Sequelae of cesarean and vaginal deliveries: psychosocial outcomes for mothers and infants

Mother-infant dyads grouped according to whether the infants had been delivered vaginally (n = 74) or by planned (n = 37) or unplanned cesarean (n = 56) were compared on psychosocial outcomes at 4 and 12 months postpartum. Hypotheses were that unplanned cesarean delivery would be related to less optimal outcomes and that this relationship would be mediated by mother's appraisal of the delivery and would attenuate over time. No delivery-related differences in mother-infant interactions were found at 4 or 12 months postpartum with one exception: Women low in neuroticism who delivered by unplanned cesarean showed less positive affect toward their infants at 4 months than did women high in neuroticism who delivered by unplanned cesarean or women in any other group. There was some evidence of the mediating role of maternal appraisal of the delivery on these effects. In general, the results indicate little cause for concern about the quality of mother-infant interactions following cesarean deliveries.     

Cesarean childbirth in sweden: Effects on the mother and father-infant relationship

The effects of Cesarean delivery on father-infant and mother-infant interaction were studied in a sample of 30 Swedish, two-parent families with a full-term healthy first-born infant. Fifteen infants were delivered vaginally, and 15 infants were delivered under full anesthesia by Cesarean section. The infants and parents were observed at home when the infants were 3 and 8 months old. The findings indicate that mothers of infants delivered by Cesarean section reacted less positively when they saw their infants for the first time and encountered more difficulties breastfeeding than did mothers of vaginally delivered infants. At 3 months post-partum, fathers of infants who were Cesarean-delivered participated in a greater amount of caregiving activities. There were no differences between Cesarean and vaginally delivered mothers at 3 months after delivery. At 8 months, there were no differences between the two groups (Cesarean and vaginal) on either the interview questions or on-any of the behavioral measures. Results from this study do not support reports from the USA of long-lasting effects of Cesarean delivery on parent-infant interaction. The results suggest the need to study cultural variations that surround Cesarean section delivery so as to understand in what way the subsequent parent-infant relationship is influenced by this event.     

Marital Satisfaction and Child Adjustment: Direct and Mediated Pathways

We explored whether there is a direct association between marital satisfaction and children's psychological adjustment. We also investigated a competing model to assess whether marital satisfaction is indirectly related to child outcomes through its associations with parents' depression and involvement in childrearing. Analyses of data from 1,101 participants in the National Survey of Families and Households indicated that mothers' and fathers' reports of marital satisfaction were significantly associated with child symptomatology. Moreover, mothers who experienced marital dissatisfaction were less involved with their children, which in turn was associated with greater child psychological distress. This mediated pathway was not significant for fathers.     

Supportive Coparenting Relationships as a Haven of Psychological Safety at the Transition to Parenthood

Guided by research on psychological safety, the authors used longitudinal survey data from a sample of 182 dual-earner male–female couples to examine the role of supportive coparenting in mediating relations between adult attachment orientations and parenting stress/satisfaction and further considered whether parenting self-efficacy moderated relations between supportive coparenting and parenting stress/satisfaction. Path analyses using IBM SPSS AMOS 22 and bootstrapping techniques indicated that fathers’ (but not mothers’) perceptions of supportive coparenting at 3 months postpartum mediated the associations between their attachment anxiety in the third trimester of pregnancy and their parenting stress and satisfaction at 9 months postpartum. Additional tests of moderation revealed that mothers’ perceptions of greater supportive coparenting were associated with lower parenting stress only when their parenting self-efficacy was low, but fathers’ perceptions of greater supportive coparenting were associated with greater parenting satisfaction only when their parenting self-efficacy was high. Implications and limitations are discussed.     

Acculturation and adjustment among immigrant Chinese parents: mediating role of parenting efficacy

This study examined parenting efficacy beliefs as a mediator of the association between acculturation and adjustment. The sample consisted of 177 immigrant Chinese mothers and fathers with early adolescent children in Canada. Acculturation was assessed bidimensionally as Canadian and Chinese orientations. A latent psychological adjustment variable was composed of symptoms of depression, feelings of self-esteem, and life satisfaction. Results showed that relations between Canadian orientation and psychological adjustment were partially mediated by parenting efficacy. As expected, the more parents were oriented toward Canadian culture, the more efficacious they felt in their parenting, which in turn was associated with better psychological adjustment. In contrast, mediation of relations between Chinese orientation and psychological adjustment was not supported, as Chinese orientation was not associated with parenting efficacy and was positively associated with psychological adjustment for mothers only. Similar results were found when the meditational model was extended to evaluate parenting practices as an outcome (i.e., warmth, reasoning, and monitoring). That is, parenting efficacy mediated the relation between higher Canadian orientation and more positive parenting practices, whereas Chinese orientation was unrelated to parenting practices. Invariance testing suggested that the models were similar for mothers and fathers. Results support the theory that higher orientation to Canadian culture may advance feelings of parenting efficacy because parents have the cultural knowledge and skills to feel confident parenting in a new intercultural context. Further, they support the expectation that parenting efficacy beliefs, in turn, are important determinants of psychological adjustment and effective parenting for immigrant parents.     

Long-term support and personal adjustment of adolescent and older mothers.

Adolescent and older mothers reported the size and quality of social networks and perceptions of family support at 1, 6, and 12 months postpartum. Maternal behavior, general life satisfaction, and parental satisfaction were assessed at 12 months. No significant differences were found in the size of social networks and quality of interactions within those networks, though older mothers had significantly higher scores on perceived family support than did adolescent mothers. Perceived family support and quality of interactions within the social network generally were associated positively with maternal behavior, life satisfaction, and parental satisfaction. This was true in more cases for the adolescent than for older mothers.     

Prospective study of postpartum depression: 4 1/2-year follow-up of women and children

The consequences of maternal postpartum depression for mothers and children were investigated in a 4 1/2-year follow-up study, which included 70 of 99 women who had participated in an earlier study of postpartum depression. Information about maternal adjustment and depression during the follow-up period and child adjustment at age 4 1/2 years was obtained. Women who had experienced a postpartum depression were predicted to be at increased risk for subsequent depression and poor adjustment of their child. Postpartum depression was directly related to subsequent depression but not child problems. Later depression was related to child problems at 4 1/2 years. We concluded that postpartum depression may increase risk for later maternal depression and in turn increases risk for child behavior problems. Intervening with women who have experienced a postpartum depression may reduce likelihood of future depressions and child behavior problems.     

DIMENSIONS OF FAMILY RELATIONSHIPS ASSOCIATED WITH DEPRESSIVE SYMPTOMATOLOCY IN MOTHERS OF YOUNG CHILDREN

Although mothers of young children have a higher incidence of depressive symptomatology than do either women who are not mothers or men, very little is known about the psychological nature of this phenomenon. This study examines the way in which psychological dimensions of family relationships are associated with or contribute to this increased risk in married Caucasian mothers raising first-born children. The relationships between maternal depressive symptomatology and recollections of parental relationships during childhood, marital satisfaction, and maternal separation anxiety were examined. Hierarchical regression analyses revealed that these three factors explained 35.5% of the variance in maternal depressive symptomatology. These results, in addition to significant zero-order correlations, are discussed in light of the existing psychological literature.     

Sexual well-being and perceived stress in couples transitioning to parenthood: A dyadic analysis

Background/ObjectiveThe transition to parenthood encompasses several psychological and relational changes that might contribute to couples’ high levels of stress postpartum. Although common across the postpartum, couples’ sexual changes are frequently overlooked.MethodWe surveyed 255 mixed-sex new parent couples to examine the associations between sexual well-being—sexual satisfaction, desire, and postpartum sexual concerns—and perceived stress postpartum. Couples completed self-report questionnaires assessing perceived stress and sexual well-being.ResultsFor both mothers and fathers, greater sexual satisfaction was associated with their partners’ lower perceived stress and, for fathers, this was also associated with their own lower perceived stress. For mothers, greater partner-focused sexual desire was associated with their own lower perceived stress whereas, for fathers, greater partner-focused sexual desire was associated with their partners’ higher perceived stress. In addition, greater solitary sexual desire and postpartum sexual concerns were associated with both parents’ own higher perceived stress.ConclusionsThis study highlights the association between sexual well-being and couples’ postpartum stress, suggesting that more positive sexual experiences are linked to lower perceptions of stress across this vulnerable period. Couples’ sexual well-being may be an important target for interventions aimed at helping postpartum couples cope with stress.     

Invisible Household Labor and Ramifications for Adjustment: Mothers as Captains of Households

We address the issue of invisible labor in the home by examining how the distribution of the mental and emotional labor inherent in managing the household between spouses may be linked with women’s well-being, including their satisfaction with life, partner satisfaction, feelings of emptiness, and experiencing role overload. In a sample of 393 U.S. married/partnered mothers, mostly of upper-middle class backgrounds with dependent children at home, results showed that a majority of women reported that they alone assumed responsibility for household routines involving organizing schedules for the family and maintaining order in the home. Some aspects of responsibilities related to child adjustment were primarily handled by mothers, including being vigilant of children’s emotions, whereas other aspects were shared with partners, including instilling values in the children. Responsibility was largely shared for household finances. Regression analyses showed that after controlling for dimensions of emotional and physical intimacy, feeling disproportionately responsible for household management, especially child adjustment, was associated with strains on mothers’ personal well-being as well as lower satisfaction with the relationship. The implications of our work highlight the need to consider the burden of household management on mothers’ well-being and speak to mothers’ own needs for support and care as the primary managers of the household. In future research on division of labor, it will be useful to measure these critical but often neglected dimensions of who coordinates the household, given potential ramifications of this dimension for the quality of marriages and women’s personal well-being.

     

POSTPARTUM PARTNER SUPPORT, DEMAND-WITHDRAW COMMUNICATION, AND MATERNAL STRESS

The weeks following the birth of a child can be stressful for new mothers. Maternal stress may be increased when mothers are dissatisfied with instrumental partner support (e.g., division of childcare duties and family decision-making power). The purpose of the current study was to determine if there is an association between dissatisfaction with partner support and maternal stress in the postpartum period, and to examine whether that association is mediated by demand-withdraw communication between partners. Participants were 49 women who completed questionnaires about satisfaction with partner support, female demand/male withdraw communication in their relationship, and their own perceived stress approximately 8 weeks after giving birth. Findings support the hypothesis that demand-withdraw communication mediates the association between dissatisfaction with partner support and maternal stress. This finding suggests that fathers' withdrawal in the context of mothers' requests for discussion or change appears to be associated with increased levels of maternal stress.     

Relational Aggression in Mothers and Children: Links with Psychological Control and Child Adjustment

This study assesses associations between mothers’ use of relational aggression with their peers and psychological control with their children, and child adjustment in a sample of fifty U.S. mothers of elementary and middle school children. Mothers completed surveys assessing their relational aggression and psychological control. Teachers completed surveys assessing children’s externalizing behavior, internalizing symptoms, and relational aggression. Results suggest that mothers who are relationally aggressive with their peers are more likely to be psychologically controlling with their children. Results also showed that relational aggression predicted adjustment problems in youth. Relational aggression was associated with externalizing problems among boys and girls, and with internalizing problems among boys. Few gender differences in mean levels of maternal or child behaviors emerged.     

Optimism,appraisals, and coping in the adjustment of mothers and their children with spina bifida

Families of children with physical disabilities show substantial differences in the levels of adjustment of both the children and their parents. These differences result, in part, from the complex interplay of family and child adaptation resources, such as coping and social support. In order to identify factors which may differentiate levels of adjustment among families with children with physical disabilities, this study examined relationships among optimism, primary and secondary appraisals of and coping with child-related stressors, maternal psychological adjustment, and child adjustment in 29 families with a child with spina bifida without mental retardation and 28 comparison families with a nondisabled child. For the spina bifida group, primary appraisals were related to the use of avoidant coping strategies, and these coping strategies were related to maternal psychological adjustment and child internalizing behavior problems. No significant differences between the groups in terms of the nature of the relationships or in the levels of the variables were found with the exception that mothers of children with spina bifida were less optimistic than comparison mothers. These data support the importance of coping in understanding the psychological adjustment of mothers faced with a chronic stressor in the family.     

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self‐report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off‐treatment). These findings reinforce the need for family‐ and parent‐based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.     

Sport participation,body satisfaction and depressive symptoms in adolescence: a moderated-mediation analysis of gender differences

This research aimed to analyse the partial mediating role of body satisfaction in the relationship between sport participation and depressive symptoms, as well as to examine the moderating role of gender in these associations. A cross-sectional study was conducted with a sample of 1810 adolescents aged 13–18 years old who completed self-report measures regarding sport participation, body satisfaction and depressive symptoms. The results indicated that a higher frequency of sport participation was associated with a lower presence of depressive symptoms, both directly and through greater body satisfaction, although gender differences were found in this partial mediation model. It was detected that sport participation had a greater effect on positive body satisfaction among boys, whereas body dissatisfaction indicated a greater presence of depressive symptoms among girls. The results emphasize the need to implement gender-specific programmes to improve psychological adjustment in adolescents by promoting sport practice and body acceptance.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

Dissimilarity in mother and adolescent illness representations of type 1 diabetes and negative emotional adjustment

The study explored how two measures of mother–adolescent dissimilarity in illness representations relate to negative emotional adjustment in mothers and adolescents. Eighty-four adolescents with type 1 diabetes (age 11.5–17.5) and their mothers completed the Revised Illness Perceptions Questionnaire and measures of negative emotional adjustment. Adolescents viewed diabetes as less chronic, containing fewer negative emotional representations, and that mother had less control over the illness than did mothers. Mother–adolescent mean differences in representations were not associated with negative adjustment for adolescents; mean differences in coherence were related to negative adjustment for mothers, when controlling the individual's own representations. A measure of dissimilarity based on the sum of squared differences between mother and adolescent was associated with negative adolescent adjustment when controlling adolescent's own representations, but no relations were found for mothers. Dyadic approaches to coping with chronic illness will benefit by understanding how dissimilarity in illness representations between patient and caregiver relate to adjustment.     

How Do Mothers in Prison Differ From Non-Mothers?

Adjustment patterns and criminal characteristics of 350 incarcerated mothers of children under 21 years of age were contrasted to those of 166 women from the same institution that had never had children. There were no observed differences between mothers and non-mothers in terms of self-reported mental illness symptoms, emotional distress, or conflict with other individuals at the prison. There were also no differences in terms of institutional infractions observed by prison officials. Consistent with previous research with the same sample, there were adjustment differences between mothers reporting high versus low levels of parenting stress, but neither group of mothers evidenced different adjustment patterns relative to non-mothers. However, there were differences in criminal characteristics. Mothers were more likely than non-mothers to be incarcerated for property or drug offenses, and were more likely to have at least one current or previous drug offense in their criminal history. Non-mothers were more likely than mothers to be incarcerated for violent offenses, including homicide. Results indicate that although there are differences between mothers and non-mothers in the contexts associated with criminal behavior, both groups show the same range of adjustment problems once in prison.     

Social Comparison Among Individuals With Rheumatoid Arthritis1

This study examined the types of social comparisons made by individuals with rheumatoid arthritis (RA) and the role these comparisons play in illness adjustment. Seventy-five women with RA were interviewed. The interview included measures of social comparison preferences assessed within two different contexts: the establishment of standards for desired performance and the experience of performance difficulties. Perceived ability, satisfaction with ability, and psychological adjustment also were assessed. We found that when respondents were experiencing performance difficulties they compared more frequently with other RA patients than with individuals not affected by RA. However, when establishing standards for desired performance, the latter type of comparison was more common. Further, respondents' comparison preferences were not related to perceptions of ability, but were related to satisfaction with ability. Greater satisfaction was associated with comparison with individuals not affected by RA when establishing standards for desired performance and comparison with other RA patients when experiencing performance difficulties. Satisfaction, in turn, was positively related to psychological adjustment.