MIDLIFE CHILDBEARING Strategies for Informed Decisionmaking

More and more women in the United States are choosing to delay mother-hood until their 30s or even 40s. Yet traditional medical advice warns against midlife pregnancy, predicting a variety of adverse reproductive outcomes associated with "advanced maternal age." Assignment to a high-risk category may result in heightened feelings of concern about pregnancy complications among midlife mothers. Because it is possible that increased emotionality during pregnancy may itself give rise to various childbearing complications, some middle-aged women may become victims of iatrogenic stress during pregnancy. This article first examines critically the medical literature describing the relationship between maternal age and pregnancy outcomes and finds little support for the medical pessimism. Next, the article describes the literature that explores the links between heightened emotionality during pregnancy and various negative outcomes and suggests that, despite serious methodological flaws, there is some evidence that fear-induced stress during pregnancy may place certain middle-aged women at higher risk for complications. Finally, strategies for improved decisionmaking and for enhancing the pregnancy experience of midlife women are proposed.     

Alliance and Group Cohesion in Relationship Education

Relationship education programs have been shown as an effective way to increase relationship functioning. There is less known about how process factors, such as alliance with the leader or group dynamics, affect outcomes in these interventions. We examined group cohesion and alliance with the leader in a relationship education program tailored for individuals. Specifically, we examined whether participants' ratings (n = 126) of the group cohesion and alliance with the leader were associated with changes in relationship adjustment, relationship confidence, and communication quality from pre‐ to postintervention. The results demonstrated that participants' perceptions of the cohesion among the members in their relationship education group, but not the leader–participant alliance, made a significant contribution to the changes in participants' relationship functioning. These results suggest that the group dynamics among the members in the group are important ingredients in relationship education. Implications for relationship programs are provided.