Top

Published in:

Open Access 01-12-2023 | COVID-19 | Research

Partner support and relationship quality as potential resources for childbirth and the transition to parenthood

Authors: Lisa Hoffmann, Norbert Hilger, Elena Riolino, Annika Lenz, Rainer Banse

Published in: BMC Pregnancy and Childbirth | Issue 1/2023

Abstract

Background

The aim of the present paper was to explore the role of partners for the stressful life events of birth and the transition to parenthood.

Methods

In a first prospective longitudinal study (N = 304 dyads) we tested whether relationship quality positively predicted fewer interventions during labor and birth, a more positive birth experience, and better well-being during the first six weeks after birth. In a second study we surveyed mothers (N = 980; retrospective quasi-experimental design) who had given birth during the first lockdown of the COVID-19 pandemic in spring 2020 – some in the absence of their partners – to test the assumption that regardless of relationship quality, the presence of the partner was positively related to low-intervention births and the birth experience.

Results

The results of the longitudinal study (Study 1) could be integrated into a Single Indicator model. They revealed that a high relationship quality assessed between week 5 and week 25 of pregnancy had a positive effect on birth experience for the mother and on psychological well-being during the transition to parenthood for both mothers and fathers. Results of the retrospective quasi-experimental field study (Study 2) revealed that the continuous presence of the partner was associated with a higher probability of a low-intervention birth and a more positive birth experience. Presence of a partner for only part of the birth did not positively predict labor and birth, but did positively predict the birth experience. The effects were independent of relationship quality.

Conclusion

The results of both studies highlight the importance of partners for psychological well-being during labor and birth and the transition to parenthood.

Since the results do not change when the group someone else is not included in the analyses, results are based on the whole sample; see OSF.

during data collection, some participants had problems entering the weight and size of the baby. These values were replaced by missing values in the data set. All analyses were performed with a control variable for these cases. No effect on the results could be found; see OSF

In an independent data collection (N = 2,379) for the years 2020 and 2021 and with only 3% (n = 88) without an accompanying person, these results only partially replicated. AUC analyses indicated a slightly higher probability of a low-intervention birth for continuous presence (AUC = 0.53, p = .027) but results of logistic regression did not yield significant results for presence or continuous presence. For birth experience results of the initial study could be replicated. Again, low-intervention birth, B = 1.184, SE = 0.061, p < .001, and both presence, B = 0.400, SE = 0.149, p = .007, and continuous presence, B = 0.415, SE = 0.058, p < .001, positively predicted birth experience. See OSF for the detailed results.

We also explored relationship quality and continuous midwifery support as potential moderators (also for low-intervention birth as the outcome variable) but results did not yield significant interaction terms. Their results can be found at OSF.

Proulx CM, Helms HM, Buehler C. Marital quality and personal well-being: a meta-analysis. J Marriage Family. 2007;69(3):576–93. https://doi.org/10.1111/j.1741-3737.2007.00393.x.CrossRef

Diener E, Suh EM, Lucas RE, Smith HL. Subjective well-being: three decades of progress. Psychol Bull. 1999;125(2):276–302. https://doi.org/10.1037/0033-2909.125.2.276.CrossRef

Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: a meta-analytic review. Psychol Bull. 2014;140(1):140–87. https://doi.org/10.1037/a0031859.CrossRefPubMed

Bodenmann G, Cina A. Stress and coping among stable-satisfied, stable-distressed, and seperated/divorced swiss couples. J Divorce Remarriage. 2006;44(1):71–89. https://doi.org/10.1300/J087v44n01_04.CrossRef

Bodenmann G. Dyadic coping and the significance of this concept for prevention and therapy. Z für Gesundheitspsychologie. 2008;16(3):108–11. https://doi.org/10.1026/0943-8149.16.3.108.CrossRef

Banse R, Kowalick C. Implicit attitudes towards romantic partners predict well-being in stressful life conditions: evidence from the antenatal maternity ward. Int J Psychol. 2007;42(3):149–57. https://doi.org/10.1080/00207590601067037.CrossRef

Dixson BJW, Borg D, Rae KM, Whittingha K, Gannon B, McPhail SM, et al. The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study. Arch Women Ment Health. 2023;26(1):107–16. https://doi.org/10.1007/s00737-022-01257-1.CrossRef

Mikulincer M, Shaver PR. The attachment behavioral system in adulthood: activation, psychodynamics, and interpersonal processes. In: Zanna MP, editor. Advances in experimental social psychology. Elsevier Academic Press; 2003. pp. 53–152. https://doi.org/10.1016/S0065-2601(03)01002-5.

Hazan C, Shaver P. Romantic love conceptualized as attachment process. J Personal Soc Psychol. 1987;52(3):511–24. https://doi.org/10.1037/0022-3514.52.3.511.CrossRef

10.

Simpson JA, Rholes WS. Adult attachment orientations and well-being during the transition to parenthood. Curr Opin Psychol. 2018;25:47–52. https://doi.org/10.1016/j.copsyc.2018.02.019.CrossRefPubMedPubMedCentral

11.

Iles J, Slade P, Spiby H. Posttraumatic stress symptoms and postpartum depression in couples after childbirth: the role of partner support and attachment. J Anxiety Disord. 2011;25(4):520–30. https://doi.org/10.1016/j.janxdis.2010.12.006.CrossRefPubMed

12.

Bowlby J. A secure base: parent-child attachment and healthy human development. New York: Basic Books; 1988.

13.

Mazzeschi C, Pazzagli C, Radi G, Raspa V, Buratta L. Antecedents of maternal parenting stress: the role of attachment style, prenatal attachment, and dyadic adjustment in first-time mothers. Front Psychol. 2015;6:1443. https://doi.org/10.3389/fpsyg.2015.01443.CrossRefPubMedPubMedCentral

14.

Kaźmierczak M. Couple empathy – the mediator of attachment styles for partners adjusting to parenthood. J Reproductive Infant Psychol. 2014;33(1):15–27. https://doi.org/10.1080/02646838.2014.974148.CrossRef

15.

Quinn K, Spiby H, Slade P. A longitudinal study exploring the role of adult attachment in relation to perceptions of pain in labour, childbirth memory and acute traumatic stress responses. J Reproductive Infant Psychol. 2015;33(3):256–67. https://doi.org/10.1080/02646838.2015.1030733.CrossRef

16.

Reisz S, Brennan J, Jacobvitz D, George C. Adult attachment and birth experience: importance of a secure base and safe haven during childbirth. J Reproductive Infant Psychol. 2019;37(1):26–43. https://doi.org/10.1080/02646838.2018.1509303.CrossRef

17.

Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, et al. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007;32(5):565–74. https://doi.org/10.1016/j.psyneuen.2007.03.011.CrossRefPubMed

18.

van Syckle K, Caron C. ‘Women Will Not Be Forced to Be Alone When They Are Giving Birth’: The New York Times; 2020, March 28. Available from: URL: http://www.nytimes.com.

19.

World Health Organisation. Coronavirus disease (COVID-19): Pregnancy and childbirth. 2020, September. Available from: URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-pregnancy-and-childbirth.

20.

Schmitt N, Striebich S, Meyer G, Berg A, Ayerle GM. The partner’s experiences of childbirth in countries with a highly developed clinical setting: a scoping review. BMC Pregnancy Childbirth. 2022;22(1):742. https://doi.org/10.1186/s12884-022-05014-1.CrossRefPubMedPubMedCentral

21.

Bradley R, Slade P. A review of mental health problems in fathers following the birth of a child. J Reproductive Infant Psychol. 2011;29(1):19–42.CrossRef

22.

Howat A, Masterson C, Darwin Z. Non-birthing mothers’ experiences of perinatal anxiety and depression: understanding the perspectives of the non-birthing mothers in female same-sex parented families. Midwifery. 2023;120:103650. https://doi.org/10.1016/j.midw.2023.103650.CrossRefPubMed

23.

World Health Organisation. Companion of choice during labour and childbirth for improved quality of care. 2020. Available from: URL: https://apps.who.int/iris/bitstream/handle/10665/334151/WHO-SRH-20.13-eng.pdf.

24.

Savalei V. A comparison of several approaches for controlling measurement error in small samples. Psychol Methods. 2018;24(3):352–70. https://doi.org/10.1037/met0000181.CrossRefPubMed

25.

Stone AA, Shiffman S. Ecological Momentary Assessment (EMA) in behavioral medicine. Ann Behav Med. 1994;16(3):199–202. https://doi.org/10.1093/abm/16.3.199.CrossRef

26.

Banse R. Attachment style and marital satisfaction: evidence for dyadic configuration effects. J Social Personal Relationships. 2004;21(2):273–82. https://doi.org/10.1177/0265407504041388.CrossRef

27.

Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. J Personal Soc Psychol. 1991;61(2):226–44. https://doi.org/10.1037/0022-3514.61.2.226.CrossRef

28.

Sander J, Böcker S, Die deutsche Form der Relationship Assessment Scale (RAS). Eine kurze Skala zur Messung der Zufriedenheit in einer Partnerschaft [The german version of the Relationship Assessment Scale (RAS): a short scale for measuring satisfaction in a relationship]. Diagnostica. 1993;39(1):55–62.

29.

Hendrick SS. A generic measure of relationship satisfaction. J Marriage Fam. 1988;50(1):93–8. https://doi.org/10.2307/352430.CrossRef

30.

Bodenmann G. Dyadisches Coping Inventar (DCI). Testmanual. [Dyadic Coping Inventory. Testmanual]. Bern, Göttingen: Huber & Hogrefe; 2008.

31.

Hoffmann L, Banse R. Psychological aspects of childbirth: evidence for a birth- related mindset. Eur J Social Psychol. 2021;51(1):124–51. https://doi.org/10.1002/ejsp.2719.CrossRef

32.

Hoffmann L, Hilger N, Banse R. The mindset of birth predicts birth outcomes: evidence from a prospective longitudinal study. Eur J Social Psychol. 2023;1–15. https://doi.org/10.1002/ejsp.2940.

33.

Werkmeister G, Jokinen M, Mahmood T, Newburn M. Making normal labour and birth a reality – developing a multi disciplinary consensus. Midwifery. 2008;24(3):256–9. https://doi.org/10.1016/j.midw.2008.06.001.CrossRefPubMed

34.

Statistisches Bundesamt. Mehr Krankenhausentbindungen 2016 bei niedrigerer Kaiserschnittrate; [More hospital deliveries in 2016 with lower cesarean rate]. 2017 [cited 27.03.2023]. Available from: URL: https://www.destatis.de/DE/Presse/Pressemitteilungen/2017/10/PD17_348_231.html.

35.

Statistisches Bundesamt. 30,5% der Krankenhausentbindungen per Kaiserschnitt im Jahr 2017; [30.5% of hospital deliveries by cesarean section in 2017]. 2018 [cited 27.03.2023]. Available from: URL: https://www.destatis.de/DE/Presse/Pressemitteilungen/2018/09/PD18_349_231.html.

36.

Statistisches Bundesamt. Krankenhausentbindungen in Deutschland; [Hospital deliveries in Germany] 2023 [cited 27.03.2023]. Available from: URL: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Krankenhaeuser/Tabellen/krankenhausentbindungen-kaiserschnitt.html.

37.

Shiffman S, Stone AA, Hufford MR. Ecological Momentary Assessment. Ann Rev Clin Psychol. 2008;4(1):1–32. https://doi.org/10.1146/annurev.clinpsy.3.022806.091415.CrossRef

38.

Siegrist J, Broer M, Junge A. Profil der Lebensqualität chronisch Kranker [Quality of life profile for chronically ill patients]. Göttingen, Germany: Beltz; 1996.

39.

Gemeinsamer Bundesausschuss. Richtlinien des Gemeinsamen Bundesausschusses über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung („Mutterschafts-Richtlinien. “) [Guidelines of the Federal Committee on Medical Care during pregnancy and after delivery (“Maternity Guidelines”)]. 2015; 2015. Available from: URL: https://www.g-ba.de/downloads/62-492-1080/Mu-RL_2015-08-20_iK-2015-11-10.Pdf.

40.

Statistisches Bundesamt. Ein Drittel aller Geburten in 2020 durch Kaiserschnitt; [One-third of all births in 2020 by cesarean section]. 2022 [cited 27.03.2023]. Available from: URL: https://www.destatis.de/DE/Presse/Pressemitteilungen/2022/04/PD22_N022_231.html.

41.

Hodnett E. Nursing support of laboring woman. J Obstetric Gynecologic Neonatal Nurs. 1996;25(3):257–64. https://doi.org/10.1111/j.1552-6909.1996.tb02434.x.CrossRef

42.

Babchishin KM, Helmus LM. The influence of base rates on correlations: an evaluation of proposed alternative effect sizes with real-world data. Behav Res Methods. 2016;48(3):1021–31. https://doi.org/10.3758/s13428-015-0627-7.CrossRefPubMed

43.

Mplus user’s guide (Seventh edition) [Computer software]. Version Seventh Edition. Los Angeles: Muthén & Muthén; 1998–2015.

44.

Yu C-Y. Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes [Doctoral dissertation]. Los Angeles: University of California; 2002.

45.

Borenstein M. Effect sizes for continuous data. In: Cooper H, Hedges LV, Valentine JC, editors. The handbook of research synthesis and meta-analysis. New York: Russel Sage Foundation; 2009. pp. 221–35.

46.

Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. Mahwah: Lawrence Erlbaum; 2003.

47.

Carli LL. Cognitive Reconstruction, Hindsight, and reactions to victims and perpetrators. Pers Soc Psychol Bull. 1999;25(8):966–79. https://doi.org/10.1177/01461672992511005.CrossRef

48.

Bell AF, Andersson E. The birth experiences and women’s postnatal depression: a systematic review. Midwifery. 2016;39:112–23. https://doi.org/10.1016/j.midw.2016.04.014.CrossRefPubMed

49.

Durik AM, Hyde JS, Clark R. Sequelae of cesarean and vaginal deliveries: psychosocial outcomes for mothers and infants. Dev Psychol. 2000;36(2):251–60. https://doi.org/10.1037/0012-1649.36.2.251.CrossRefPubMed

50.

DiMatteo MR, Morton SC, Lepper HS, Damush TM, Carney MF, Pearson M, et al. Cesarean childbirth and psychosocial outcomes: a meta-analysis. Health Psychol. 1996;15(4):303–14. https://doi.org/10.1037/0278-6133.15.4.303.CrossRefPubMed

51.

Seefeld L, Buyukcan-Tetik A, Garthus-Niegel S. The transition to parenthood: perspectives of relationship science theories and methods. J Reproductive Infant Psychol. 2022;40(2):105–7. https://doi.org/10.1080/02646838.2022.2039864.CrossRef

Title: Partner support and relationship quality as potential resources for childbirth and the transition to parenthood
Authors: Lisa Hoffmann
Norbert Hilger
Elena Riolino
Annika Lenz
Rainer Banse
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: COVID-19
Published in: BMC Pregnancy and Childbirth / Issue 1/2023
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-023-05748-6

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Partner support and relationship quality as potential resources for childbirth and the transition to parenthood

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Prevalence of maternal mortality causes based on ICD-MM: a systematic review and meta-analysis

BMC pregnancy and childbirth - ‘screening and management of food insecurity in pregnancy’

Navigating miscarriage in Jordan: understanding emotional responses and coping strategies

Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis

Cultural beliefs and practices on perinatal death: a qualitative study among the Lango community in Northern Uganda

Effect of preoperative prophylactic intravenous tranexamic acid on perioperative blood loss control in patients undergoing cesarean delivery: a systematic review and meta-analysis