Mothers' and fathers' sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review.

BACKGROUND: From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents' experiences of their sense of security associated with pregnancy, childbirth and the postnatal period. METHODS: A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers' and fathers' experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings. RESULTS: Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security. CONCLUSIONS: The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers' sense of security is lacking. Further research focused on the experiences of security from the parents' perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.

[Motherhood at the Age of 35 and Over: The Risk of Advanced Maternal Age as Perceived by Women - a Literature Study]. / Mutterschaft ab 35 Jahren: Das Altersrisiko in der Wahrnehmung von Frauen ­ eine Literaturstudie.

Background Delaying motherhood is an ongoing trend in industrialized countries worldwide. The higher the mother´s age, the greater the risks for fertility, pregnancy, childbearing, and for the newborn. The psychosocial situation of women who are conscious of pregnancy risks is thus negatively affected. This paper aims to answer the question as to how women experience the risks of age. Methodology An systematic search of the international literature was carried out between December 2015 and March 2016, using the electronic databases PubMed, CINAHL, PsycINFO, Sowiport, as well as a manual search. The inclusion criterion was the perception of reproductive age risks of motherhood at an advanced age, defined as ≥ 35 years. Results Eleven studies with different designs were evaluated. The participants were sufficiently informed about decreasing fertility rates and the increasing risk of trisomy 21, but less knowledge was shown about the remaining age-associated risks. The awareness of these risks made women feel anxious and scared. They showed various strategies for dealing with their concern: information management, associated with problems of overand misinformation and, in contrast, information avoidance. Other strategies were distraction from thinking about the risks, the need for control and good preparation, or emotional distancing from the pregnancy. The women´s personal risk assessment was complex. They related their social circumstances and their lifestyle and thought about the medical attributions in relative terms. By focusing on giving birth to a healthy child, the mothers often neglected to prepare themselves for living with the newborn. Postpartum they were overwhelmed by the care needed by the newborn child. Discussion The age risk cannot be assessed adequately by those affected. Various phenomena determined through risk research may also appear. There was a meaningful difference between the medically assessed risk and the women's perceived risk. Taking the women´s experience with ageassociated risks and the consequences of motherhood into consideration, it seems necessary to discuss the concept of age risk. Healthcare professionals should focus on health support and encourage older pregnant women to familiarize themselves with family-orientated care of a newborn family member.