Since the late 1970s, disruptions and “failure” of maternal-infant bonding have been causally linked to postpartum depression. Part I of this paper examines the grounds for this connection while tracing the ramifications of bonding theory (Klaus and Kennell 1976) through obstetrics, pediatrics, and psychiatry, as well as in the (mis)representations of it in the popular media. This discussion resolves into a view of maternal attachment as a long-term development progressively established through intensive mother-infant interaction. The forms of this interaction (...) are phylogenetically determined, albeit culturally and personally mediated. Flowing from this premise, Part II of the paper casts postpartum depression as an adaptive response to threat (from whatever cause) to adequate mothering, and develops an argument for the evolutionary role of enacted social ties in the establishment of maternal responsiveness. (shrink)

We must reconceive the ethical relationship between mothers and their newborn babies. The intertwinement of mother and baby does not disappear with birth but rather persists in the form of postpartum maternal tethering. Drawing upon three years of ethnographic fieldwork and training in the United States and China, I argue that dependencies associated with postpartum maternal tethering make it extremely difficult for postpartum mothers to act autonomously, even in the relational sense. Breaching this tether opens up new (...) possibilities for thinking about the bioethics of vulnerability, dependency, and care by denaturalizing and desanctifying the mother-baby relationship and diversifying newborn care. (shrink)

Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period.Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years,SD= 4.59; mothers median age of 30.23 years,SD= 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as (...) measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers’ presence at childbirth, education level, age, and parental experience.Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b= 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b= 0.41). Results of regression analyses have revelated that maternal infant bonding (p< 0.01) and paternal stress (p< 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding.Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery.Clinical Trial Registration:ClinicalTrials.govIdentifier: NCT04118751. (shrink)

Terminological debates are often circular and unproductive, so it is a pleasure to investigate the terminology of LeRon Shults, who argues with clarity, defines his terms, and offers reasons for preferring one term over another. I would not, however, waste the readers' time if my aim were merely to challenge some of Shults's nomenclature. When one sets out, as does Shults, to intervene in the process of theogonic reproduction, terminological and metaphorical choices matter a great deal insofar as the semiotic (...) tools one deploys carry emotional and affective baggage that can deeply influence the efficacy of the hoped-for intervention. As I argue below, there is much to commend... (shrink)

This paper calculates the mean duration of the postpartum amenorrhoea (PPA) and examines its demographic, and socioeconomic correlates in rural north India, using data collected through 'retrospective' (last but one child) as well as 'current status' (last child) reporting of the duration of PPA.

Postpartum mood disorders develop shortly after childbirth in a significant proportion of women and have severe effects. Two evolutionary explanations are currently available. The first is that poor postpartum mental health is a consequence of an evolutionary trade-off – a compromise of neurological changes in the maternal brain during pregnancy which, on the one hand, maintain pregnancy, and on the other, increase the likelihood for postpartum women to develop psychopathology. The second explanation is that poor postpartum (...) mental health is a disease of civilization. This theoretical paper demonstrates that both explanations ignore the crucial event of childbirth. I elaborate on environmental features of childbirth, a physiological process that is substantially different in the current versus evolutionary childbirth and postpartum setting, and argue that maternal brain neuroplasticity and biochemical alterations are not an evolutionary trade-off, but an adaptation. Additionally, the incidents of poor postpartum mental health are better viewed as a maladaptation of the typical modern environments – an evolutionary mismatch. Thus, the potential to suffer from poor mental health in postpartum is an external, contingent happening, dependent on contemporary childbirth and postpartum environments, and not due to any essential property women possess as a result of evolutionary compromise. In fact, women are probably adapted to feel like superwomen right after birth, a state of mind that is an aid in adapting to motherhood. Distinguishing between evolutionary concepts in the context of pregnancy, birth, and motherhood is vital for developing more accurate preventions and interventions. (shrink)

Support from grandparents plays a role in mothers’ perinatal mental health. However, previous research on maternal mental health has mainly focused on influences of partner support or general social support and neglected the roles of grandparents. In this narrative review and meta-analysis, the scientific evidence on the association between grandparental support and maternal perinatal mental health is reviewed. Searches in PubMed, EMBASE, MEDLINE, Scopus, and PsycINFO yielded 11 empirical studies on N = 3381 participants, reporting on 35 effect sizes. A (...) multilevel approach to meta-analysis was applied to test the association between grandparental support and maternal mental health. The results showed a small, statistically significant association (r =.16; 95% CI: 0.09–0.25). A moderator test indicated that the association was stronger for studies reporting on support from the maternal grandmother in particular (r =.23; 95% CI: 0.06–0.29). Our findings suggest that involved grandparents, in particular mother’s own mother, constitute a protective factor for the development of maternal postpartum mental health problems. These findings have clear implications for interventions. Future studies should examine whether stimulating high-quality support from grandparents is a fruitful avenue for enhancing maternal postpartum mental health. (shrink)

Our aim with this descriptive phenomenological study was to identify and describe the essential meaning structure in the experience of postpartum depression . We interviewed four women diagnosed with major depression and analyzed the data with Giorgi’s descriptive phenomenological method. Our analysis revealed two essential meaning structures of PPD. The first structure describes the mother as thrown into a looming, dangerous world, coupled with a restricted, heavy body that hindered her attunement to her baby. Tormented by anxiety, guilt and (...) shame, she tried to deal with her pain by analytical reflection and social isolation. The second structure describes sudden lapses into intense feelings of alienation from the self, the baby, and from the social and material world. With a distorted primordial self-awareness, the mother no longer felt that she existed as herself in the world. We reflect on these findings using the insights of Fuchs, Van den Berg, Heidegger and Merleau-Ponty. (shrink)

Objectives: Mental disorders are vastly underdiagnosed in low-income countries that disproportionately affect women. We aimed to evaluate the prevalence of common mental disorders in newly postpartum women, and stigma associated with mental health reporting in an Ethiopian community using a validated World Health Organization survey.Methods: The Self Reporting Questionnaire for psychological distress was administered in Amharic by nurses to 118 women aged 18–37 years who had given birth in the prior 3 months in the Glenn C. Olsen Memorial Primary (...) Hospital in Yetebon. Mental health stigma among the four nursing staff was assessed using Link and Phelan's Components of Stigma.Results: Among 118 women surveyed, 18% had a probable common mental disorder using the SRQ 4/5 cutoff and 2% admitted to suicidal thoughts. Presence of stigma in the healthcare staff was verified, including labeling, stereotyping, separating, and status loss and discrimination.Conclusion: Postpartum mental health disorders as well as stigma against such diagnoses are common in the Yetebon community. There is an urgent need for increased availability of properly trained and supervised healthcare staff in the identification and referral of postpartum women with common mental disorders. (shrink)

INTRODUCTION: Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand (...) how these syndromes present in perinatal mental illness. METHODS: In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period. RESULTS: Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient’s husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs. CONCLUSION: This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized. (shrink)

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to (...) 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care. (shrink)

During the postpartum period, the paternal brain suffers extensive and complex neurobiological alterations, through the experience of father–infant interactions. Although the impact of such experience in the mother has been increasingly studied over the past years, less is known about the neurobiological correlates of fatherhood—that is, the alterations in the brain and other physiological systems associated with the experience of fatherhood. With the present study, we aimed to perform a scoping review of the available literature on the genetic, neuroendocrine, (...) and brain correlates of fatherhood and identify the main gaps in the current knowledge. PubMed, Scopus, and Web of Science electronic databases were searched for eligible studies on paternal neuroplasticity during the postpartum period, over the past 15 years. Reference lists of relevant key studies and reviews were also hand-searched. The research team independently screened the identified studies based on the established inclusion criteria. Extracted data were analyzed using tables and descriptive synthesis. Among the 29 studies that met our inclusion criteria, the vast majority pertained to neuroendocrine correlates of fatherhood, followed by brain activity or connectivity, association studies of candidate genes, and brain structure correlates. Collectively, studies published during the past 15 years suggest the existence of significant endocrine and neurofunctional alterations as a result of fatherhood, as well as preliminary evidence of genetic variability accounting for individual differences during the postpartum period in fathers. No studies were so far published evaluating epigenetic mechanisms associated with the paternal brain, something that was also the focus of the current review. We highlight the need for further research that examines neuroplasticity during the experience of fatherhood and that considers both the interplay between hormones and simultaneous assessment of the different biomarkers ; data collection protocols and assessment times should also be refined. (shrink)

BackgroundSolution-focused model is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression in nulliparous pregnant women compared with routine care services.MethodsWe chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group (...) took the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire.ResultsCompared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group.ConclusionIn conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women. (shrink)

Most studies conducted in the West on the role played by intergenerational families in co‐parenting have focused mostly on families with a single mother or those in difficult circumstances, while little is known about the experiences of members of intergenerational intact families during the early postpartum period. This study aimed to explore the intergenerational co‐parenting experiences of young parents and grandmothers in China, focusing on how they shared the responsibility of caring for the new mother and infant during the (...) postpartum period. A total of 16 eligible intergenerational intact families, including 16 mothers, 15 fathers and 12 grandmothers, were interviewed. The data set was analysed using the approach of directed content analysis guided by Feinberg's Ecological Model of Co‐parenting. The data were categorized into four themes: ‘division of labour’, ‘postpartum and infant care agreement’, ‘support‐undermining’ and ‘joint family management’. An additional theme, ‘expressed a need for family support’, emerged from the data on these intergenerational families. The findings emphasize the importance of intergenerational co‐parenting relationships in families where two generations co‐parent the newborn together. (shrink)

Background and aimThe postpartum depression literacy of perinatal women is closely related to the occurrence, recognition, and treatment of postpartum depression, therefore valid instruments for evaluating the level of PoDLi are of great significance for both research and clinical practice. This study aimed to cross-culturally adapt the postpartum depression literacy scale into Chinese and to test its psychometric properties among Chinese perinatal women.Materials and methodsA cross-sectional study was conducted from April to May 2022 in a tertiary hospital (...) in Hangzhou, Zhejiang Province, China. 619 out of the 650 perinatal women that were approached via a convenience sampling method completed the Chinese version of the PoDLiS. Content validity [the content validity index of items and scale-level content validity index ] was evaluated by an expert panel. Psychometric properties, including item analysis, structure validity, convergent and discriminant validity, reliability, criterion validity, and floor/ceiling effect were examined.ResultsThe final version of C-PoDLiS is a six-factor structure consisting of 27 items, which explained 61.00% of the total variance. Adequate content validity was ensured by the expert panel. The modified confirmatory factor analysis model revealed that the 6-factor model fitted the data well. The total Cronbach’s α was 0.862, the total McDonald’s ω was 0.869, and the test-retest reliability coefficient was 0.856. Results of convergent validity and discriminant validity provided good or acceptable psychometric support. Significant correlations between scores of the C-PoDLiS and Mental health literacy scale and Attitudes toward seeking professional psychological help short form scale supported good concurrent and predictive validity, respectively. No floor/ceiling effect was found.ConclusionThe C-PoDLiS was demonstrated to be a sound instrument with good reliability and validity for evaluating Chinese perinatal women’s PoDLi levels. Its use in the future can facilitate data aggregation and outcome comparisons across different studies on this topic. (shrink)

Background: Prenatal and postnatal mental disorders can exert severe adverse influences on mothers, fetuses, and children. However, the effect of the coronavirus disease 2019 pandemic on the mental health of pregnant and postpartum women remains unclear.Methods: Relevant studies that were published from January 1, 2019 to September 19, 2020 were identified through the systematic search of the PubMed, EMBASE, and Web of Science databases. Quality assessment of included studies, random-effects meta-analysis, sensitivity analysis, and planned subgroup analysis were performed.Results: A (...) total of 23 studies conducted with 20,569 participants during the COVID-19 pandemic and with 3,677 pregnant women before the COVID-19 pandemic were included. The prevalence rates of anxiety, depression, psychological distress, and insomnia among pregnant women during the COVID-19 pandemic were 37%, 31%, 70%, and 49%, respectively. The prevalence of postpartum depression was 22%. Multigravida women and women in the first and third trimesters of pregnancy were more vulnerable than other pregnant women. The assessment of the associations between the COVID-19 pandemic and mental health problems revealed that the pooled relative risks of anxiety and depression in pregnant women were 1.65 and 1.08, respectively.Conclusions: The prevalence rates of mental disorders among pregnant and postpartum women during the COVID-19 pandemic were high. Timely and tailored interventions should be applied to mitigate mental problems among this population of women, especially multigravida women and women in the first and third trimesters of pregnancy. (shrink)

Based on in-depth interviews, this article examines a sample of 48 Canadian women’s feelings about their changed postpartum bodies, their sense of self, and the factors that affect both. Our findings suggest that understanding women’s postpartum feelings requires contextualizing them in the work of infant care and women’s life circumstances, as well as ideologies about mothering and feminine appearance. Motherhood afforded the women in this study a new appreciation of their bodies, and a positive embodied sense of themselves, (...) but only if they felt their bodies performed maternal functions well. Concerns about appearance persisted and became especially salient when women faced the return to paid work. Moreover, varied life circumstances influenced women’s overall feelings about their changed bodies as insecurities were displaced onto women’s body images. (shrink)

The purpose of this study was to evaluate the international scientific output on postpartum depression research during 2000–2020 through a bibliometric analysis and to explore research hotspots, frontiers, and trends in the field of postpartum depression. We searched the Web of Science Core Collection for publications on postpartum depression published between 2000 and 2020. CiteSpace, gCluto, and other software applications were used to analyze the data by year, journal, and country. A total of 2,963 publications were retrieved (...) and 96 countries or regions published related papers. The United States had the largest number of published papers and the highest betweenness centrality, which is the dominant position in the field of postpartum depression. A total of 717 journals published papers, with the Archives of Womens Mental Health ranked first in terms of volume and betweenness centrality. In this study, 31 high-frequency main MeSH terms/subheadings were selected. The high-frequency MeSH terms were clustered into six categories: an overview of depression-related research, diagnostic and screening scales for postpartum depression, epidemiological investigation into postpartum depression, treatment and drug selection for postpartum depression, psychological research on postpartum depression, and etiology, physiopathology, complications, genetics of postpartum depression. Finally, we used strategic diagram to analyze research trends in postpartum depression. This study has identified a continuous significant increase in the publication of PPD articles. Currently, the etiology, physiological pathology, intervention and treatment of complications on PPD are immature, which provides reference for the trend of obstetric psychology. (shrink)

IntroductionHistory of depression symptoms, including before and during pregnancy, has been identified as an important risk factor for postpartum depression symptoms. This condition has also been associated with diverse implications, namely, on the quality of mother–infant bonding. Moreover, the role of self-criticism on PPD has been recently found in several studies. However, the link between these factors has not been explored yet. Furthermore, anxiety symptoms in postpartum has been less studied.MethodsThis study analyzed whether the history of depression symptoms (...) predicted mother–infant bonding, via self-criticism and PPD symptoms. The same model was repeated with a history of anxiety and postpartum anxiety symptoms. A total of 550 mothers of infants <24 months old participated in this cross-sectional study and answered an online survey.ResultsThrough a parallel–serial mediation model, the results show that in a first step, self-criticism dimensions of inadequate-self, hated-self, and reassuring-self, and in a second step, PPD symptoms, mediate the relationship between the history of depression symptoms and mother–infant bonding. However, the relationship between the history of anxiety symptoms and bonding is not mediated by all the considered chain of mediators, being only mediated by one of the self-criticism dimensions, inadequate self.ConclusionsThe current study confirmed the association of history of both depression and anxiety with mother–infant bonding. While in the case of history of anxiety symptoms, the relation was only mediated by inadequate self-dimension of self-criticism, in the case of history of depression symptoms, the relation was mediated by self-criticism and postpartum depressive symptoms. The buffering effect of reassuring-self on bonding and negative affect was also evidenced. Psychological and preventive interventions should address this evidence to target interventions for mother–infant bonding problems in accordance with previous and actual current maternal risk factors. (shrink)

ABSTRACT Historically, maternal HIV research has focused on prevention of mother‐to‐child transmission and child outcomes, with little focus on the health outcomes of mothers. Over the course of the HIV epidemic, the approach to including pregnant women in research has shifted. The current landscape lends itself to reviewing the public health ethics of this research. This systematic review aims to identify ethical barriers and considerations for including pregnant and postpartum women living with HIV in treatment adherence and retention research. (...) We completed a systematic literature review following PRISMA guidelines with analysis using a relational ethics perspective. The included studies (n = 7) identified ethical barriers related to (a) women research participants as individuals, (b) partner and family dynamics, (c) community perspectives on research design and conduct, and (d) policy and regulatory implications. These broader contextual factors will yield research responsive to, and respectful of, the needs of pregnant and postpartum women living with HIV. While current regulatory and policy environments may be slow to change, actions can be taken now to foster enabling environments for research. We suggest that a relational approach to public health ethics can best support the needs of pregnant and postpartum women living with HIV; acknowledging this population as systematically disadvantaged and inseparable from their communities will best support the health of this population. (shrink)

BackgroundThe SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental (...) health and the early parent–infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic.MethodsAs part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables.ResultsCompared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs.LimitationsDue to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis.ConclusionsThe pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged. (shrink)

The Baby Care Scale was designed to assess the involvement of father in infant care during pregnancy and the postpartum period. This study aimed to examine the psychometric characteristics of the BCS – antenatal and BCS – postnatal versions. A sample of 100 primiparous fathers completed the BCS-AN and/or the BCS-PN and self-reported the measures of anxiety and depressive symptoms and of father–infant emotional involvement during pregnancy and the postpartum period, respectively. Good internal consistency was found for both (...) the BCS-AN and the BCS-PN. A two-factor model was found for both versions of the instrument: household tasks and infant care tasks. The BCS-AN and BCS-PN subscales revealed good internal consistency. Higher scores on the BCS-AN predicted higher scores on the BCS-PN. Significant associations were found among the BCS, depressive and anxiety symptoms, and father–infant emotional involvement, revealing good criterion validity. This study suggested that both the BCS-AN and the BCS-PN are reliable multidimensional self-report measures that assess the involvement of father in infant care during pregnancy and the postpartum period. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 (...) male participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

Background Maternal mental health during the peripartum period is critically important to the wellbeing of mothers and their infants. Numerous studies and clinical trials have focused on various aspects of interventions and treatments for perinatal mental health from the perspective of researchers and medical health professionals. However, less is known about women’s experiences of participating in perinatal mental health research, and the ethical issues that arise. Aim To systematically review the literature on the ethical issues that emerge from pregnant and/or (...) postpartum women’s experiences of taking part in perinatal mental health-related research. Methods Systematic review of nine bibliographic databases, from inception to July 2021. Qualitative, quantitative and mixed method studies were included if they reported on ethical issues experienced by perinatal women. Research ethical issues encompassed any issue relating to women’s experiences of being offered study information, recruitment, consent, retention and respect for autonomy. Titles, abstracts and full text screening, appraisal of the methodological quality of included studies, and data extraction, were conducted independently by two reviewers. Ethical considerations Ethical approval was not required for this systematic review. Findings A total of 9830 unique citations was retrieved. Six studies met the inclusion criteria. Studies were clinically and methodologically heterogenous, and only one was purposively designed to explore women’s experiences. The key finding was the establishment of trust between the researcher and participant in all stages of the research process. Findings are presented according to recruitment and consent processes, participation and retention, and study follow-up and completion. Conclusion The establishment of trust between the researcher and perinatal women leads to a dynamic with research ethical implications relevant to all stages of perinatal mental health-related research. Further research on the research ethical issues experienced by perinatal women is required because of the limited literature. (shrink)

Alors que l’anthropologie montre que la naissance est d’abord un événement communautaire, actuellement des parents se retrouvent de plus en plus profondément seuls et démunis devant leur bébé. Ce phénomène est l’objet d’une recherche en cours qui essaie d’évaluer après la naissance les effets de l’isolement familial des parents sur la vie psychique du bébé lors de sa première année. Dans le cas clinique qui illustre ici cette « nouvelle solitude » des parents, les forums d’internet tentent de relayer la (...) faiblesse du soutien familial alors que les anxiétés, bien légitimes autour de la naissance, perdurent quand le bébé grandit. Au-delà des problèmes de la dépression maternelle du postpartum, l’accent est mis sur la place réelle que prend l’entourage comme soutien des processus plus intrapsychiques propres à la construction de la parentalité. (shrink)

Alors que l’anthropologie montre que la naissance est d’abord un événement communautaire, actuellement des parents se retrouvent de plus en plus profondément seuls et démunis devant leur bébé. Ce phénomène est l’objet d’une recherche en cours qui essaie d’évaluer après la naissance les effets de l’isolement familial des parents sur la vie psychique du bébé lors de sa première année. Dans le cas clinique qui illustre ici cette « nouvelle solitude » des parents, les forums d’internet tentent de relayer la (...) faiblesse du soutien familial alors que les anxiétés, bien légitimes autour de la naissance, perdurent quand le bébé grandit. Au-delà des problèmes de la dépression maternelle du postpartum, l’accent est mis sur la place réelle que prend l’entourage comme soutien des processus plus intrapsychiques propres à la construction de la parentalité. (shrink)

Postnatal/postpartum depression had a pre-COVID-19 estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America, and is detrimental to both mothers and their infants. Low social support is a key risk factor for developing PND. From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is (...) likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. Using data from 162 mothers living in London with infants aged ≤6 months, we explore how communication with members of a mother’s social network related to her experience of postnatal depressive symptoms during the first “lockdown” in England. Levels of depressive symptoms, as assessed via the Edinburgh Postnatal Depression Scale, were high, with 47.5% of the participants meeting a ≥11 cut-off for PND. Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding. While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still “takes a village” to raise children in high-income populations and mothers are struggling in its absence. (shrink)