Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2012

Open Access 01-12-2012 | Research article

Can father inclusive practice reduce paternal postnatal anxiety? A repeated measures cohort study using the hospital anxiety and depression scale

Authors: Jenny Tohotoa, Bruce Maycock, Yvonne L Hauck, Satvinder Dhaliwal, Peter Howat, Sharyn Burns, Colin W Binns

Published in: BMC Pregnancy and Childbirth | Issue 1/2012

Login to get access

Abstract

Background

Perinatal research on anxiety and depression has primarily focused on mothers. We have limited knowledge of fathers’ anxiety during the perinatal period yet there is evidence that the parenting capacity of a person can be compromised by anxiety and depression. The purpose of this paper is to identify the impact of a father inclusive intervention on perinatal anxiety and depression. The prime focus of the intervention was to provide education and support to fathers of breastfeeding partners with the aim of increasing both initiation and duration of breastfeeding.

Methods

A repeated measures cohort study was conducted during a RCT that was implemented across eight public maternity hospitals in Perth, Western Australia between May 2008 and June 2009. A baseline questionnaire which included the Hospital Anxiety and Depression Scale (HADS) was administered to all participants on the first night of their hospital based antenatal education program and was repeated at six weeks postnatal. SPSS version 17 was used for reporting descriptive results.

Results

The mean anxiety levels at baseline for the fathers in the intervention group (n=289) and control group (n=244) were 4.58 and 4.22 respectively. At 6 weeks postnatal (only matched pairs), intervention and control group were 3.93 and 3.79. More intervention group fathers self-rated less anxiety compared to the fathers in the control group from baseline to post test (p=0.048). Depression scores for intervention fathers at baseline (mean =1.09) and at six weeks (mean=1.09) were very similar to fathers in the control group at baseline (mean=1.11) and at six weeks (mean =1.07) with no significant changes.

Conclusions

Both intervention and control group fathers experienced some anxiety prior to the birth of their baby, but this was rapidly reduced at six weeks. Paternal anxiety is common to new fathers and providing them with information and strategies for problem-solving can increase their knowledge and potentially lower the risk of postnatal anxiety.

Trial registration

(Australian New Zealand Clinical Trials Registry ACTRN12609000667213)
Literature
1.
Buist A, Austin M-P, Hayes B, Speelman C, Bilszta J, Gemmill A, Brooks J, Ellwood D, Milgrom J: Postnatal mental health of women giving birth in Australia 2002–2004: findings from the beyondblue National Postnatal Depression Program. Aust N Z J Psychiatry. 2008, 42 (1): 66-73. 10.1080/00048670701732749.CrossRefPubMed
2.
Watanabe M, Wada K, Sakata Y, Aratake Y, Kato N, Ohta H, Tanaka K: Maternity blues as predictor of postpartum depression: A prospective cohort study among Japanese women. J Psychosom Obstet Gynaecol. 2008, 29 (3): 211-217. 10.1080/01674820801990577.CrossRef
3.
Leigh B, Milgrom J: Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. 2008, 8 (24): -10.1186/1471-244x-8-24.
4.
Marcus SM: Depression during pregnancy: rates, risks and consequences–Motherisk Update 2008. Can J Clin Pharmacol. 2009, 16 (1): 15-22.
5.
Marcus SM, Heringhausen JE: Depression in childbearing women: when depression complicates pregnancy. Prim Care. 2009, 36 (1): 151-165. 10.1016/j.pop.2008.10.011.CrossRefPubMedPubMedCentral
6.
Grant K-A, McMahon C, Austin M-P: Maternal anxiety during the transition to parenthood: a prospective study. J Affect Disord. 2008, 108 (1–2): 101-111.CrossRefPubMed
7.
Phillips J, Sharpe L, Matthey S, Charles M: Maternally focused worry. Arch Womens Ment Health. 2009, 12 (6): 409-418. 10.1007/s00737-009-0091-4.CrossRefPubMed
8.
Rowe H, Fisher J, Loh W: The Edinburgh Postnatal Depression Scale detects but does not distinguish anxiety disorders from depression in mothers of infants. Arch Womens Ment Health. 2008, 11 (2): 103-108. 10.1007/s00737-008-0003-z.CrossRefPubMed
9.
Heron J, O'Connor TG, Evans J, Golding J, Glover V: The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004, 80 (1): 65-73. 10.1016/j.jad.2003.08.004.CrossRefPubMed
10.
Matthey S, Barnett B, Howiec P, Kavanagh DJ: Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?. J Affect Disord. 2003, 74 (2): 139-147. 10.1016/S0165-0327(02)00012-5.CrossRefPubMed
11.
Fletcher RJ, Matthey S, Marley CG: Addressing depression and anxiety among new fathers. Medical Journal of Australia. 2006, 185: 461-463.PubMed
12.
Cowan CP, Cowan PA: When partners become parents: the big life change for couples. 1999, Basic Books, Routledge; New York, Reprinted by Lawrence Eribaum Associates
13.
Perren S, von Wyl A, Bürgin D, Simoni H, von Klitzing K: Depressive symptoms and psychosocial stress across the transition to parenthood: associations with parental psychopathology and child difficulty. J Psychosom Obstet Gynaecol. 2005, 26 (3): 173-183. 10.1080/01674820400028407.CrossRefPubMed
14.
Buist A, Morse C, Durkin S: Men's adjustment to fatherhood: implications for obstetric health care. Journal of Obstetric, Gynaecologic, & Neonatal Nursing. 2003, 32 (2): 172-180. 10.1177/0884217503252127.CrossRef
15.
Condon J: What about dad? Psychosocial and mental health issues for new fathers. Aust Fam Physician. 2006, 35 (9): 690-692.PubMed
16.
Cabrera NJ, Shannon JD, Tamis-LeMonda C: Fathers' Influence on Their Children's Cognitive and Emotional Development: From Toddlers to Pre-K. Appl Dev Sci. 2007, 11 (4): 208-213. 10.1080/10888690701762100.CrossRef
17.
Fägerskiöld A: A change in life as experienced by first-time fathers. Scand J Caring Sci. 2008, 22 (1): 64-71. 10.1111/j.1471-6712.2007.00585.x.CrossRefPubMed
18.
Austin MP, Tully L, Parker G: Examining the relationship between antenatal anxiety and postnatal depression. J Affect Disord. 2007, 101 (1–3): 169-174.CrossRefPubMed
19.
O'Connor TG, Heron J, Glover V: Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry. 2002, 41 (12): 1470-1477. 10.1097/00004583-200212000-00019.CrossRefPubMed
20.
Wilson S, Durbin CE: Effects of paternal depression on fathers' parenting behaviors: a meta-analytic review. Clinical Psychological Review. 2010, 30 (2): 167-180. 10.1016/j.cpr.2009.10.007.CrossRef
21.
Bögels SM, Bamelis L, van der Bruggen CO: Parental rearing as a function of parent's own, partner's, and child's anxiety status: fathers make the difference. Cognition and Emotion. 2008, 22 (3): 522-538. 10.1080/02699930801886706.CrossRef
22.
Condon JT, Boyce P, Corkindale CJ: The First-Time Fathers Study: a prospective study of the mental health and wellbeing of men during the transition to parenthood. Aust N Z J Psychiatry. 2004, 38: 56-64. 10.1111/j.1440-1614.2004.01298.x.CrossRefPubMed
23.
Zareai M, O'Brien M, Fallon A: Creating a breastfeeding culture: A comparison of breastfeeding practises in Australia and Iran. Breastfeed Rev. 2008, 16 (1): 41-43.
24.
Tohotoa J, Maycock B, Hauck YL, Howat P, Burns S, Binns CW: Dads make a difference: an exploratory study of paternal support for breastfeeding in Perth, Western Australia. Int Breastfeed J. 2009, 4 (15): 10-1186/1746-4358-4-15.
25.
Nolan ML, Hicks C: Aims, processes and problems of antenatal education as identified by three groups of childbirth teachers. Midwifery. 1997, 13: 179-188. 10.1016/S0266-6138(97)80004-6.CrossRefPubMed
26.
Seligman MEP, Walker EF, Rosenhan DL: Abnormal psychology. 2001, W.W. Norton & Company, Inc, New York
27.
Beck AT, Alford B: Depression Causes and Treatment. 2009, University of Pennsylvania Press, Philadelphia
28.
Hranov LG: Comorbid anxiety and depression: illumination of a controversy. Int J Psychiatry Clin Pract. 2007, 11 (3): 171-189. 10.1080/13651500601127180.CrossRefPubMed
29.
Preisig M, Merikangas KR, Angst J: Clinical significance and comorbidity of subthreshold depression and anxiety in the community. Acta Psychiatrica Scandinavia. 2001, 104: 96-103. 10.1034/j.1600-0447.2001.1040s2096.x.CrossRef
30.
Gjerdingen DK, Center BA: First-time parents prenatal to postpartum changes in health and the relation of postpartum health to work and partner characteristics. J Am Board Fam Pract. 2003, 16 (4): 304-311. 10.3122/jabfm.16.4.304.CrossRefPubMed
31.
Quinlivan JA, Condon J: Anxiety and depression in fathers in teenage pregnancy. Aust N Z J Psychiatry. 2005, 39 (10): 915-920. 10.1080/j.1440-1614.2005.01664.x.CrossRefPubMed
32.
Skari H, Skredon M, Malt UF: Comparative levels of psychological distress, stress symptoms, depression, and anxiety after childbirth: A prospective population-based study of mothers and fathers. Bjog-International Journal ofObstetrics & Gynaecology. 2002, 109 (10): 1154-1163.
33.
Bögels S, Phares V: Fathers' role in the etiology, prevention and treatment of child anxiety: A review and new model. Clin Psychol Rev. 2008, 28 (4): 539-558. 10.1016/j.cpr.2007.07.011.CrossRefPubMed
34.
Ramchandani PG, Stein A, O'Connor TG, Heron J, Murray L, Evans J: Depression in men in the postnatal period and later child psychopathology: a population cohort study. J Am Acad Child Adolesc Psychiatry. 2008, 47 (4): 390-398. 10.1097/CHI.0b013e31816429c2.CrossRefPubMedPubMedCentral
35.
Edwards B, Galletly C, Semmler-Booth T, Dekker G: Does antenatal screening for psychosocial risk factors predict postnatal depression? A follow-up study of 154 women in Adelaide, South Australia. Aust N Z J Psychiatry. 2008, 42 (1): 51-55. 10.1080/00048670701739629.CrossRefPubMed
36.
Figueiredo B, Costa R: Mother’s stress, mood and emotional involvement with the infant: 3 months before and 3 months after childbirth. Arch Womens Ment Health. 2009, 12 (3): 143-153. 10.1007/s00737-009-0059-4.CrossRefPubMed
37.
Ramchandani P: G, Stein A, O'Connor TG, Heron J, Murray L, Evans J: Depression in men in the postnatal period and later child psychopathology: a population cohort study. J Am Acad Child Adolesc Psychiatry. 2008, 47 (4): 390-398. 10.1097/CHI.0b013e31816429c2.CrossRefPubMedPubMedCentral
38.
Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987, 150: 782-786. 10.1192/bjp.150.6.782.CrossRefPubMed
39.
Matthey S, Barnett B, Ungerer J, Waters B: Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord. 2000, 60 (2): 75-85. 10.1016/S0165-0327(99)00159-7.CrossRefPubMed
40.
41.
Johnston M, Pollard B, Hennessey P: Construct validation of the hospital anxiety and depression scale with clinical populations. J Psychosom Res. 2000, 48 (6): 579-584. 10.1016/S0022-3999(00)00102-1.CrossRefPubMed
42.
Martin CR, Thompson DR: The hospital anxiety and depression scale in patients undergoing peritoneal dialysis: internal and test-retest reliability. Clin Eff Nurs. 2002, 6 (2): 78-80. 10.1016/S1361-9004(02)00029-8.CrossRef
43.
Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale; an updated review. J Psychiatr Res. 2002, 52: 69-77.
44.
Robertson E, Grace S, Wallington T, Stewart DE: Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004, 26 (4): 289-295. 10.1016/j.genhosppsych.2004.02.006.CrossRefPubMed
45.
Abiodun OA: A validity study of the Hospital Anxiety and Depression Scale in general hospital units and a community sample in Nigeria. Br J Psychiatry. 1994, 165 (5): 669-672. 10.1192/bjp.165.5.669.CrossRefPubMed
46.
Spinhoven PH, Ormel J, Sloekers PPA, Kempen GIJM, Speckens AEM, Van Hemert AM: A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997, 27: 363-370. 10.1017/S0033291796004382.CrossRefPubMed
47.
Quinlivan JA, Condon J: Anxiety and depression in fathers in teenage pregnancy. Aust N Z J Psychiatry. 2005, 39 (10): 915-920. 10.1080/j.1440-1614.2005.01664.x.CrossRefPubMed
48.
Everingham CR, Heading G, Connor L: Couples' experiences of postnatal depression: A framing analysis of cultural identity, gender and communication. Soc Sci Med. 2006, 62 (7): 1745-1756. 10.1016/j.socscimed.2005.08.039.CrossRefPubMed
49.
Wang S-Y, Chen C-H: Psychosocial health of Taiwanese postnatal husbands and wives. J Psychosom Res. 2006, 60 (3): 303-307. 10.1016/j.jpsychores.2005.08.012.CrossRefPubMed
50.
Paulson JF, Dauber S, Leiferman JA: Individual and combined effects of postpartum depression in mothers and fathers on parenting behaviour. Pediatrics. 2006, 118 (2): 659-668. 10.1542/peds.2005-2948.CrossRefPubMed
51.
Ballard CG, Davies R: Postnatal depression in fathers. Int Rev Psychiatry. 1996, 8 (1): 65-71. 10.3109/09540269609037818.CrossRef
52.
Escribè-Agüir V, Gonzalez-Galarzo MC, Barona-Vilar C, Artazcoz L: Factors related to depression during pregnancy: are there gender differences?. J Epidemiol Community Health. 2008, 62 (5): 410-414. 10.1136/jech.2007.063016.CrossRef
53.
Ramchandani PG, O'Connor TG, Evans J, Heron J, Murray LAS: The effects of pre- and postnatal depression in fathers: a natural experiment comparing the effects of exposure to depression on offspring. J Child Psychol Psychiatry. 2008, 49 (10): 1069-1078. 10.1111/j.1469-7610.2008.02000.x.CrossRefPubMedPubMedCentral
54.
O'Connor TG: Annotation: The `effects' of parenting reconsidered: findings, challenges, and applications. J Child Psychol Psychiatry. 2002, 43 (5): 555-572. 10.1111/1469-7610.00046.CrossRefPubMed
55.
Rohde P, Lewinsohn PM, Klein DN, Seeley JR: Association of parental depression with psychiatric course from adolescence to young adulthood among formerly depressed individuals. J Abnorm Psychol. 2005, 114 (3): 409-420.CrossRefPubMedPubMedCentral
56.
Parker G, Barnett B: A test of the social support hypothesis. Br J Psychiatry. 1987, 150 (1): 72-77. 10.1192/bjp.150.1.72.CrossRefPubMed
57.
Davey SJ, Dziurawiec S, O'Brien-Malone A: Men's Voices: Postnatal Depression From the Perspective of Male Partners. Qual Health Res. 2006, 16 (2): 206-220. 10.1177/1049732305281950.CrossRefPubMed
58.
Buist A, Morse CA, Durkin S: Men's adjustment to fatherhood: implications for obstetric health care. Journal of Obstetric & Gynaecological Neonatal Nursing. 2003, 32 (2): 172-180. 10.1177/0884217503252127.CrossRef
59.
Tohotoa J, Maycock B, Hauck YL, Howat P, Burns S, Binns CW: Supporting mothers to breastfeed: The development and process evaluation of a father inclusive perinatal education support program in Perth, Western Australia. Health Promot Int. 2011, 26 (3): 351-361. 10.1093/heapro/daq077.CrossRefPubMed
60.
Nutbeam D: Health promotion glossary Health Promotion International. 1998, 13: 349-364.CrossRef
61.
Lawler PA: The Keys to Adult Learning: Theory and Practical Strategies. 1991, Research for Better Schools, Philadelphia
62.
Hans S, Marianne S, Ulrik Fredrik M, Merethe D, Anniken Bjornstad O, Thore E, Ragnhild E: Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth&;a prospective population-based study of mothers and fathers. BJOG. 2002, 109 (10): 1154-1163.
63.
Renkert S, Nutbeam D: Opportunities to improve maternal health literacy through antenatal education: an exploratory study. Health Promot Int. 2001, 16 (4): 381-388. 10.1093/heapro/16.4.381.CrossRefPubMed
64.
McMillan AS, Barlow J, Redshaw M: A Review of the Evidence about Antenatal Education. 2009, Birth and Beyond, London: DH, 112-
65.
Barclay L, Donovan J, Genovese A: Men's experiences during their partner's first pregnancy: a grounded theory analysis. Aust J Adv Nurs. 1996, 13 (3): 12-24.PubMed
66.
Hsin-Tzu L, Kuan-Chia L, Shu-Chen C, Chien-Huei K, Chieh-Yu L, Su-Chen K: A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety. Birth. 2009, 36 (4): 289-296. 10.1111/j.1523-536X.2009.00356.x.CrossRef
67.
Weber S: The Effects of Relaxation Exercises on Anxiety Levels in Psychiatric Inpatients. J Holist Nurs. 1996, 14 (3): 196-205. 10.1177/089801019601400303.CrossRefPubMed
68.
Dellmann T: "The best moment of my life": a literature review of fathers' experience of childbirth. Australian Midwifery. 2004, 17 (3): 20-26. 10.1016/S1448-8272(04)80014-2.CrossRef
69.
Diemer GA: Expectant fathers:influence of perinatal education on coping, stress, and spousal relations. Res Nurs Health. 1997, 20: 281-293. 10.1002/(SICI)1098-240X(199708)20:4<281::AID-NUR2>3.0.CO;2-C.CrossRefPubMed
70.
Svensson J, Barclay L, Cooke M: Randomised-controlled trial of two antenatal education programs. Midwifery. 2009, 25 (2): 114-125. 10.1016/j.midw.2006.12.012.CrossRefPubMed
71.
Ballard CG, Davis R, Cullen PC, Mohan RN, Dean C: Prevalence of postnatal psychiatric morbidity in mothers and fathers. Br J Psychiatry. 1994, 164 (6): 782-788. 10.1192/bjp.164.6.782.CrossRefPubMed
72.
Goodman J: Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. J Adv Nurs. 2004, 45 (1): 26-35. 10.1046/j.1365-2648.2003.02857.x.CrossRefPubMed
73.
Liber JM, van Widenfelt BM, Goedhart AW, Utens EMWJ, van der Leeden AJM, Markus MT: Parenting and Parental Anxiety and Depression as Predictors of Treatment Outcome for Childhood Anxiety Disorders: Has the Role of Fathers Been Underestimated?. J Clin Child Adolesc Psychol. 2008, 37: 747-758. 10.1080/15374410802359692.CrossRefPubMed
74.
Fletcher R, Vimpani G, Russell G, Sibbritt D: Psychosocial assessment of expectant fathers. Archives of Womens Mental Health. 2008, 11 (1): 27-32. 10.1007/s00737-008-0211-6.CrossRef
Metadata
Title
Can father inclusive practice reduce paternal postnatal anxiety? A repeated measures cohort study using the hospital anxiety and depression scale
Authors
Jenny Tohotoa
Bruce Maycock
Yvonne L Hauck
Satvinder Dhaliwal
Peter Howat
Sharyn Burns
Colin W Binns
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2012
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-12-75

Other articles of this Issue 1/2012

BMC Pregnancy and Childbirth 1/2012 Go to the issue

Research article

Influence of interpersonal violence on maternal anxiety, depression, stress and parenting morale in the early postpartum: a community based pregnancy cohort study

Research article

How good are we at implementing evidence to support the management of birth related perineal trauma? A UK wide survey of midwifery practice

Research article

Estimating coverage of a women’s group intervention among a population of pregnant women in rural Bangladesh

Research article

Intraclass correlation coefficients in the Brazilian network for surveillance of severe maternal morbidity study

Research article

The differential effects of maternal age, race/ethnicity and insurance on neonatal intensive care unit admission rates

Research article

The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth