Predictors of postpartum depression in first-time fathers.

OBJECTIVE: A significant number of men suffer from paternal postpartum depression (PPPD). This is detrimental to family and personal well-being. This study aims to report rates of PPPD in first-time fathers in New Zealand. It also aims to find predictors of PPPD. METHODS: Data from 116 men were analysed. Men completed questionnaires at 24 weeks gestation, 36 weeks gestation, post-birth and 6 months after the baby was born. The outcome of interest was scores on the Edinburgh Postnatal Depression Scale 6 months after the baby was born. RESULTS: Twelve percent of the participants met criteria for PPPD. Factors that predicted PPPD were: earlier depression, family life satisfaction, expectations, birth interventions, pain management for their partner and pregnancy anxiety. CONCLUSIONS: It is important that PPPD is recognised and treated. More research is needed on the mental health of fathers.

Low-cost self-paced interventions increase birth satisfaction in first time fathers.

OBJECTIVE: This research aims to investigate whether a skills or birth stories intervention for fathers can improve birth satisfaction of fathers. STUDY DESIGN: One hundred and seventy-four men were recruited and randomly assigned to a skills preparation group, a birth stories group, or a treatment as usual (TAU) group. One hundred sixteen men completed the three questionnaires relevant for this report (67% retention rate). Birth satisfaction was measured soon after birth. MEASURES: Demographic data and data related to partners pregnancy, birth and preparation were collected. The Mackey Childbirth Satisfaction Rating Scale was the primary outcome measure. RESULTS: It was found that men who received either of the birth preparation interventions (skills or birth stories booklet) had significantly higher birth satisfaction scores. An analysis found that, irrespective of intervention, his partner having an induction, a caesarean section, and his not being in full-time employment had a negative effect on birth satisfaction, while his partner having an epidural, his experiencing family life satisfaction before the birth, his finding antenatal classes useful, and having his birth delivery expectations met had a positive impact on birth satisfaction. CONCLUSION: Increasing the father's understanding, role expectations, and preparation for his partner's childbirth, may be important for fathers birth satisfaction. Expectations around childbirth and expectations of himself might be better managed to improve satisfaction. This study found evidence that simple low-cost interventions can improve birth satisfaction for new fathers.

Skills-based childbirth preparation increases childbirth self-efficacy for first time mothers.

OBJECTIVE: To explore the potential benefits of skills-based childbirth preparation on first time mother's childbirth self-efficacy. DESIGN: An RCT of an education programme for skills-based childbirth preparation was conducted. Data were examined for significant differences between groups over time and at outcome. SETTING: First time New Zealand mothers completed the requirements of the study in the privacy of their own homes. PARTICIPANTS: One hundred and eighty-two first time mothers who self-selected met eligibility and were recruited to the study. Of these 137 completed the study (75% retention rate). INTERVENTION: An anonymised version of The Pink Kit Method for Birthing Better® (CKT, 2001), a multi-media, skills-based and self-directed childbirth preparation programme. The course includes: breathing exercises, verbal and non-verbal communication exercises, tension reducing exercises, and body exercises as well as advice about stages, delivery methods, and when to use the skills. MEASUREMENTS: the Childbirth Self-Efficacy Inventory (Scale) (CBSEI), New Zealand Adaptation (Lowe, 1993) at 24 weeks and 36 weeks gestation. FINDINGS: There were no differences between groups in childbirth self-efficacy at the baseline measurement at 24 weeks gestation. At 36 weeks gestation the Intervention Group showed a significant increase in childbirth self-efficacy. The Intervention Group self-efficacy score was also statistically different from each of the control groups at 36 weeks gestation. KEY CONCLUSIONS: A skills-based self-directed childbirth preparation programme was able to increase childbirth self-efficacy in a sample of first time mothers. IMPLICATIONS: for practice: Women might be encouraged to participate in these types of skills-based programmes to aid childbirth.

First-time fathers' perception of their childbirth experiences.

Birth satisfaction impacts on a man's adjustment to his new role as father. Fathers have been found to have needs similar to those of mothers during pregnancy and childbirth. Research suggests that these needs may not be being met for first-time fathers. In a quantitative survey, fathers' birth satisfaction was similar to mothers. This study then used a phenomenological form of thematic analysis to gain an insight into the birth experiences of 155 first-time New Zealand fathers. Core themes included safety of mother and baby, understanding support role, mother in control and managing pain and care and communication after birth. Fathers commented on what impacted on their childbirth experiences and in so doing outlined their needs for a positive experience. Fathers experienced a high level of satisfaction along with a need to be involved and included.

Skills-based childbirth preparation reduces stress for midwives.

OBJECTIVE: to explore the potential benefits of skills-based childbirth preparation on the work related stress levels of midwives. DESIGN: a questionnaire was sent out to midwives who had clients participating in an RCT of an education package for childbirth preparation (The Pink Kit (PK) Method for Birthing Better®) delivered to parents. SETTING: midwives were in private practice and acted as lead maternity carers to New Zealand first time mothers. PARTICIPANTS: one hundred and four independent midwives participated. MEASUREMENTS: a brief questionnaire using a Visual Analogue Scale to portray perceptions of work-related stress and a yes/no question about expected and/or unexpected physical complications. FINDINGS: midwives working with clients in the intervention group experienced less work-related stress after correction for medical complications compared to the two control groups. KEY CONCLUSIONS: working with mothers who have used a programme that increased their childbirth self-efficacy decreased the work-related stress experienced by midwives. IMPLICATIONS FOR PRACTICE: encouraging pregnant women to develop childbirth skills merits further investigation in an effort to reduce the work-related stress experienced by midwives.

First-time mothers' perspectives on relationships with and between midwives and doctors: insights from a qualitative study of giving birth in New Zealand.

OBJECTIVE: to explore the experience of giving birth for first-time New Zealand mothers. DESIGN: qualitative methodology was employed to obtain an in-depth insight into the birth experience using semi-structured interviews conducted face-to-face 11 days to 16 weeks (median 13.5 weeks) after giving birth were audio-recorded and transcribed verbatim. SETTING: the interviews were of a small group of New Zealand mothers. PARTICIPANTS: ten first-time mothers aged 24-38 years (median 31.5 years) participated. MEASUREMENTS: transcripts were analysed using a phenomenological form of thematic analysis. FINDINGS: a core theme was relationship issues. Two subthemes were delineated: lack of relationship between mothers and midwives and doctors; and the conflict between midwives and doctors. KEY CONCLUSIONS: personal, caring and co-operative relationships with all maternity care professionals were basic to New Zealand mothers feeling good about their birth experience. IMPLICATIONS FOR PRACTISE: relationships, with and between, all maternity care professionals merit further investigation in an effort to optimise birth satisfaction.

Taking personal responsibility for well-being increases birth satisfaction of first time mothers.

Birth satisfaction has been found to enhance a mother's capacity to develop a sense of maternal identity. This study used a phenomenological form of thematic analysis to gain in-depth insights into the birth experiences of first-time New Zealand mothers. Taking personal responsibility (the choices participants made in relation to being in control of and accountable for their own birth processes) was a core theme. Those participants who described the neoliberalist ideal of taking personal responsibility to be well informed and well prepared for any birth experience felt more confident that they would be able to work with whatever labour and birth event eventuated.