathers of preterm infants during early parenthood.

Solo mothers' by choice experiences during pregnancy and early parenthood: Thoughts and feelings related to maternal health-services.

The present study examined the thoughts and feelings of solo mothers by choice (SMC) regarding their experiences during pregnancy and early parenthood, with special focus on their contact with maternal health-services (MCHS). Semi-structured interviews were carried out with solo mothers (N = 10) who had undergone assisted fertilization in Sweden. Thematic analysis revealed two main themes. The first theme, "Strong individual, vulnerable group", illustrated a perception among participants that, although SMC as a group are vulnerable, they themselves are strong and do not identify with this vulnerability. It is thus conceivable that staff in MCHS may not detect the vulnerability and needs of these women who have strong incentives to present themselves as strong and competent. The second theme, "Same but different", reflected the participants' conflicting needs to be treated like everyone else within the MCHS while at the same time wishing for adaptations of the healthcare services' praxis so that it better suits their needs as solo mothers. These themes illustrate what may be considered as paradoxical expectations and unreasonable needs in the participants' contacts with the MCHS, but they also highlight how social attitudes can have an impact on these parents' individual experiences of healthcare. Because contact with MCHS takes place during a vulnerable period, particular sensitivity and compassionate attention may be needed in order to encourage these women to bring their needs forward.

Working out dads (WOD): a study protocol for a randomised controlled trial of a group-based peer support intervention for men experiencing mental health difficulties in early fatherhood.

BACKGROUND: Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers' mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) - a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms. METHODS: This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation. DISCUSSION: This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated. TRIAL REGISTRATION: The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042 ). Date of Registration: March 22nd, 2021.

Maternal Psychological Distress and Executive Functions Are Associated During Early Parenthood - A FinnBrain Birth Cohort Study.

Parental executive functioning (EF) and parenting behaviors can be affected by the multiple stressors that are often present during early parenthood. However, little is known about how commonly experienced psychological distress during early parenthood is associated with parental EF capacity. We explored the links between psychological distress and EFs in a general population sample of 150 Finnish birth cohort mothers with 2.5-year-old children. The symptoms of depression, anxiety, insomnia, and poor couple relationship adjustment were measured with the self-report questionnaires EPDS, SCL-90, AIS, and RDAS. EFs were assessed with five computerized Cogstate tasks. When the psychological distress measures were added to a hierarchical regression analysis as continuous variables, no significant single or additive associations with EFs were found. When the distress measures were dichotomized to compare symptoms below/above cutoffs indicating clinically elevated levels, single distress domains remained as non-significant predictors, but a cumulative risk index of the number of concurrent clinically elevated distress domains was significantly associated with EFs. Thus, mothers with a higher number of concurrent clinically elevated psychological distress domains (i.e., depression, anxiety, insomnia, and poor couple relationship adjustment) tended to have lower EFs. This association is possibly bi-directional - clinically elevated distress within several domains could have a cumulative, depleting effect on maternal EF capacity, but a lower EF capacity could also increase the vulnerability for experienced distress within several concurrent domains. Longitudinal studies are needed to clarify potential causal links between stressors and EF.

The Relationship Context of Early Transitions to Parenthood: The Influence of Arrest.

In the U.S., many young adults who have had contact with the criminal justice system are parents. Using the Toledo Adolescent Relationships Study (n = 1321), we drew on family demography and criminology literatures to examine the association between arrest, an understudied indicator of contact with the criminal justice system, and transitions to early parenthood. We also distinguished transitions to parenthood that occurred within four different relationship contexts: (1) single; (2) dating; (3) cohabiting; and (4) married. Using event history analyses, we found that young men and women who experienced an arrest transitioned to parenthood earlier than their counterparts who were not arrested. Further, men with an arrest, compared to men who had not been arrested, were more likely to report that they were dating the biological mother of their first child around the time of birth. In contrast, women with an arrest had an increased likelihood of having their first birth while cohabiting with the biological father. Our results highlighted the importance of a prior arrest for early transitions to parenthood and are relevant for understanding the intergenerational transmission of disadvantage and the diverging destinies of children and parents. Furthermore, the gender differences in the results illustrated the importance of including women in criminal justice analyses and men in fertility analyses.

Prevalence and Risk Factors for Early Motherhood Among Low-Income, Maltreated, and Foster Youth.

Early childbearing is associated with a host of educational and economic disruptions for teenage girls and increased risk of adverse outcomes for their children. Low-income, maltreated, and foster youth have a higher risk of teen motherhood than the general population of youth. In this study, we assessed differences in the risk of early motherhood among these groups and investigated whether differences likely reflect selection factors versus effects of involvement with Child Protective Services (CPS) or foster care. Using a statewide linked administrative data system for Wisconsin, we employed survival analysis to estimate the hazard of early birth (child conceived prior to age 18) among females. We found that both the youth involved in CPS and youth in foster care were at significantly higher risk of early motherhood than low-income youth, and these differences were not explained by a range of sociodemographic and family composition characteristics. Moreover, our findings indicate that CPS and foster care are unlikely to be causal agents in the risk of early motherhood: among foster youth, risk was lower during foster care compared with before; among CPS-involved girls, risk was the same or lower after CPS investigation compared with before. Subsequent analysis showed that after girls exited foster care, those who were reunified with their birth families were at higher risk than those placed in adoption or guardianship. Overall, our findings suggest that whereas CPS and foster youth are high-risk populations for early motherhood, CPS involvement and foster care placement do not exacerbate, and may instead reduce, risk.

Exploring parental mentalization in postnatal phase with a self-report questionnaire (PRFQ): Factor structure, gender differences and association with sociodemographic factors. The Finn Brain Birth Cohort Study.

The objective was to explore the preliminary functioning of a self-report questionnaire designed to assess parental reflective functioning (PRFQ, Luyten et al., 2009, unpublished manual) during early postnatal phase and with a large population-based sample. Parental reflective functioning (PRF) refers to parental capacity to focus on experience and feelings, within self, in the child and underlying observed reactions. Individual differences in PRF reportedly affect child attachment and socio-emotional development. Cost-effective tools to assess key areas of early parenting are needed for both research and clinical purposes. The factor structure of a 36-item version suitable for early postnatal phase was explored using population-based data from the Finn Brain Birth Cohort Study (425 mothers and 237 fathers). Exploratory and confirmatory factor analysis resulted in a 14-item version comprising four factors capturing relevant aspects of early PRF. The factor structure was further tested with separate participants from the cohort (1030 mothers and 422 fathers). Mothers tended to score higher than fathers in PRF. Among mothers, parity, age, and financial situation were associated with postnatal mentalization. Level of education was associated with postnatal mentalization in both genders. The 14-item PRFQ-Fi has potential to serve as a new screening tool for very early parenting.

First-time parents' prenatal needs for early parenthood preparation-A systematic review and meta-synthesis of qualitative literature.

OBJECTIVE: contribute to the existing body of knowledge about the specific needs of first-time parents specifically for early parenthood. METHOD: the databases PubMed, MEDLINE, PSYCINFO, CINAHL, EMBASE, Family Studies Abstracts, and Web of Science, were searched using search terms: prenatal, antenatal, preparation, education, parents, parenthood. The meta-synthesis included 12 articles representing 12 studies. The meta-ethnographic approach of Nobilt and Hare was used in the meta-synthesis. SYNTHESIS AND FINDINGS: first-time expectant and new parents reflect a need for antenatal education to actively include male partners pre- and postnatal. Participants wished for early and realistic information about parenting skills, and to have the opportunity to seek support and help from health professionals when need arose especially during the early postnatal period. Another element was the need to learn both from peers and other new parents coming as guest speakers. Participants wished to have been well informed ahead of time, about the possible changes in their conjugal relationship and the related coping strategies. KEY CONCLUSIONS: equal emphasis should be placed both during the prenatal and postnatal periods in antenatal education classes. IMPLICATIONS FOR PRACTICE: interventions aiming at enhancing positive transitions to parenthood could be introduced early during the postnatal period. Parenthood education classes could adopt adult learning strategies that are participatory, and experiential in nature.