Information-seeking and maternal self-definition during the transition to motherhood

The Dynamics of Becoming a Mother during Pregnancy and After Childbirth

Background: The aim of this study was to explore the relationship between one’s maternal attachment style and one’s self-image as a mother, image of one’s mother as a mother, and bond with the child over a period of several months. Methods: A total of 86 women took part in the study The Adjective Check List (ACL), Postpartum Bonding Questionnaire (PBQ), Maternal–Fetal Attachment Scale (MFAS), and a modified version of the Experiences in Close Relationships (ECR) were used. Two measurements were used: during pregnancy and about six months after the birth of the child. Results: In terms of their self-image as mothers, the women had higher results the first time they took the questionnaire, regardless of their attachment style. An interaction effect was found between attachment style and the ‘need for changes’ scale. The image of one’s mother as a mother depended on the level of avoidance in attachment, regardless of the measurement. An interaction effect was found between attachment style and the scale of ‘personal adaptation’. There was a correlation between the bond with the child during pregnancy, the bond following birth, and the style of maternal attachment; the main predictor of the bond with the child after birth is the bond with the child during the pregnancy. Conclusion: Those who provide care for pregnant women and new mothers should be aware of the complex psychological processes in the transition to motherhood, have knowledge about perinatal mental health, and when necessary, refer women to specialists such as support groups for new mothers, trained midwives, psychologists, psychotherapists, or psychiatrists.

Views and preferences of medical professionals and pregnant women about a novel primary prevention intervention for hypertensive disorders of pregnancy: a qualitative study

Background

Calcium and low-dose aspirin are two potential approaches for primary prevention of hypertensive disorders of pregnancy (HDP). This study aimed to explore the acceptability, views and preferences of pregnant women and primary healthcare providers for a fixed-dose combined preparation of aspirin and calcium (a polypill) as primary prevention of HDP in an unselected pregnant population.

Methods

In this qualitative study eight in-depth semi-structured interviews were conducted with Dutch primary care midwives and general practitioners. Seven focus group discussions were organised with women with low-risk pregnancies. Topics discussed were: perceptions of preeclampsia; information provision about preeclampsia and a polypill; views on the polypill concept; preferences and needs regarding implementation of a polypill. Thematic analysis of the data transcripts was carried out to identify emerging themes.

Results

Two major themes shaped medical professionals’ and women’s views on the polypill concept: ‘Informed Choice’ and ‘Medicalisation’. Both could be divided into subthemes related to information provision, personal choice and discussions with regard to the balance between ‘unnecessary medicalisation’ and ‘scientific progress’.

Conclusions

In general, women and healthcare practitioners expressed a positive attitude towards a polypill intervention as primary prevention strategy with aspirin and calcium, providing some conditions are met. The most important conditions for implementation of such a strategy were safety, effectiveness and the possibility to make a well-informed autonomous decision.

Electronic supplementary material

The online version of this article (10.1186/s12978-019-0707-8) contains supplementary material, which is available to authorized users.

Social media as social support in pregnancy and the postpartum

Based on the rapidly growing use of social media and its influence on society an online survey to explore social media use and perceptions of social support was developed. A survey link or QR, quick read code was provided to new mothers in the postpartum setting of an academic medical center, posted on the hospital hosted website for new mothers and shared with Centering Pregnancy groups at the research hospital. The survey link was available for 4 weeks and 117 mothers from 64 different zip codes across the United States completed the survey. The majority of respondents indicated the main source of social support came from their current partner (92%). In addition, 43% used blogs to communicate with other mothers, 99% used the internet for answers to parenting questions, 89% used social media sites for questions and advice related to pregnancy and/or their role as a parent, and 84% considered social media friends a form of social support. These results demonstrate social media plays a substantial role in the lives of mothers today. Providers of healthcare should become familiar and comfortable with social media resources to support mothers of young children.

Present and past selves: a steady-state visual evoked potentials approach to self-face processing

The self-face has a prioritized status in the processing of incoming visual inputs. As the self-face changes over the lifespan, this stimulus seems to be well-suited for investigation of the self across time. Here, steady-state visual evoked potentials (SSVEP, oscillatory responses to periodic stimulation with a frequency that mirrors the frequency of stimulation) were used to investigate this topic. Different types of faces (present self, past self, close-other’s, unknown, scrambled) flickered four times per second in two types of stimulation (‘identical’, with the same image of a given type of face; ‘different’, with different images of the same type of face). Each of the 10 stimulation sessions lasted 90 seconds and was repeated three times. EEG data were recorded and analyzed in 20 participants. In general, faces evoked higher SSVEP than scrambled faces. The impact of identical and different stimulation was similar for faces and scrambled faces: SSVEP to different stimuli (faces, scrambled faces) was enhanced in comparison to identical ones. Present self-faces evoked higher SSVEP responses than past self-faces in the different stimulation condition only. Thus, our results showed that the physical aspects of the present and past selves are differentiated on the neural level in the absence of an overt behavior.

Factors influencing parenting efficacy of Asian immigrant, first-time mothers: A cross-sectional, correlational survey

In this study, we determined the factors influencing parenting efficacy of Asian immigrant, first-time mothers. The research design was a cross-sectional, correlational study. The study included 125 first-time mothers who immigrated and married Korean men, and were living in Korea. Data were collected using translated questionnaires, and analyzed for descriptive statistics, Pearson correlation, and multiple regression analysis. The major finding was that the parenting efficacy of immigrant women was influenced by childcare support from their husbands, maternal identity, and original nationality. The findings suggest that customized programs be developed and used to enhance parenting efficacy for Asian immigrant, first-time mothers. In developing such programs, the advantages of maternal identity, social support from the husband, and women's cultural context should be considered.

Mentors Offering Maternal Support Reduces Prenatal, Pregnancy-Specific Anxiety in a Sample of Military Women

OBJECTIVE

To determine the efficacy of the Mentors Offering Maternal Support (MOMS) program to reduce pregnancy-specific anxiety and depression and build self-esteem and resilience in military women.

DESIGN

Randomized controlled trial with repeated measures.

SETTING

Large military community in Texas.

PARTICIPANTS

Pregnant women (N = 246) in a military sample defined as active duty or spouse of military personnel.

METHODS

Participants were randomized in the first trimester to the MOMS program or normal prenatal care. Participants attended eight 1-hour sessions every other week during the first, second, and third trimesters of pregnancy. Pregnancy-specific anxiety, depression, self-esteem, and resilience were measured in each trimester. Linear mixed models were used to compare the two-group difference in slope for prenatal anxiety, depression, self-esteem, and resilience.

RESULTS

The Prenatal Self-Evaluation Questionnaire was used to measure perinatal anxiety. Rates of prenatal anxiety on the Identification With a Motherhood Role (p = .049) scale and the Preparation for Labor (p = .017) scale were significantly reduced for participants in MOMS. Nulliparous participants showed significantly lower anxiety on the Acceptance of Pregnancy scale and significantly greater anxiety on the Preparation for Labor scale. Single participants had significantly greater anxiety on the Well-Being of Self and Baby in Labor scale, and participants with deployed husbands had significantly greater anxiety on the Identification With a Motherhood Role scale.

CONCLUSION

Participation in the MOMS program reduced pregnancy-specific prenatal anxiety for the dimensions of Identification With a Motherhood Role and Preparation for Labor. Both dimensions of anxiety were previously found to be significantly associated with preterm birth and low birth weight. Military leaders have recognized the urgent need to support military families.

The loss of self: The effect of miscarriage, stillbirth, and child death on maternal self-esteem

A child's death augments how grieving parents view the world, the family, and the self. Using a representative sample of women ages 25-45 who have ever given birth, we assessed whether miscarriage, stillbirth, and child death impact self-esteem and whether this loss is moderated by maternal identity. We found that stillbirth and child death, but not miscarriage, negatively impacted self-esteem. For those who experienced a loss, the impact on self-esteem was moderated by maternal identity. Women who experienced a stillbirth were the only group who had significantly lower self-esteem after controlling for background characteristics and maternal identity variables.

Breastfeeding in Women Having Experienced Childhood Sexual Abuse

BACKGROUND

Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child. Research aim: As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA.

METHODS

Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children's age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data.

RESULTS

Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding.

CONCLUSION

In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother-child relationship.

Who's Responsible? Media Framing of Pediatric Environmental Health and Mothers' Perceptions of Accountability

How the media frames issues of environmental health may affect mothers' views of who is responsible for addressing environmental risks to pediatric health and, ultimately, their protective behaviors. This article describes how information-oriented media sources attribute responsibility for such risks and examines associations between mothers' routine media exposure, or scanning, and perceptions of responsibility. First, a content analysis was conducted on a sample of 474 media stories (i.e., Associated Press, parenting magazines, and websites) about childhood exposure to environmental chemicals over a 6-month period (September 2012-February 2013). We found that media stories attributed responsibility most frequently to parents, though significant differences were observed across media sources, such that websites focused more on parents and general news more on government agencies and manufacturers. Next, we conducted an online survey of mothers (N = 819) and revealed that website scanning during the prior 6 months was significantly associated with perceived personal responsibility, even after we adjusted for potential confounders. Scanning general news was also significantly associated with perceived government and manufacturer responsibility. Understanding media framing of these issues highlights opportunities for health communicators to offset pressure placed on mothers by encouraging greater social and policy support in and exposure to certain media.

Is pregnancy a teachable moment to promote handwashing with soap among primiparous women in rural Bangladesh? Follow-up of a randomised controlled trial

OBJECTIVE

Promoting handwashing with soap to mothers of young children can significantly reduce diarrhoea and pneumonia morbidity among children, but studies that measured long-term behaviour after interventions rarely found improvements in handwashing habits. Expecting mothers may experience emotional and social changes that create a unique environment that may encourage adoption of improved handwashing habits. The objective of this study was to determine whether exposure to an intensive handwashing intervention in the perinatal period (perinatal arm) was associated with improved maternal handwashing behaviour vs. exposure to the same intervention after the end of the perinatal period (post-neonatal arm).

METHODS

We identified primiparous women previously enrolled a randomised controlled handwashing intervention trial (November 2010-December 2011) and observed handwashing behaviours at the home 1-14 months after completion of the RCT (January-May 2012). We observed maternal handwashing and estimated the prevalence ratio (PR) of maternal handwashing using log-binomial regression.

RESULTS

We enrolled 107 mothers in the perinatal arm and 105 mothers in the post-neonatal arm. Handwashing with soap at recommended times was low overall (4.6%) and comparable between arms (PR = 0.9, 95% CI 0.5, 1.5).

CONCLUSIONS

This handwashing intervention was unable to develop and establish improved handwashing practices in primiparous women in rural Bangladesh. While pregnancy may present an opportunity and motivation to do so, further studies should assess whether social, individual and environmental influences overcome this motivation and prevent handwashing with soap among new mothers.

Parental practices of Italian mothers and fathers during early infancy: The role of knowledge about parenting and child development

Our contribution aims to verify whether parental knowledge about child development and parenting constitutes a protective factor in the application of dysfunctional educational practices. Numerous studies have found that parental knowledge has a great influence on parenting, however it remains unclear whether both are casually linked in a direct and linear way. Data currently available on parental knowledge almost exclusively refers to mothers and subjects at risk. Furthermore, there are almost no studies which take into consideration subjects who are Italian citizens. In contrast our work takes into consideration a normative sample of 157 Italian couples who are the parents of children aged between 16 and 36 months and who completed the Knowledge of Infant Development Inventory (KIDI; MacPhee, 1981) and the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993). The results highlight differences between mothers and fathers, both in terms of knowledge levels (higher for mothers) and educational practices (maternal practices are more frequently dysfunctional); knowledge influences educational practices above all in the case of fathers, although said effect is slight, which supports the idea that interaction between knowledge and parental practices is not linear but rather mediated by other factors.

The Impact of the Transition to Parenthood on Marital Leisure

A longitudinal study examined whether the transition to parenthood affects the amount of time spouses pursue leisure activities-both together and apart-and the degree to which they pursue leisure activities they particularly enjoy. Results indicated that (a) new parents and childless couples do not differ in the amount of time they spend in leisure activities both spouses like, (b) parenthood reduces the amount of time new fathers engage in leisure activities independently, (c) parenthood increases the amount of time couples pursue activities together that are liked by the wife but not the husband, and (d) parenthood reduces the amount of time wives pursue leisure activities they dislike but their husbands like. The results show that parenthood restricts husbands' independent leisure pursuits and increases the extent to which spouses' leisure activities reflect the preferences of wives rather than husbands.

The Impact of Family Resources and Satisfaction with Division of Labour on Coping and Worries after the Birth of the First Child

Data on spouse support, family environment (cohesion and conflict), worries and depressed mood, parental coping, ”nancial resources, and employment status were recorded longitudinally by means of questionnaires among Swiss first-time parents. The first data collection was administered when the first-born child was aged between two and six months, the second one year later. Both mothers ( n = 164) and fathers ( n = 164) completed separate questionnaires. Structural equation models suggested both cross-sectional and longitudinal effects of cohesion, conflicts, and partner support on parental coping and worries/mood. Additional LISREL analyses revealed that both mothers’ perceptions of family resources and their worries/mood were affected by the couples’ satisfaction with division of labour (SWDL), and that the latter was related to the perception of ”nancial resources. Among fathers, these findings were paralleled with respect to the impact of SWDL on perceived family resources but SWDL did not affect worries/mood.

Present-self, past-self and the close-other: neural correlates of assigning trait adjectives to oneself and others

Information regarding the past-self may be viewed as information referring to other people. However, evidence supporting this notion at the neural level is rather sparse and it remains unclear whether the past-self is processed like any 'other' or like the close-other only. The aim of this event-related potential study was to investigate this issue. A reflection task requiring evaluation of positive and negative trait adjectives with respect to present- and past-self, a close-other and a famous person was applied. We hypothesized that the past-self and close-other conditions would share their neural underpinnings. The process of reflection on the past-self and close-other was indeed associated with similar mean amplitudes of the late positive component (LPC), whereas in the case of the past-self vs. famous person comparison LPC was significantly enhanced for the past-self. Analogous effects were observed when LPC was calculated for trials with traits judged as either suitable or unsuitable to describe a person who was the target of reflection. Thus, these findings suggest that the processing of information related to the past-self resembles processing of information related to a personally relevant other. Moreover, sex-differences were observed in reaction times and LPC amplitudes for responses reflecting the positivity bias.

Matrix Of Tensions: A Model of Mothering

Questions about how women integrate maternity into their sense of self have generated a quest for an heuristic model. We suggest that mothers struggle to balance themselves amid a set of polarities/tensions and that mothering can be situated within a phenomenological matrix of such tensions. We propose a model that includes the following developmental issues: loss of self/expansion of self; omnipotence/liability; life-destroying/life-promoting behavior; maternal isolation/maternal community; cognitive strategies/intuitive responses; maternal desexualization/ maternal sexualization. Investigation and understanding of how mothers cope with these tensions could yield insights into both universal and particular aspects of mothering.

I held him so and rocked him. I cradled him. I closed my eyes and leaned on his dark head. But the sun in its course emerged from among the water towers of down-town office buildings and suddenly shone white and bright on me. Then through the short fat fingers of my son, interred forever, like a black and white barred king in Alcatraz, my heart lit up in stripes.

— Grace Paley, The Little Disturbances of Man

Heart Disease and Colon Cancer Prevention Beliefs and Their Association With Information Seeking and Scanning

Despite their understanding of the links between (a) information seeking and scanning and (b) health outcomes, researchers still know relatively little about the impact of information behaviors on people's disease-related beliefs and attitudes. The goal of this study was to validate findings linking information and health behaviors and to assess whether information seeking and scanning are associated with beliefs about the effectiveness of heart disease and colon cancer risk prevention behaviors (in regard to exercise, controlling one's diet to prevent overweight/obesity, and daily fruit and vegetable intake), as well as determine whether the effects of seeking versus scanning on these beliefs differ. Data from the Annenberg National Health Communication Survey were analyzed (N = 3,212). For colon cancer, significant main effects were detected for information scanning for each of the 3 beliefs assessed (p < .05). For heart disease, both information scanning and heart disease media exposure (p < .05) were associated with stronger beliefs. Information seeking was not associated with beliefs for either disease (p > .05). Our results suggest that disease-related cognitions and beliefs, which ultimately impact decisions to engage in prevention behaviors, may be influenced most by less purposeful forms of information acquisition.

Gender, justice and work: a distributive approach to perceptions of housework fairness

Most women and men report that the division of domestic labor in their household is fair, despite women undertaking approximately seventy percent of housework. This raises questions about how fairness is evaluated within partnerships. We explore how parenthood and relationship transitions affect perceptions of housework fairness using panel data from the Household, Income and Labour Dynamics in Australia Survey and panel regression models. Our results indicate that net of actual housework divisions, socio-demographic factors, time availability and relative resources, the transition to parenthood increases women's perceptions of housework fairness immediately following the birth of a child, but decreases them in the long run. Relationship transitions have no independent effects. Our findings suggest that parenthood transitions are associated with changes in women's identity, cognitive evaluations of fairness and feelings of entitlement, as indicated by distributive justice theory.

Concerns for self or family? Sources of and responses to altruistic fear

While the vast majority of research on the causes and consequences of fear of crime has been focused on personal fears, Warr and Ellison have suggested that fears for one's family are both more common and more important in explaining protective actions like gun ownership. The present work not only provides new evidence supporting these findings but also expands our understanding of altruistic fears in two important directions: by exploring the potential sources of such fears in exposure to crime and by exploring new potential responses to such fears, including residential mobility decisions. The results suggest that altruistic fears are rooted in personal experiences with victimization and personal evaluations of the local danger posed by crime-though the ways that people react to victimizations depend on their opportunities for personal versus altruistic fears. In turn, altruistic fears are associated with taking protective measures, withdrawing from local organizational participation, and the desire and intent to flee neighborhoods altogether. However, the article also acknowledges important independent roles for personal fears and cognitive evaluations of danger, ultimately recommending a more holistic perspective on reactions to crime.

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first-time-pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long-term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.

A longitudinal process analysis of mother-child emotional relationships in a rural Appalachian European American community

This prospective longitudinal study examines emotional relationships in 58 Appalachian mother-child dyads observed at home at 5 and 20 months. Between infancy and toddlerhood, 3 of 4 dimensions of dyadic emotional relationships were stable, and three remained continuous in their mean level. Increasing maternal age was associated with greater maternal sensitivity and structuring and with more responsive and involving children. Marital status and father presence in the home as well as maternal openness, parenting knowledge, investment, and satisfaction accounted for effects of maternal age on dyadic emotional relationships. This longitudinal process analysis provides unique insights into temporal dynamics of mother-child emotional relationships and their determinants in an underserved and underresearched US community. Implications for community-specific interventions are discussed.

Nutrition awareness before and throughout different trimesters in pregnancy: a quantitative study among Dutch women

OBJECTIVE

To examine the nutrition awareness of women before and during pregnancy in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviours and pregnancy.

METHOD

Data were collected in a cross-sectional study with the aid of a face-to-face interview, based on our conceptualization of nutrition awareness and the 'rules of thumb' designed by the Dutch Nutrition Centre. The sample consisted of five groups each of ~100 Dutch nulliparous women: women not trying to conceive a child, women trying to conceive a child and women in their first, second or third trimesters of pregnancy.

RESULTS

The measurement tool based on our conceptualization of nutrition awareness resulted in a Cronbach's alpha of 0.84. Pregnant women are significantly more aware of their nutrition than women who are not trying to conceive. The scores on nutrition awareness do not differ significantly between the three trimester groups of pregnant women. Women who are trying to conceive do not have a significantly higher nutrition awareness than women who are not trying to conceive.

CONCLUSIONS

Our conceptualization of nutrition awareness has shown to be fruitful in obtaining a better understanding of behavioural changes in health. The study provided indications in favour of the LCP; pregnancy could indeed be an event in a woman's life that causes increased nutrition awareness. This should be kept in mind when healthy nutrition promotion activities are being developed.

Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention

This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a ‘fear of childbirth’ questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers’ preparedness for childbirth, which predicted an increase in positive motherhood.

Spousal support for personal goals and relationship satisfaction among women during the transition to parenthood

The aim of this three-wave cross-lagged longitudinal study was to examine the prospective relationships between women’s goal-related spousal support and their relationship satisfaction during the transition to parenthood. Two-hundred and forty-six Finnish women who were either married or cohabited (45% primiparous; 55% multiparous) filled in questionnaires on personal projects (Little, 1983) and related spousal support, relationship satisfaction (Spanier, 1976), and background data three times: in their early pregnancy; one month before childbirth; and three months after childbirth. Among the primiparous women the results showed a cumulative cycle of goal-related spousal support and relationship satisfaction: goal-related spousal support in early pregnancy predicted higher relationship satisfaction just before childbirth, and, vice versa, relationship satisfaction in early pregnancy predicted higher goal-related spousal support just before childbirth. In turn, among the multiparous women only relationship satisfaction predicted goal-related support later on. In addition, the results showed that women perceived low spousal support for individualistic goals, such as self-related goals, and high support for shared goals, such as family-related goals.

Understanding Interventions and Outcomes in Mothers of Infants

The first two years after an infant's birth is a time of transition for mothers as changes in roles, responsibilities, expectations, and behaviors occur in response to the demands of caring for newborn infants and young children. Mothers play pivotal roles in overall child development and health and may benefit from nursing intervention that assists in the transition to motherhood. A review of the intervention literature related to the promotion of effective mothering was performed in order to examine the range of interventions and evidence of their usefulness for maternal-child and pediatric nursing practice. Five broad categories of interventions appropriate for nursing practice were identified through the literature review. Home visiting, skin-to-skin contact, individual, infant-focused education/counseling, and theory-based group intervention have a specific applicability for the promotion of mothering in particular populations of mothers. Based on the evidence, nurses can incorporate selected strategies into nursing care to promote effective mothering during the first years of a child's life.

Self-reflection across time: cortical midline structures differentiate between present and past selves

The processing of personal changes across time and the ability to differentiate between representations of present and past selves are crucial for developing a mature sense of identity. In this study, we explored the neural correlates of self-reflection across time using functional magnetic resonance imaging (fMRI). College undergraduates were asked to reflect on their own psychological characteristics and those of an intimate other, for both the present time period (i.e. at college) and a past time period (i.e. high school years) that involved significant personal changes. Cortical midline structures (CMS) were commonly recruited by the four reflective tasks (reflecting on the present self, past self, present other and past other), relative to a control condition (making valence judgments). More importantly, however, the degree of activity in CMS also varied significantly according to the target of reflection, with the ventral and dorsal medial prefrontal cortex and the posterior cingulate cortex being more recruited when reflecting on the present self than when reflecting on the past self or when reflecting on the other person. These findings suggest that CMS may contribute to differentiate between representations of present and past selves.

The relationship of military imposed marital separations on maternal acceptance of pregnancy

The effect of military deployment and perceived availability and source of community support on women's acceptance of pregnancy were examined in each trimester of pregnancy at four military bases. The sample was 503 primigravida or multigravida women eligible for care in the military medical system. Military deployment and community support had a statistically significant effect on pregnancy acceptance. Gravidas with deployed husbands had higher conflict for accepting pregnancy than gravidas without deployed spouses. Community support had a significant positive effect on pregnancy acceptance. Women perceiving support predominantly from off-base versus on-base communities had significantly higher conflict with acceptance of pregnancy. Findings point to improved maternal acceptance of pregnancy with paternal presence and community support in the event of military deployment.

The project: Having a baby over 35 years

PURPOSE

The purpose of this Australian study was to evaluate the experiences of a group of first time mothers aged more than 35 years.

PROCEDURES

In depth qualitative interviewing was employed and a total of 22 women were interviewed over three points of time during late pregnancy and the early postpartum period.

FINDINGS

Findings indicated that a percentage of mothers approached childbearing as a major project in their lives. Data analysis revealed that the project progressed through clearly defined stages of: information gathering; planning and preparing and finishing up tasks prior to the birth (clearing the deck).

PRINCIPAL CONCLUSIONS

Findings from this study provide an opportunity for greater understanding of the first mothering experiences of women aged more than 35 years, particularly women with significant career investment. Greater understanding, in turn, may enable health professionals to identify specific needs and concerns of this cohort, and thus to provide more meaningful maternal support and woman sensitive care.

Health literacy and the information needs and dilemmas of first-time mothers over 35 years

AIM AND OBJECTIVES

This paper aims to highlight the information-based dilemmas of a particular group of healthcare patients, first-time mothers over 35 years.

BACKGROUND

In recent years, there has been a proliferation of health-related information and a move towards greater public access to health information as an important step towards patient education and empowerment. Information technologies, such as the Internet, have added considerable momentum to this trend. Many health professionals now consider the provision of detailed health information to patients as requisite for informed decision making. Within the literature there is some emphasis on the importance of patient understanding of information received; however, to date, few studies have considered information over-consumption as problematic.

METHODS

Using in-depth interviews, a sample of 22 first-time mothers over 35 years was interviewed over three junctures: 35 weeks gestation, 10-14 days postpartum and six to eight months postpartum. Three focus group interviews of midwives and maternal and child health nurses were also conducted. This paper was undertaken as part of a larger project to evaluate the experience of first mothering over 35 years.

RESULTS

Mothers in this study were found to have access to large volumes of health information. This tendency was driven by both the women and the health professionals who cared for them. Midwives and maternal and child health nurses revealed a tendency to provide older first-time mothers with considerable health information of a medical orientation, understanding that this is what the women required. However, despite common perceptions of empowerment, the consumption of medical-type information proved frightening and many mothers described feeling overwhelmed by 'knowing too much'.

CONCLUSION

This study contributes to the limited understanding of the information needs of a growing group of childbearing women, first-time mothers over 35 years. By providing an insight into the 'downside' of extensive health information, nursing staff, in particular, may consider the amount and type of information they distribute. Some suggestions are offered to health professionals to ameliorate the information-based dilemmas of these women.

RELEVANCE TO CLINICAL PRACTICE

As the number of childbearing women over 35 years continues to grow, it is important for health professionals to understand the particular needs of this group. In doing so, doctors, midwives and maternal and child health nurses may be in a position to provide more meaningful maternal support.

First Mothering Over 35 Years: Questioning the Association of Maternal Age and Pregnancy Risk

Women having a first baby at 35+ years are commonly considered to be "at risk" for pregnancy complications. This understanding appears to be based primarily on age, and curerntly many healthy women are included in this category. There is clear evidence to suggest that, for these women, being considered "at risk" is anxiety provoking. In this Australian qualitative study of first mothering over 35 years, we found four risk-related themes, "realizing I was at risk," "hoping for reassurance," "dealing with uncertainty," and "getting through it/negotiating risk." We concluded that successful adjustment to motherhood related principally to participants negotiating risk and also to the infant growing and becoming more responsive. Attitudes of health professionals were found to contribute to rather than ameliorate participant dilemmas. Understanding how healthy women over 35 years engage with and negotiate notions of risk may assist health professionals in the provision of more meaningful maternal support for this growing group of women.

Is seeing believing? Expectant parents' outlooks on coparenting and later coparenting solidarity

This study examined short- and longer-term sequelae of parents' prenatal expectations of their future family process, and traced subsequent stability in coparenting solidarity from infancy through the toddler years. One hundred and ten couples expecting a first child participated in prenatal assessments of coparenting expectations and differences, and in 3-month post-partum evaluations. Forty-five couples completed subsequent assessments at 12 and 30 months. At each time point multi-method evaluations of coparental adjustment were obtained. Men's and women's expectancies during the pregnancy and the degree of difference between their self-reported beliefs about parenting predicted post-baby coparental adjustment, with latent class analyses suggesting aftereffects of prenatal expectancies up through 30 months for some couples. Coparental solidarity was also stable from 3 to 12 and from 12 to 30 months. Data indicate that the lens parents bring to bear on their emerging family system is not immaterial, and that early-emerging coparenting dynamics portend longer term coparenting adjustment.

Evaluating health visitor parenting support: validating outcome measures for parental self-efficacy

Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere. This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test-re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions. The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.

Mood state and psychological adjustment to pregnancy

The aim of this study was to investigate whether there is an association between antenatal mood state (depression and anxiety) and psychological adjustment to pregnancy. Participants were first-time, low obstetric risk mothers at a Sydney teaching hospital who completed self-report questionnaires measuring depression, anxiety, thoughts about motherhood and self as mother and relationship with the fetus. Higher symptom levels of antenatal anxiety were related to less optimal maternal-fetal quality of attachment, more negative attitudes towards motherhood and the self as mother. Similar trends were found for symptoms of depression, however depression was not significantly related to psychological adjustment to pregnancy variables. The significance of anxiety in the current study highlights the importance of considering anxiety in the psychological adjustment to pregnancy, as well as the in the context of perinatal mental health more generally. Implications of these findings for intervention are also briefly discussed.

The symbolic self in evolutionary context

We propose that the capacity for a symbolic self(a flexible and multifaceted cognitive representation of an organism's own attributes) in humans is a product of evolution. In pursuing this argument, we note that some primates possess rudimentary elements of a self (an objectified self) and that the symbolic self (a) is a trait that is widely shared among humans, (6) serves adaptive functions, and (c) could have evolved in response to environmental pressures, with ecological and social pressures being of particular relevance. We suggest that these two environmental pressures caused the symbolic self to emerge in the Pleistocene epoch as an adaptation for Homo erectus, and we review the possible functions served by such an adaptation.

Perceived parental efficacy: concept analysis

AIMS

This paper describes a concept analysis carried out to remove some of the ambiguity surrounding the conceptual meaning of perceived parental efficacy and to distinguish it from related concepts such as parental confidence and parental competence.

BACKGROUND

Constructing parental efficacy is a crucial step for family members after the birth of their first child. For some authors, perceived parental efficacy is a motor for adequate parental practices. Confusion about the definition and measurement of this concept has hindered both psychology and nursing practice and research. Concept delineation and concept clarification are required in order to further the development of the concept of perceived parental efficacy.

METHODS

A literature search using a variety of online databases yielded 113 articles between the years 1980 and 2000. The final sample (n=60) consisted of 30 articles from two disciplines: nursing and psychology. A content analysis of the literature was done using Rodger's evolutionary concept analysis method.

FINDINGS

Content analysis of the literature yielded four contributors to perceived parental efficacy: positive enactive mastery experiences, vicarious experiences, verbal persuasion and an appropriate physiological and affective state. Perceived parental efficacy can thus be defined as 'beliefs or judgements a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child'.

CONCLUSION

This conceptual analysis has allowed perceived parental efficacy to be distinguished from parental confidence and parental competence. Both nursing and psychology research, practice and education will benefit from a more precise and delineated concept.

What do mothers know? Maternal knowledge of child development

Maternal knowledge of child development has been shown to affect how mothers raise their children and the environments they provide. This study examines maternal knowledge of child development and whether level of knowledge varies by content area. Additionally, this study explored maternal characteristics that predict knowledge levels globally and by content area. Low-income women (N = 203) in the waiting room of an obstetric clinic (n = 97) and pediatric clinic (n = 106) in a southern state were asked to complete questionnaires on typical child development and demographic characteristics. Overall, women correctly answered 65% of the criterion-referenced knowledge questions. Mothers lacked the most knowledge about infant sleep patterns and developmental ability of 6-month-old infants. Maternal education, race, number of children, and assistance with childcare were significantly related to maternal knowledge. Identifying gaps in maternal knowledge and characteristics that correspond to knowledge deficits provides insight into how best to tailor educational interventions for mothers. ©2005 Michigan Association for Infant Mental Health.

Predictors of maternal competence by first-time mothers when the child is 8 months old

BACKGROUND

Maternal role attainment is largely a cognitive and social process that is influenced by the cultural and family context and the mother's and child's traits and characteristics. Feedback from a social network is important to validate competent performance.

AIM

To ascertain factors that contributed to the maternal competence of first-time mothers when the child was 8 months old.

METHODS

Data collection was by structured questionnaires. The sample consisted of 248 first-time mothers who completed the questionnaires when their child was 8 months old. The data were analysed using stepwise regression analysis.

RESULTS

According to the multivariate analysis, nine predictors remained in the model to explain maternal competence. The more balanced the mother's state of mind, the better she felt about succeeding in child care, and the more easy going the child was, the greater was the mother's competence. The more the mother felt isolation from society, the less was her maternal competence. Younger and healthier mothers, and those who readily accepted their child showed better competence. Also, if the mother still breast-fed her child, the more concrete support she received from the support network, the better was her maternal competence.

CONCLUSION

The findings suggest important factors that contribute to the maternal competence of first-time mothers include mothers' resources, ease of caring for the child, breast-feeding and social support received from those close to them.

The "I," the "we," and the "when": a meta-analysis of motivational primacy in self-definition

What is the primary motivational basis of self-definition? The authors meta-analytically assessed 3 hypotheses: (a) The individual self is motivationally primary, (b) the collective self is motivationally primary, and (c) neither self is inherently primary; instead, motivational primacy depends on which self becomes accessible through contextual features. Results identified the individual self as the primary motivational basis of self-definition. People react more strongly to threat and enhancement of the individual than the collective self. Additionally, people more readily deny threatening information and more readily accept enhancing information when it pertains to the individual rather than the collective self, regardless of contextual influences. The individual self is the psychological home base, a stable system that can react flexibly to contextual influences.

Goal reconstruction and depressive symptoms during the transition to motherhood: evidence from two cross-lagged longitudinal studies

Two cross-lagged longitudinal studies were carried out to investigate the extent to which the adjustment of personal goals to match the particular stage-specific demands of the transition to motherhood has consequences for women's depressive symptoms. In Study 1. 348 women filled out a revised version of Little's (1983) Personal Project Analysis and a revised version of Beck's Depression Inventory (A. T. Beck. C. H. Ward. M. Mendelsohn, L. Mock, & J. Erlaugh. 1961) 4 times: during early pregnancy, 1 month before childbirth, 3 months after childbirth. and 2 years after childbirth. In Study 2. 140 women who reported high levels of fear of childbirth filled out identical measures during early pregnancy, 1 month before childbirth, and 3 months after childbirth. The results showed that an increase in family-related goals during pregnancy and after the birth of the child predicted a decline in women's depressive symptoms. By contrast, an increase in self-focused goals predicted an increase in women's depressive symptoms.