The partner's experiences of childbirth in countries with a highly developed clinical setting: a scoping review

Birthing partners - validation of a questionnaire to assess the well-being of support persons

BACKGROUND

There is little research on the well-being of the persons giving support during childbirth and how they feel when doing this. The aim of this study is to validate a questionnaire that assesses the well-being of those support persons during childbirth. This publication focuses on the validation of the questionnaire; the development is described in more detail in a previous publication.

METHODS

After the questionnaire had been developed, it was sent online to a sample for validation. Subsequently, the internal consistency was determined to assess the reliability and the correlation with an external criterion in order to assess the criterion validity. Known-groups validation was used to assess the construct validity of the questionnaire. Linear regressions were carried out to analyse which variables influence well-being.

RESULTS

The results show good reliability and high criterion validity. The known-groups analyses identified group differences between the different birth modes regarding the different domains of well-being of the support persons. Factors influencing well-being are whether it is a first time or repeated support, whether the birthing woman is a primiparous or multiparous woman and whether the birth is vaginal or operative.

CONCLUSION

Our results suggest that this questionnaire adequately captures important aspects of the well-being of support persons during childbirth. The questionnaire is designed for all birth experiences. In the case of negative experience it can be used to assess additional support and counselling and thus potentially promote the mental health of the support persons preventively.

Barriers and opportunities for health service access among fathers: A review of empirical evidence

ISSUE ADDRESSED

Engagement with health supports benefits the whole family, yet few health services report successful engagement of fathers. Our aim was to describe available evidence on barriers and opportunities relevant to health system access for fathers.

METHODS

Scoping reviews were conducted seeking empirical evidence from (1) Australian studies and (2) international literature reviews.

RESULTS

A total of 52 Australian studies and 44 international reviews were included. The most commonly reported barriers were at the health service level, related to an exclusionary health service focus on mothers. These included both 'surface' factors (e.g., appointment times limited to traditional employment hours) and 'deep' factors, in which health service policies perpetuate traditional gender norms of mothers as 'caregivers' and fathers as 'supporters' or 'providers'. Such barriers were reported consistently, including but not limited to fathers from First Nations or culturally diverse backgrounds, those at risk of poor mental health, experiencing perinatal loss or other adverse pregnancy and birth events, and caring for children with illness, neurodevelopmental or behavioural problems. Opportunities for father engagement include offering father-specific resources and support, facilitating health professionals' confidence and training in working with fathers, and 'gateway consultations', including engaging fathers via appointments for mothers or infants. Ideally, top-down policies should support fathers as infant caregivers in a family-based approach.

CONCLUSIONS

Although barriers and opportunities exist at individual and cultural levels, health services hold the key to improved engagement of fathers. SO WHAT?: Evidence-based, innovative strategies, informed by fathers' needs and healthy masculinities, are needed to engage fathers in health services.

Providing clinicians with 'how to' knowledge for technology-based innovation: Introducing the SMS4dads texts

ISSUE ADDRESSED

Male partners are key supports for women in birth preparation and postnatally. Text-messaging can deliver timely information to expectant and new fathers to increase their support of the mother. However, technological innovations in healthcare often fail to be adopted. This study aims to assess the impact of disseminating a 'taster' set of SMS messages to increase clinicians' engagement with the intervention.

METHODS

Example messages from SMS4dads were delivered to clinicians over a 3-week period and a link provided to an evaluation survey. Agreement to two closed questions was rated on a five-point Likert scale; the frequency of specific recalled messages was calculated for the first open-ended question. Responses to the remaining open-ended questions were analysed with a descriptive thematic approach.

RESULTS

A total of 418 participants (female 61.5%) working in health organisations (80.4%), mostly in nursing (33.9%) or midwifery (19.6%) enrolled. Of the 77 (18.4%) participants who provided an evaluation, 96% agreed or strongly agreed that the Professional Taster gave them a better understanding of how to explain the program, and 88% agreed or strongly agreed that they are now more likely to tell parents about the program. Analysis of the remaining two open-ended questions revealed clinicians' concerns for fathers alongside their primary focus on maternal wellbeing.

CONCLUSION

Providing 'how to' knowledge through receiving a sample of the intervention may increase clinicians' acceptance of technological innovation. SO WHAT?: Health-promoting digital interventions using text are increasing. Novel tested strategies for gaining buy-in from healthcare staff will be needed.

Men, mindsets and birth: results of a prospective longitudinal study

AIMS/BACKGROUND

In recent years, there has been an increased interested in the contribution of fathers to childbirth. In the present paper we explore whether the father's birth-related mindset (being either more natural or more medical) can predict the mother's labour and birth outcomes and whether the father's experience and evaluation of the birth can predict his psychological well-being after the birth.

DESIGN/METHODS

We conducted a longitudinal study (N = 304 expecting fathers) spanning the first trimester of pregnancy up to six months after birth.

RESULTS

The study results could be integrated into a Single Indicator Model. They indicated that a father's more natural birth-related mindset predicted low-intervention birth for the mother. A low-intervention birth led to a more positive birth experience for the father, and in turn to better postpartum adjustment, fewer symptoms of postpartum paternal depression eight weeks after birth, and more secure bonding to the infant six months after birth.

CONCLUSION

The study results indicate that fathers do not take a merely passive role in childbirth. On the contrary, analogous to pregnant mothers, fathers' views about childbirth might contribute to the course of birth, and their own postpartum psychological well-being. The results of the present study, thus, highlight the importance of fathers for childbirth and in a broader sense, the results also contribute to a better understanding of the psychological framework of birth and represents a valuable starting point for further research.

Factors intervening in the childbirth experience: a mixed-methods study

OBJECTIVE

To analyze the childbirth experience focusing on the intervening factors and on the delivery method.

METHOD

A sequential and explanatory mixed-methods study guided by the World Health Organization document for positive childbirth experiences. The participants were puerperal women in a maternity teaching hospital from inland São Paulo (Brazil). The first quantitative stage involved descriptive analysis with Poisson regression of 265 answers to the "Termômetro da Iniciativa Hospital Amigo da Mulher e da Criança" ("Women- and Baby-Friendly Hospital Initiative Thermometer") questionnaire. The second stage, qualitative, thematically analyzed the interviews conducted with 44 puerperal women who took part in the first stage. Data integration was by connection.

THE RESULTS AND DISCUSSION

The analysis by connection showed that among the factors that restricted the positive experience, C-section was predominant (61.9%), understood as an option due to fear of pain, the treatment modality and previous traumas. Restrictions referring to the presence of a companion (99.6%), not having privacy (83%), disrespectful situations (69.5%), too many touches (56.9%) and the absence of skin-to-skin contact (55%), among others, potentiated fear, loneliness, concern, shame, the perception of disrespect and insecurity with the assistance provided. The promoting factors were as follows: choosing the companion (95.4%) for collaborating in the safety perception, not having infections (83.9%), having continuous team monitoring (82.2%) and pain relief methods (78.9%), which were valued by the women.

CONCLUSION

The intervening factors that promoted positive experiences were related to clinical and protocol-related issues and to service availability. The restrictive factors were associated with excess interventions, deprivation of rights and of choice, absence of privacy and restriction referring to the presence of a companion. Women with a normal postpartum period felt more insecure and disrespected when compared to those subjected to C-sections, whose choices were considered, although they had lower prevalence of skin-to-skin contact. There is an urgent need to apprehend women's experiences and turn them into actions that guarantee their lives in a safe and respectful way.

[Fathers' Experiences of Pregnancy, Birth and Postpartum During the Covid 19 Pandemic]

INTRODUCTION

In order to reduce the possible risk of infection by SARS-CoV-2, access restrictions have been introduced in all areas of public life. In extra- and intramural health care facilities, these measures also affect pregnant women, women giving birth, and women who have recently given birth as well as their partners. The aim of this study is to collect and reflect on the experiences of expectant fathers against the background of pandemic-related restrictions.

METHOD

Following a qualitative study design, 11 guided interviews with fathers who experienced a birth during the Covid 19 pandemic were conducted in June 2022. Based on a content analysis according to Mayring, categories were derived, and the results from the interviews were transferred to a higher level of abstraction and interpreted.

RESULTS

The fathers felt excluded, stressed and insecure due to the pandemic-related restrictions during pregnancy, birth, and the women's inpatient stay. Although there was understanding for the measures, there was a prevailing fear of not being able to support the partner sufficiently and of not having enough opportunities for bonding with the newborn.

CONCLUSION

The results of the study make it clear that during the covid pandemic, the need for structured frameworks for the involvement of accompanying persons in the obstetric setting should receive increased attention. The active participation of partners in antenatal and birth care should be encouraged.

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

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.