Lecture 6

Question 1

Biological changes:

Answer 1

ACOG - 2004
- nausea and vomiting is experienced by 70-85% of pregnant women
Zib, Lim & Walters, 1999
- fatigue experienced by 96.6% of first trimester mothers
Bialobock & Monga, 2000
- continuing factors include oxygen consumption, metabolic changes and oestrogen/progesterone
Nakiz & Eryilmaz, 2013
- found symptoms most likely to impact quality go life are urinating frequently, fatigue + heartburn (75-88%)

Question 2

Key social transitions: woman to mother

Answer 2

Emmanuel & St John, 2010

• suggest becoming a mother encompasses several psychological changes:
• known to unknown reality
• new maternal identity w associated feelings, behaviour and skills
• renegotiating social roles e.g. employment, relationship with partner, wider family roles
• balancing demands
• experiencing losses - control, sleep, freedom, sense of self

Question 3

Key social transitions: relationship and sexual functioning

Answer 3

Hansen, 2012
- common belief that parenthood is central to fulfilling romantic relationship
Mitnick, 2009
- relationship satisfaction and sexual functioning decline moderately among men and women from pregnancy to childs first birthday
Hanington et al., 2012
- increased marital conflict in the postpartum compared to pregnancy

Question 4

relationship and sexual functioning 2

Answer 4

Twenge et al., 2003

• meta analysis of 90 studies comparing parents to childless individuals
• parent experience lower levels of relationship satisfaction than non-parents
• parents of infants report lower levels of relationships quality than childhood individuals or parent of older children

Question 5

key psychological changes: adaptive anxiety

Answer 5

Fallon et al., 2016

- tightly linked to period of childbearing

Question 6

key psychological changes: stress and response coping

Answer 6

Glym et al., 2014
- psychological reactions to stress response are attenuated during pregnancy when compared to non-pregnant controls
Entringer et al., 2010
- lab studies - Trier Social Stress Test - found lower stress responses in late pregnancy compared with early pregnancy
Hamilton + Lobel, 2008
- cope with stress more effectively during pregnancy
- avoidant coping strategies used less
- avoidant strategies associated w reduced prep for parenting, bonding problems, less preventative health care
Van den Bergh, 2005
- exposure to high levels of maternal stress during pregnancy has potential to adversely impact foetal development, birth outcomes, subsequent child and adult health outcomes

Question 7

key psychological changes: post-partum blues

Answer 7

Edborgh, 2008
- found predominant mood experienced is happiness
Wilkinson, 1999
- both positive and negative mood states are significantly elevated in first 10 days after birth

Question 8

Perinatal Depression

Answer 8

Nicholson, 2001
- paradox of loss theory
loss of autonomy, loss of time, loss of appearance, loss of sexuality, loss of occupation identity

Question 9

PND - not just mums

Answer 9

Paulson et al., 2016
- paternal depression rates have found to be twice the national average in men in the same age group in US
Dudley et al., 2001
- predictors of paternal depression include infant related problems, prior experience of fatherhood and relationship quality
Paulson & Basemore, 2010
- meta analysis finds having a partner who is depressed increases risk of paternal depression
Field., 1998
- father support has been found to shield infants chronically depressed mothers from negative outcomes
Jackson, 1999
- reducing mothers parenting stress
Brunelli et al., 1995
- minimising negative maternal child-rearing attitudes

Question 10

Perinatal anxiety

Answer 10

Kuo et al., 2004
- prevalence rates up to 43%
Muzik et al., 2000
- occurs independently of depression

Question 11

Methodological Limitations

Answer 11

Wenzel., 2011
- perinatal anxiety becomes problematic when it consumes a sig proportion of woman time, prevents her from fulfilling her parenting role, interferes with self-care
Matthey, 2016
- lots of studies assume when anxiety is present in any form the women is ‘pathologically anxious’
Phillips et al., 2009
- do not address specific maternal or infant focused activities

Question 12

PTSD after childbirth

Answer 12

Slade et al., 2016

• must include presence of 3 key symptoms which make PTSD after birth heard to treat
  1. re-experiencing symptoms
  2. avoidance and numbing
  3. hyperarousal symptoms like sleep disturbances

Question 13

Postpartum psychosis

Answer 13

Brockington, 2006

• severe mental illness with dramatic onset shortly after birth
• most cases represent variance of bipolar disorder

Question 14

Perinatal wellbeing

Answer 14

Cacioppo & Bernston, 1999

- just as a positive effect into the opposite of negative effect - wellbeing is not the absence of mental illness

Question 15

high risk pregnancies - causes

Answer 15

Davis & Miles, 2016

- 15% of pregnancies are affected by significant medical complications for mother and/or foetus

Question 16

high risk pregnancies - parental responses

Answer 16

Price et al., 2007
- shock, uncertainty, sadness, excitement and happiness
Stark & Brinkley, 2007
- lower use of health promoting behaviours- diet, exercise, attendance at prenatal appts.
White et al., 2008
- lower quality of maternal-foetal attachment particularly is hospitalised women

Question 17

high risk infants

Answer 17

Hamilton et al., 2010
- prematurity affects around 12% of births
Pelcovitz, 1996
- PTSD reactions are common - ‘are few life events as horrifying and as far outside the range of normal experience as coping with a life threatening illness in ones child’
Franck et al., 2005
- grief over the loss of parental role: insanity of grief similar to the grief of parents whose infant died in newborn period

Question 18

Perinatal loss of grief

Answer 18

Cote-arsenault & Dombeck., 2011

- grief reactions are thought to vary ‘based on assignment of personhood’

Question 19

Teenage pregnancy

Answer 19

Lodgson, Hipwell & Monk., 2016

• pregnancy and parenting prior to age 20 associated with compromised biopsychosocial outcomes
• competing biological demands of maturing and carrying baby
• social tension between adolescence and pregnant/parenting
• more common on low SES groups and individual w depression

Question 20

Teenage pregnancy: poorer outcomes in pregnancy

Answer 20

Wallace et al., 1997

- on going maternal growth is a risk factor for low birthweight

Question 21

Teenage pregnancy: positives?

Answer 21

Clemens (2013)

• 25 qualitative studies - 5 themes
  1. reality of mother good brings hardship
  2. straddling two worlds of motherhood and adolescence
  3. motherhood as positively transforming
  4. baby stabilising influence
  5. positive influence of social support reshaping future

Question 22

cultural context

Answer 22

Kitzinger, 2001
- experience of pregnancy and childbirth can be strongly rooted in cultures
Hertog & Iwasawa - shameful for women to become pregnant before marriage in Japan
Darby, 2007
- good health requires balancing the environment and intake of substances that are hot and cold
Onoye, Goebert & Morland, 2016
- biomedical model and medicalisation of pregnancy dominate western cultures

Question 23

infertility

Answer 23

Deatsmen et al., 2016
- fertility declines as women age
Lampig et al., 2016
- particularly relevant to women who are career-focused or in higher education as these groups are more likely to put off childbearing

Question 24

Psychological consequences of infertility

Answer 24

Matthews & Martin, 1986
- unable to achieve a desired life-course change
sense of isolation and alienation for the ‘fertile world’
loss of control and identity
Van Balen, 2002
- psychological distress and infertility linked
not being able to conceive causes stress
stress reduces the chances of pregnancy
some women report pregnancy after ‘all hope is gone’ - stress reduction