Learning About Baby: What New Mothers Would Like to Know

As part of a larger research project to evaluate a new model of care for first-time mothers in a community health-care setting, this study aimed to identify the preparation and information needs of first-time mothers. All first-time mothers attending a selection of community child health centers in Brisbane, Australia, who presented with no overt risk factors and with a thriving child, were invited to participate in the study. Three months after mothers entered the service, data were collected via telephone survey (N = 151). In addition, focus group interviews were conducted 7–9 months following entry to the service (n = 8). Participants reported seeking information from a variety of sources during pregnancy. Few participants felt well prepared for managing either the physical or emotional experience of early mothering or the essential maternal and child health issues and common problems in the early months. Findings suggest that current approaches to care and education may not meet the needs of first-time mothers. Different approaches are suggested to enhance women's maternal competence during the first few months of becoming a new mother.     

Parenting behaviours among low‐income mothers of preschool age children in the USA: implications for parenting programmes

This study examines the overall quality of parenting behaviours among low‐income mothers in the USA and the extent to which they are influenced by risk factors within the family environment, maternal well‐being and maternal risk characteristics associated with socio‐economic status. Participants consisted of 1070 low‐income mothers of three‐year‐old children who were enrolled in the Early Head Start (EHS) Research and Evaluation Project. Data were collected using structured interviews with the mothers and from videotaped mother–child interactions during play activities when children were age three. Findings indicated that less‐positive parenting behaviours and fewer supports for language and learning were predicted by higher family conflict, higher parental distress and maternal social risk factors including younger age, less education and a history of public assistance. Fewer household resources also predicted fewer supports for language and learning, but not positive parenting. Negative parenting behaviours were not predicted by maternal well‐being, although higher family conflict and maternal demographic risk factors (younger age, history of public assistance, not being married or living with partner) were statistically significant predictors. Findings from this study suggest that programmes to address the parenting abilities of low‐income mothers are warranted, and that national programmes geared at helping mothers should be augmented by efforts to decrease the degree of stress they experience in their parenting role, as well as by effective strategies to increase available household resources and reduce family conflict. They also indicate that particular attention should be paid to enhance the parenting abilities of mothers who are younger, have lower levels of education, have a history of receiving public assistance and those who are not married or living with their partner.     

Changes in depressive symptoms in first time mothers in home visitation

ObjectiveThe expansion of Home Visitation Programs for at-risk, first-time mothers and their young children has drawn attention to the potential impact of depression on program outcomes, yet little research has examined depression in the context of home visitation. The purpose of this study was to determine the prevalence of and changes in depressive symptoms in mothers enrolled in home visitation and identify predictors of change in symptoms over the first 9 months of service.MethodsSubjects consisted of 806 at-risk, first-time mothers enrolled in a Home Visitation Program. Self-reported depression was measured at enrollment and again 9 months later. Established clinical cutoffs were used to identify clinically elevated levels of depression. Additional measures were taken of interpersonal trauma history, concurrent intimate partner violence, and social support.ResultsResults indicated that: (1) 45.3% of mothers had clinically elevated symptoms of depression at some point during the first 9 months of service, (2) 25.9% of mothers had elevated symptoms at both time points or at the 9-month assessment, and (3) 74.1% experienced an interpersonal trauma prior to enrollment. Lack of improvement or worsening of depressive symptoms from enrollment to 9 months was best predicted by pre-enrollment interpersonal trauma history, young maternal age, being African American, and symptoms severe enough to have led to mental health treatment.ConclusionsFindings suggest that maternal depressive symptoms are a significant problem in home visitation. The role of interpersonal trauma in depressive symptoms, and how to best address these clinical issues in home visitation, warrants further examination.Practice implicationsMaternal depression is prevalent in Home Visitation Programs, and many mothers exhibit elevated symptoms at multiple time points over the first year of service. Interpersonal trauma history is also prevalent, and is predictive of increased depressive symptoms over time. Home Visitation Programs should note that mothers with interpersonal trauma history, young maternal age, and being African American have an increased likelihood of persistent depressive symptoms, which may in turn pose significant challenges to providing services.     

Maternal chronological age, prenatal and perinatal history, social support, and parenting of infants

The role of maternal chronological age in prenatal and perinatal history, social support, and parenting practices of new mothers (N=335) was examined. Primiparas of 5-month-old infants ranged in age from 13 to 42 years. Age effects were zero, linear, and nonlinear. Nonlinear age effects were significantly associated up to a certain age with little or no association afterward; by spline regression, estimated points at which the slope of the regression line changed were 25 years for prenatal and perinatal history, 31 years for social supports, and 27 years for parenting practices. Given the expanding age range of first-time parents, these findings underscore the importance of incorporating maternal age as a factor in studies of parenting and child development.     

The academic impact on children of maternal post-secondary enrollment

Numerous empirical studies have found that maternal educational attainment is correlated positively with desirable outcomes for children, including academic achievement. At the same time, little is known about the effect of the timing of mothers’ schooling on the same set of child outcomes. Using the Early Childhood Longitudinal Study - Kindergarten Cohort (ECLS-K), I find a positive effect of full-time maternal post-secondary enrollment on the reading scores of kindergarten students after controlling for child-specific, time-persistent unobserved heterogeneity. This effect is especially strong when the sample is narrowed to children with married mothers or in households where a father is present. No similar effect is found for kindergarten math scores.     

Physiological effects of infant exposure to environmental tobacco smoke: a passive observation study

This study explored infant physiologic responses of exposure to environmental tobacco smoke (ETS) using a longitudinal passive observation study with a control group. Fifteen smoking and 15 non-smoking mothers were initially contacted in hospital maternity units, with home visits made when their infants were 2, 4, and 6 weeks old. Exposure to ETS was measured using infant urinary nicotine and cotinine levels. The physiologic effects of infant ETS exposure were measured by rectal temperature, pulse rate, respiratory rate, blood pressure, and oxygen saturation. The smoking mothers in this sample were poorer, had less education, and were less likely to be married than the mothers who did not smoke. At birth, the infants of smoking mothers had higher diastolic blood pressure than infants of non-smoking mothers (p < .008). Mothers who smoke cigarettes should be educated that maternal smoking behavior can affect an infant's cardiovascular function. Parents should also be counseled about the risks of smoking in close proximity and/or in an enclosed space with an infant, especially in a motor vehicle.     

First-time fathers and stressors in the postpartum period

The purpose of this pilot study was to examine the everyday stressors of first-time fathers during the postpartum period and to begin the process of establishing reliability and validity for the use of the Everyday Stressors Index with a sample of first-time fathers. A convenience sample of 19 participants included first-time fathers ranging in age from 18 to 45 years and mostly living in medium-sized cities. The results indicated that factors such as a feeling of not having enough time for too many responsibilities, financial issues, and concerns about the health of the child and other family member(s) were sources of stress. However, with the exception of slight differences in the ranking, everyday stressors among first-time fathers closely resembled previously reported stressors of first-time mothers. Although the sample was small and the results nongeneralizable, these findings suggest that educational efforts by health-care professionals could beneficially be directed toward fathers as well as mothers throughout the prenatal and postpartum periods. Policy implications for nursing and new directions for future research are discussed.     

Teenage childbearing,marital status,and depressive symptoms in later life

This study examined the role of prechildbearing characteristics in later-life depressive symptomatology among 990 married and unmarried teenage childbearers. Data from teenagers in the National Longitudinal Survey of Youth (NLSY79) were used to test the relative contribution of age and marital status at first birth to depressive symptomatology measured during young adulthood (ages 27-29). Unmarried teenage childbearers displayed higher levels of depressive symptoms in young adulthood than did women who first give birth as married adults. However, the psychological health of married teenage mothers in later life was as good as that of married adult mothers, whereas unmarried adult mothers and unmarried teenage mothers had similarly poor outcomes. The findings of this study suggest that marital status, rather than age at first birth, may be more relevant for later-life psychological health.     

Maternal support following childhood sexual abuse: Links to parent-reported children’s outcomes

Maternal support is touted to play a critical role in predicting children’s symptom trajectories following sexual abuse disclosure. Yet, a recent meta-analysis indicates that this widely held belief may actually have limited empirical support. The lack of correspondence between maternal support and children’s symptoms may be the result of the limitations of the prior literature including the use of maternal support measures with inadequate psychometric properties. The aim of the present study was to utilize the only published measure with sufficient psychometrics properties, the Maternal Self-Report Support Questionnaire (MSSQ; Smith et al., 2010), to determine the relationships between maternal support and demographic and family characteristics, parent-reported children’s symptoms, and aspects of the traumatic event in a treatment-seeking sample. The sample included 252 treatment-seeking children (M = 8.86, SD = 3.85; 67.5% female, 59.5% White) and their mothers, who completed the MSSQ and other measures at pre-treatment. Mothers of older children, White children, and mothers with greater educational attainment reported higher levels of Emotional Support. Single mothers were more likely to report higher levels of Blame/Doubt than married mothers. Characteristics of the traumatic event, such as sexual abuse duration and number of sexual abuse incidents were negatively correlated with Emotional Support. Maternal support was related to relatively few of children’s symptoms and was not associated with levels of posttraumatic stress disorder (PTSD) symptoms. Although several demographic and family characteristics may be related to maternal support, it is a relatively weak predictor of children’s outcomes.     

Risk factors for child physical abuse and neglect among Chinese young mothers

Although studies have reported a linkage between young pregnancy and child maltreatment risk, it is still unclear about what factors place young mothers at greater risk of maltreating their child in Chinese context. Based on the socio-ecological model, risk factors in 4 domains: family background/structure, maternal stressors, mother-child interaction, and child behavioral issue in relation to physical assault, neglect, both physical assault and neglect, and either physical assault or neglect among Chinese young mothers in Hong Kong were assessed. 392 young mothers were recruited from an integrated supportive program for young mothers. The mean age of mothers at delivery was 21.8 (SD = 3.0) and 52.3% were married. Individual risk factors and cumulative risk domains related to different child maltreatment groups were examined. Our results show both overlapping and unique risk factors across the domains associated with physical assault and neglect. Further, young families exposed to higher number of risk domains show higher rates for physical assault and neglect, co-occurrence of physical assault and neglect, and either form of maltreatment. In addition, various risk domains were found to be particularly important for different forms of maltreatment: family background/structure domain was found to be an important risk domain for neglect; mother-child interaction domain for both physical assault and neglect; family background/structure and maternal stressors domains for either physical assault or neglect. Closer examination of a subgroup of adolescent mothers aged 18 and below shows that family background/structure was an important risk domain for this group.     

Higher Education of Single and Married Mothers

This paper describes an Australian sample of 78 single and 107 partnered mothers who entered or re‐entered tertiary study as mature age students. 27% were early school leavers; of those who had matriculated, early marriage and/or early pregnancy were major reasons for non‐continuance with study, and this was particularly the case among those who subsequently became single mothers. Both partnered and single were enrolled in more traditionally female courses of study than were younger female students attending the same institutions. Some four‐fifths of the sample felt they were managing their time, work, relationships, finances and overall coping poorly or very poorly. However their academic performance was well above average. The single mothers felt they were coping rather better than the married, especially with regard to money (despite being poorer), relationships and time. Overall satisfaction with university life was very high, with the main benefits reported by both single and partnered mothers being self‐esteem, knowledge, intellectual interests and intelligence. Career benefits and financial potential were mentioned less often as main benefits and only slightly more frequently by the single mothers. The question is raised of whether mature age women students, as well as female school leavers, should be encouraged to enter non‐traditional courses of study.     

Conflict Between Mothers and Adolescents in Single-Mother,Blended, and Two-Biological- Parent Families

Objective. This investigation was designed to shed light on household structure differences in mother - adolescent conflict. Design. A total of 453 early, mid, and late adolescents from 3 ethnic groups completed questionnaires describing the rate and affective intensity of daily conflicts with mothers and fathers in single-mother (divorced or never married), 2-biological-parent, and blended (remarried) families. Results. Compared to sons, daughters reported more disagreements with mothers and more negative affect in disagreements with mothers and fathers. Adolescents reported more total disagreements and more angry disagreements with single mothers than with mothers in 2-biological-parent families; adolescents in blended families fell in between. Reports of conflict with fathers did not differ across 2-biological-parent families and blended families. There were no household structure differences in conflict with parents (mothers and residential fathers combined), indicating that levels of conflict with single mothers are elevated by approximately the same number of disagreements that otherwise fall to fathers in 2-parent households. Potential moderators (adolescent age, ethnicity, and gender, maternal employment, prior marital status of single-mothers, socioeconomic status, and levels of social interaction) did not alter the results. Conclusions. For adolescents, single parenthood restricts the number of partners available for disagreement but has little bearing on the number or affective tenor of daily disagreements with mothers. In contrast, single parenthood is associated with elevated levels of family discord for mothers.     

Unemployment and Work Interruption among African American Single Mothers: Effects on Parenting and Adolescent Socioemotional Functioning

Using interview data from a sample of 241 single African American mothers and their seventh- and eighth-grade children, this study tests a model of how 2 economic stressors, maternal unemployment and work interruption, influence adolescent socioemotional functioning. In general, these economic stressors affected adolescent socioemotional functioning indirectly, rather than directly, through their impact on mothers' psychological functioning and, in turn, parenting behavior and mother-child relations. Current unemployment, but not past work interruption, had a direct effect on depressive symptomatology in mothers. As expected, depressive symptomatology in mothers predicted more frequent maternal punishment of adolescents, and this relation was fully mediated by mothers' negative perceptions of the maternal role. More frequent maternal punishment was associated with increased cognitive distress and depressive symptoms in adolescents, and consistent with predictions, these relations were partially mediated by adolescents' perceptions of the quality of relations with their mothers. Increased availability of instrumental support, as perceived by mothers, predicted fewer depressive symptoms in mothers, less punishment of adolescents, and less negativity about the maternal role. Both economic stressors were associated with higher levels of perceived financial strain in mothers, which in turn predicted adolescents' perceptions of economic hardship. Adolescents who perceived their families as experiencing more severe economic hardship reported higher anxiety, more cognitive distress, and lower self-esteem.     

The lived experience of knowing in childbirth

Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth.     

Single mothers in a parent group

At theX Day Care Center, in a New York City suburb, there was a group of single mothers, some separated from their husbands, others never married, who were confused and who were unsure about what they had to offer their children without a husband and father. In some cases this resulted in the mothers' general low self-regard and defensive attitudes, misperceptions, and unavailability to the communications about the children that customarily took place between the day care staff members and the mothers.Kenneth Schwarz is a Psychologist in Pound Ridge, NY     

Healthy Families New York (HFNY) randomized trial: effects on early child abuse and neglect

OBJECTIVE: To evaluate the effects of a home visiting program modeled after Healthy Families America on parenting behaviors in the first 2 years of life. METHODS: A sample of 1173 families at risk for child abuse and neglect who met the criteria for Healthy Families New York (HFNY) was randomly assigned to either an intervention group that was offered HFNY or a control group that was given information and referrals to other services. Data were collected through a review of CPS records, and maternal interviews at baseline and the child's first birthday (90% re-interviewed) and second birthday (85% re-interviewed). RESULTS: HFNY mothers reported committing one-quarter as many acts of serious abuse at age 2 as control mothers (.01 versus .04, p<.05). Two sets of interactions were tested and found to have significant effects (p<.05). At age 2, young, first-time mothers in the HFNY group who were randomly assigned at 30 weeks of pregnancy or less were less likely than counterparts in the control group to engage in minor physical aggression in the past year (51% versus 70%) and harsh parenting in the past week (41% versus 62%). Among women who were "psychologically vulnerable," HFNY mothers were one-quarter as likely to report engaging in serious abuse and neglect as control mothers (5% versus 19%) at age 2. CONCLUSIONS: These findings suggest that who is offered home visitation may be an important factor in explaining the differential effectiveness of home visitation programs. Improved effects may be realized by prioritizing the populations served or by enhancing the model to meet program objectives for hard-to-serve families.     

Understanding Parenting Stress Among Young, Low-income, African-American, First-Time Mothers

The purpose of this study was to test a theoretical model that examined the extent to which cognitive readiness to parent, perceived difficult child temperament, observed parenting behaviors, and positive coping styles predicted parenting stress among young, low-income, first-time, African-American mothers. One hundred and twenty African-American, first-time mothers who applied to the Early Head Start program were selected to participate in this study. Results based on structural equation modeling indicated that: (1) observed positive parenting behaviors were negatively related to parenting stress; (2) difficult child temperament was positively related to parenting stress; (3) positive coping styles did not buffer the relationship between difficult child temperament and parenting stress; (4) difficult child temperament was not directly associated with observed parenting behaviors; (5) cognitive readiness to parent was only indirectly related to parenting stress; and (6) observed parenting behaviors mediated the link between cognitive readiness to parent and parenting stress. Future research directions and implications of these findings for professionals working with young mothers are discussed.     

Participant characteristics and process variables predict attrition from a home-based early intervention program

Although advocates of home visits claim that they improve access to preventive interventions for socially disadvantaged families, home visiting programs often report high dropout rates. This study investigated factors predicting attrition in a sample of 434 low-income, first-time mothers in a German program modeled on the Nurse–Family Partnership program. Both participant characteristics and process variables associated with attrition were examined. The results indicated that 38.5% of the mothers left the program before completing 75% of the enrollment time; 62% of those left for addressable reasons (e.g., losing interest in program participation). Arguably, these participants might be retained through program modifications. Almost half of the dropouts left the program before completing 25% of the enrollment time. Program dropouts were younger and did not experience pregnancy-related risks. With regard to process variables, a high frequency of unsuccessful visit attempts and low maternal engagement during the home visits increased the risk for attrition. Self-referral, a high percentage of time spent on parenting issues as well as a high percentage of grandmother participation during visits contributed to participant retention. Among mothers with a high number of risk factors for child abuse and neglect, partner (husband or boyfriend) participation during visits positively influenced the retention rate. Since process variables explained a larger amount of variance in attrition compared to participant characteristics, it is reasonable to focus on the intervention processes when trying to reduce attrition.