Aspects of marital relations over the transition to parenthood were studied as part of a longitudinal study of the experiences of first-time parents. The birth of a first child heralds a major life transition for couples and .. () Marital relationship change in the transition to parenthood: a. This study examines whether transition to parenthood results in marital relationship disruption. A total of 96 childbearing couples were tested with Spanier's.
The birth of a first child heralds a major life transition for couples and has an inextricable effect on their relationship as their affiliation transits from an intimate dyad to a dynamic triad. This integrative review set out to answer the question: The review process comprised determining a question and the inclusion and exclusion criteria, followed by a detailed systematic search of the literature, critical appraisal of retrieved papers and the synthesis of results of the selected studies.
The results were discussed within the context of broader literature, drawing conclusions, implications and dissemination plans. Seven primary research papers were identified and included in the review, which used qualitative and quantitative approaches for investigation.
Five main themes emerged that contributed to the decline of the relationship. Couples reported loss of intimacy, difficulties in communication and overall relationship discontentment. Use of therapeutic interventions antenatally may ease the transition to parenthood.
Midwives have a role to play in supporting families; they can be the first-line healthcare professional in the antenatal and postnatal period to address these problems and ensure the wellbeing of all members of the family. Couples need to adjust to the transition to parenthood, requiring a move from one state to another and these encompass a change in role, relationship and behavioural patterns Tomlinson, The way in which changes are assimilated will affect the quality of the relationship.
Should the physiological processes of bonding and attachment to the newborn be affected, then the family system may be further disrupted Perren et al, It is, however, noted that the birth of a child affects men and women differently with dissimilar consequences on the relationship.
Men may feel a sense of loss and rejection when they experience a changing relationship with their partners. They need to re-establish and re-negotiate this as well as developing a father-child dyad Barclay and Lupton, Men also report emotional changes, while much attention is given to maternal postpartum depression, little is mentioned about paternal depression impacting on marital satisfaction Beck, These authors suggest that men tend to become depressed when there is marital discord or changes in maternal personality style after giving birth.
Dudley and Roy found men to be more emotionally dependent on their partners and this is likely to create pressure and cause relationship dissatisfaction in women when they have to care for a needy baby and partner. Women report dissatisfaction with the relationship when they perceive their partners as unsupportive. Women generally perform more household and child-caring tasks than their partners, even when in full-time employment and express displeasure with this inequitable workload.
Prior to the birth of their babies, couples believed that household and childcare roles should be equally shared, however, this was not evidenced postnatally Cappuccini and Cochrane, ; Tomlinson, Marital dissatisfaction following the birth of the first child can lead to dissolution of the relationship, with 25, children in the UK under four with divorced parents Office for National Statistics, The decline in relationship satisfaction is a serious threat to family wellbeing and places a responsibility on healthcare professionals to ease this transition.
Methods An integrative review was the chosen method for this review as it includes both quantitative and qualitative research studies. Although it has been common to review quantitative and qualitative research studies separately, this is now not always the case. Increasingly, reviews are being published that include both quantitative and qualitative studies Nicholls and Webb, ; Hodnett, A master template of text words and MeSH headings was compiled and each database was searched using comparable MeSH headings and text words pertinent to individual databases.
The impact of the birth of the first child on a couple's relationship | RCM
Journal papers were retrieved for review, the rationale being that they contain the most recent information on the subject Gash, Papers that were not research based, in English or published prior to were excluded. The date restriction ensured that recent contemporaneous papers were included reflecting the present expectation of postnatal marital satisfaction, which would differ from expectations in earlier years Le Masters, The inclusion and exclusion criteria arose from a dissection of the question using the PICO framework Centre for Reviews and Dissemination, A total of 29 papers met the inclusion criteria and were subject to full review.
After review, seven papers were selected for in-depth analysis see Table 1. Process The retrieved studies used quantitative and qualitative approaches; and therefore a selection of critiquing tools were utilised to focus the appraisal Critical Appraisal Skills Framework, ; Cormack, ; Greenhalgh, Thus, while using the appraisal tools as a framework, an extensive analysis and thorough reading of the papers has been undertaken to ensure completeness and depth of analysis.
Once this was undertaken, the academic supervisor for the study reviewed, reaffirmed, discussed and agreed the analysis.
The qualitative studies were Ahlborg and Strandmark and Ahlborg et al, The quantitative studies were Schulz et alAhlborg et alGuttmann and LazarKilloran Ross and Shapiro et al Overview of methods used in studies The studies focused on how the baby creates a tension within the relationship and the decrease in relationship satisfaction. While the qualitative studies examined the lived experience, the quantitative studies examined the changed lived experience using interventions specialist antenatal classes and questionnaires see Table 1.
They differed in that they interpreted the experience numerically, but the research was notable in that it revealed a new dynamic that impacted on satisfaction with the relationship.
The quantitative studies used a variety of questionnaires to validate their research and two studies introduced specialist antenatal classes to assess whether this intervention aided postnatal marital satisfaction. The null hypothesis was that the intervention of specialist classes did not impact on marital satisfaction postpartum.
As a further control, Schultz et al assessed the marital satisfaction of childless couples during the same period of research utilising this comparator to add weight to the study. All participants completed a Marital Adjustment Test MAT — a validated instrument together with a battery of questionnaires. This study together with Guttman and Lazar and Shapiro et al included in this review compared childless and first-time parents to assess whether the baby is the factor in relationship decline or whether relationship decline is related to the longevity of the relationship.
He used a quasi-experimental approach in a comparative outcome study using four groups in three different models of antenatal education together with a control group.
A total of 11 questionnaires were administered pre- and postnatally to assess wellbeing, support and coping. The dependent variable was parental psychological adjustment during the transition to parenthood. Group 1 enhanced antenatal intervention reported greater relationship adjustment. Ahlborg et al used a cross-sectional survey utilising the results of a modified validated questionnaire, the Dyadic Adjustment Scale DAS. The authors assessed data on the quality of the intimate and sexual relationship at six months postpartum.
Guttmann and Lazarin a further cross-sectional survey compared marital satisfaction between first-time parents and childless couples. Couples completed two versions of a validated, modified questionnaire. The aim of their study was to assess marital satisfaction determinants between childless couples and parents in relationships of at least two years but less than four.
The final study was Shapiro et alwhich is a prospective panel design longitudinal study that collected data from the same cohort at varying time intervals over a period of six years. This study comprised two groups: Its aim was to establish underlying factors impacting on marital satisfaction.
Both instruments claim to have high predictive validity.
This study analysed data over four to six years. Sampling The studies used a variety of sampling techniques see Table 1 with most using a form of convenience sampling.
Sample sizes in the two qualitative studies were five and ten couples and the quantitative studies ranged from 13 to couples. In phenomenological research, participants have experienced the phenomena, and diversity in individual experience is explored, thus the small sample sizes cited above are adequate Polit and Beck, Inclusion criteria included cohabitating couples aged 18 or over expecting their first child.
Couples were randomised using a random number table. The sample size in all four groups was less than An adequate sample size can reduce sampling error, however, where a condition is common — marital dissatisfaction post delivery — a smaller sample can be studied Cluett and Bluff, The study was not blinded or double-blinded.
A lack of blinding may lead to bias and distortion in studies Greenhalgh, Given such a small sample and attrition rate, generalisability may be limited. The sample was a subset of a larger study and therefore its randomness was based on this subset and not a larger, random population.
- Transition to Parenthood - Changes In The Marital Relationship
Killoran Ross randomly assigned couples to four groups, but there are no data relating to sample size. However, it is possible that this study was limited by wordage in the selected journal. It is included as it met all inclusion criteria. Ahlborg et al surveyed couples from family health centres using convenience sampling. The advantage of this sampling method is that participants are readily available and easy to access.
The disadvantages are that they may not be representative of the population as a whole Cluett and Bluff, Nonetheless, the authors included detailed baseline characteristics to validate the representativeness of the sample. Guttmann and Lazar used convenience snowballing sampling within a university setting. They surveyed 60 childless couples and 60 couples with one child.
The impact of the birth of the first child on a couple's relationship
Polit and Beck argue that convenience sampling is the weakest form of sampling due to the prevalence of sampling bias and this group may not be representative of the general population. Clear, valid reasons are given for attrition: Data collection Data collection for the studies varied and comprised in-depth, structured and semi-structured interviews and questionnaires, some which were validated, others modified validated questionnaires see Table 1. Questionnaires were used in all the quantitative studies with some studies using questionnaires and interviews Schultz et al, ; Shapiro et al, The qualitative research collected data using in-depth interviews.
Parents were interviewed separately, undisturbed in their own homes and were encouraged, using clarifying questions. Ahlborg and Strandmark interviewed parents at six and 18 months postpartum and Ahlborg et al at nine months postpartum. Both studies used audio recordings that were transcribed and analysed.
The intervention group was split into six subgroups comprising four couples, each of whom discussed the questionnaires, facilitated by coleaders. Each session was audiotaped to ensure the treatment protocol was strictly adhered to. No reference was made to adherence to protocol.
The questionnaire was a pre-validated modified version of DAS translated into Swedish. The translated DAS was piloted initially with 80 first-time parents to enhance sensitivity and dimension of the subject. Having to complete two questionnaires with 34 items could have led to low response rates. Postal questionnaires were self-administered and without the researcher present, it is possible that questions may have been misunderstood and erroneous answers given.
Bowling argues that postal questionnaires are only suitable if the questions are straightforward. Shapiro et al collected data from couples in the first year of marriage via the OHI instrument interviews when both partners were present in the home.
All participants were followed up annually to complete the MAT questionnaire with new parents completing additional MAT questionnaires at six months antenatally and three months postnatally. Data analysis The two descriptive phenomenological studies outlined the approach to their analysis, making use of meaning units transforming them into expressed meanings, rather than interpretive, in line with descriptive phenomenology.
The quantitative studies produced statistical analyses of their data. Findings This section will report on the analysis of the seven papers selected for review see Table 2. Synthesis Five main themes emerged that contributed to the decline of the relationship. Impact on women Killoran Ross noted that women had higher levels of anxiety than men postnatally. Shapiro et al found a systematic decline in marital relationships, with a greater impact on women compared with men.
Both research programs have been concerned with documenting the changes within individuals, as well as in the marital relationship, during the transition to parenthood; both concur that the transition to parenthood is multidimensional in nature; and each deserve mention due to the holistic approach the researchers take in understanding the complicated nature of the transition to parenthood. For Cowan and Cowanp. These five domains are: Jay Belsky and John Kelly have also identified five areas related to the transition to parenthood, though their themes are focused on the areas of potential spousal disagreement.
For new parents, these include: Chores and division of labor; Money; Their relationship; and Social life. Belsky and Kelly assert that these five areas "constitute the raw material of marital change during the transition.
Quite simply, couples who manage to resolve these issues in a mutually satisfying way generally become happier with their marriages, whereas those who do not become unhappier"p. To cite one example from the list above, Cowan and Cowan state that the number one issue leading to conflict was the division of labor in the family.
Many factors may affect the division of labor issue, with labor inequity affecting wives more than husbands. For example, it is often the wife that aligns her preferences about the division of childcare tasks with her husband's preferences during the transition to parenthood Johnson and Huston In addition, during pregnancy, many women became more interested in goals related to motherhood "to be a good mother" and less interested in achievement-related goals "to make career decisions" Salmela-Aro et al.
Finally, motherhood increases wives' hours spent on at-house duties but reduces other employment hours Sanchez and Thomson These findings indicate that wives especially may have decreased satisfaction, particularly if they perceive that there is ongoing inequity between themselves and their husbands in the childcare duties.
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