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We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method. [ABSTRACT FROM AUTHOR]

Background: Measurement is critical in postnatal posttraumatic stress disorder (PTSD) because symptoms may be influenced by normal postnatal phenomena such as physiological changes and fatigue. Objective: This study examined: (1) whether hyperarousal symptoms differ between women who have traumatic or nontraumatic births; (2) whether the construct of hyperarousal is coherent in postnatal women; and (3) whether hyperarousal symptoms are useful for identifying women who have traumatic births or PTSD. Methods: A survey of PTSD symptoms in 1,078 women recruited via the community or Internet who completed an online or paper questionnaire measuring childbirth-related PTSD symptoms between 1 and 36 months after birth. Women who had a traumatic birth as defined by DSM-IV criterion A (n = 458) were compared with women who did not have a traumatic birth (n = 591). Results: A one-factor dimension of hyperarousal was identified that included all five hyperarousal items. Diagnostic criteria of two or more hyperarousal symptoms in the previous week were reported by 75.3% of women with traumatic birth and 50.5% of women with nontraumatic births. The difference in mean hyperarousal symptoms between groups was substantial at 0.76 of a standard deviation (Hedge's g, CI = 0.64, 0.89). A larger difference was observed between women with and without diagnostic PTSD (g = 1.64, CI 1.46, 1.81). However, receiver operating characteristic analyses showed hyperarousal symptoms have poor specificity and alternative ways of calculating symptoms did not improve this. Comparison with other PTSD symptoms found re-experiencing symptoms were most accurate at identifying women with traumatic births. Conclusions: Results suggest hyperarousal symptoms are associated with traumatic birth and are a coherent construct in postnatal women. However, they have poor specificity and should only be used as part of diagnostic criteria, not as a sole indicator. [ABSTRACT FROM AUTHOR]

The responses to a life-changing event can be different. The study aimed to determine the effect of counseling on coping strategies among women facing unplanned pregnancy. This quasi-experimental study was conducted on 70 unplanned pregnant women with a gestational age <10 weeks, who scored ≥ 15 in the avoidance pattern of Revised Prenatal Coping Inventory (NU-PCI). The participants were randomly assigned into the intervention and control groups. Three counseling sessions were held for the intervention group. Data were gathered using questionnaires of the women's perceptions of unplanned pregnancy, decision-making style and strategies, NU-PCI, and the checklist for the type of decision. Independent t-tests, ANCOVA, and Chi-square were used. After intervention, the mean score of the avoidance pattern in the intervention group was significantly lower than that in the control group [AMD: - 4.35, 95% CI: -8.7 to -0.13, P=0.03]. In addition, the continuation rate of pregnancy in the intervention group, 28 subjects (80%), was significantly higher than that in the control group, 21 (60%) (P = 0.03). The counseling leads to a decrease in the use of avoidance strategies among women facing unplanned pregnancies. Development of supportive interventions for women experiencing unplanned pregnancies is recommended specially in societies with induced abortion restrictions. [ABSTRACT FROM AUTHOR]

Unintended pregnancy is a risk factor for less maternal–fetal attachment (MFA) and low levels of psychological well-being. This study was conducted to determine the effect of an MFA-based training programme on maternal anxiety, depression and worries following an unintended pregnancy. This randomised clinical trial was conducted on 68 women with an unintended pregnancy in north of Iran during 2018–2019. Participants were allocated to the trained and control groups through simple randomisation. The trained group received the MFA-based training for three 90-min sessions. Demographic questionnaire, London measure of unplanned pregnancy, Cranley's MFA scale, Edinburgh postnatal depression, Spielberger anxiety and prenatal distress questionnaires were used. Data were analysed by descriptive statistics, chi square, Fisher's exact test, independent and paired-samples t-tests, Mann–Whitney U, analysis of covariance, and multivariate analysis of variance. After the intervention, the mean MFA, anxiety and depression scores were not significantly different between the trained and control groups Worry was significantly decreased in the trained group (p = 0.001) and increased in the control group (p = 0.03). Although the MFA-based training could not significantly improve MFA, maternal anxiety and depression, it has been effective on worry in women with the unintended pregnancies. [ABSTRACT FROM AUTHOR]

Reliable Fertility-specific QoL measures can be obtained through the FertiQoL, a questionnaire with six-subscales that consider different core aspects of the person's wellbeing and way of behaving during treatment. Examine the psychometric properties of all six-subscales of the Italian FertiQoL in a sample of infertile women and explore the effects of the ART treatment phases. 323 women, in three different treatment stages (Diagnostic, Stimulation, Transfer), completed the FertiQoL. Raw data were subject to Confirmatory Factor Analysis (CFA), and a structural equation modelling (SEM) was used to validate the hypothesised model. CFA shows a good fit of the data to the FertiQoL hierarchical model (chi-square/df = 1.989, CFI = 0.88, RMSEA = 0.055). After the deletion of 2 items, all FertiQoL scales have good internal consistency. SEM showed that the ART treatment phase was positively associated with fertility-related QoL scores both in the Relational (β = 0.14, p < 0.05) and in the Tolerability (β = 0.17, p < 0.05) subscales. All scales of the Italian FertiQoL version maintain good psychometric characteristics; Tolerability and Relational subscales are sensitive to the treatment stage and thus providing relevant information for the medical staff. [ABSTRACT FROM AUTHOR]

Objective and background: The 10-item Birth Satisfaction Scale - Revised (BSS-R) is increasingly being used internationally as the instrument of choice for the assessment of birth satisfaction. There remains conjecture over the most appropriate way to score the instrument; subscale scores overall total score, or both approaches. The current study sought to clarify this issue by examining the measurement characteristics of the United States version of the BSS-R from a large data set. Methods: Secondary analysis of a data matrix from a large sample US BSS-R validation study (N = 2116) using structural equation modelling. Results: A bi-factor model revealed an excellent fit to data (χ2(df = 25) = 208.21, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.04), demonstrating relative independence of the BSS-R quality of care subscale, while in contrast the women’s attributes and stress experienced during childbearing subscales could be explained more plausibly by a general factor of experience of childbirth. Conclusion: Consistent with the recommendations of the original BSS-R validation study, the current investigation found robust empirical evidence to support the use of both the subscale scoring system and the total score. Researchers and clinicians can therefore select either approach (or both) with confidence. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables.Background:Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth.Methods:UK (N= 193) and Croatian (N= 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies.Results:Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth.Conclusion:This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth. [ABSTRACT FROM PUBLISHER]

ObjectiveandBackground:Attachment styles and empathy with respect to couples’ functioning during the period of transition to parenthood have rarely been studied. The aim of the present study was to examine the link between attachment security and perceived empathy as well as their role in the adjustment to parenthood. It was hypothesised that secure parents, as opposed to insecure ones, would perceive themselves and their partners as more empathic after the child’s birth and, as a consequence, more effectively adapt to parenthood.Methods:Sixty-seven couples experiencing their first transition to parenthood participated in the study. Their attachment styles were measured before the birth of the child. Empathy (as perceived in oneself and in a partner) and adjustment to parenthood were measured when the child was a few months old.Results:The results indicated that new parents with more secure, less anxious–ambivalent, and less avoidant attachment styles expressed and perceived more empathy in their relationships, and they were better adjusted to parenthood. A partner’s perceived empathy was found to be a mediator between one’s attachment styles and their adjustment to parenthood. In particular, men’s self-assessed empathy and men’s empathy as perceived by their wives was a significant mediator of the relationship between one’s attachment styles and adjustment to parenthood.Conclusion:Attachment styles are associated with the empathy of partners (both declared and perceived), which in turn predicts their better adjustment to parenthood. [ABSTRACT FROM PUBLISHER]

Objective: To explore the life experiences and quality of life of involuntarily childless men to determine whether adoption improves their quality of life. Background: The current study focused on specific life experiences – the strength of the desire for a child, problems in marital understanding and the quality of life of involuntarily childless men undergoing fertility treatment and adoptive fathers who had experienced infertility in an Indian context. Methods: A convenience sample of 100 involuntarily childless men undergoing fertility treatment was recruited and 100 adoptive fathers were selected through snowball sampling. Participants provided demographic information and completed seven questions that measured their strength of child wish (four items) and problems in marital understanding regarding childlessness (three items). Quality of life was measured with a German instrument, the Tübingen Quality of Life Questionnaire for Men with Involuntary Childlessness (TLMK; 35 items, English version). Results: Both groups emphasised the importance of being a parent. There was only a slight difference in problems in marriage due to childlessness. However, the results of the TLMK revealed that the adoptive fathers perceived an overall better quality of life than the involuntarily childless men. Conclusion: Adoption can improve the quality of life of involuntarily childless men in this particular ethnic group. Designing culture- and gender-specific counselling could be beneficial to both groups. [ABSTRACT FROM AUTHOR]

Objective: To examine the characteristics of women with antenatal or postnatal anxiety and to investigate aspects of their care that may be associated with it. Background: Positive outcomes following childbirth are associated with good physical and mental health during pregnancy and following childbirth. Although a degree of anxiety is normal in pregnancy, for some women it can become a serious problem. Methods: This study used data on 5332 women from a 2010 national maternity survey which asked about antenatal and postnatal health and well-being three months after childbirth. Women self-identified as experiencing anxiety and other problems during pregnancy and the postnatal period. Results: Antenatal anxiety was reported by 14% of women and postnatal anxiety by 5% of women. Antenatal anxiety was associated with younger age, Black and Minority Ethnic status, single parenthood, living in a disadvantaged area, having an unwanted pregnancy and long-term health problems. Of these factors, only long-term mental health problems were associated with anxiety in the postnatal period. In the logistic regression models long-term mental health problems dominated the findings. Significant differences in the perceptions of the care experienced were evident in the responses from women with anxiety both antenatally and postnatally. Conclusions: This study shows that antenatal and postnatal anxiety are influenced by health and social factors. Asking women about their current physical and psychological health and past history during pregnancy and following up on their well-being in the postnatal period is an essential element in planning and providing care to meet their needs. [ABSTRACT FROM AUTHOR]

Background: The Prenatal Distress Questionnaire (PDQ) is a short measure designed to assess specific worries and concerns related to pregnancy. The aim of this study was to confirm the factor structure of the PDQ in a group of pregnant women with a small for gestational age infant (< 10th centile). Methods: The first PDQ assessment for each of 337 pregnant women participating in the Prospective Observational Trial to Optimise paediatric health (PORTO) study was analysed. All women enrolled in the study were identified as having a small for gestational age foetus (< 10th centile), thus representing an 'elevated risk' group. Data were analysed using confirmatory factor analysis (CFA). Three models of the PDQ were evaluated and compared in the current study: a theoretical uni-dimensional measurement model, a bi-dimensional model, and a three-factor model solution. Results: The three-factor model offered the best fit to the data while maintaining sound theoretical grounds(χ2 (51df) = 128.52; CFI = 0.97; TLI = 0.96; RMSEA = 0.07). Factor 1 contained items reflecting concerns about birth and the baby, factor 2 concerns about physical symptoms and body image and factor 3 concerns about emotions and relationships. Conclusions: CFA confirmed that the three-factor model provided the best fit, with the items in each factor reflecting the findings of an earlier exploratory data analysis. [ABSTRACT FROM AUTHOR]

Background: Human beings have an innate need to form close emotional bonds with significant others. Objective: The purpose of this research was to study the effect of domestic violence during pregnancy in the mother–infant relationship. Method: 204 pregnant outpatients (of the Obstetrics and Gynecology Department of the Hospital Pedro Hispano, Portugal) with a mean age of 29 and in their last 3 months of pregnancy were the participants of this study. To assess the violence level during pregnancy, we used the Conflict Tactic Scale 2. The mother–baby relationship was determined using the Maternal Foetal Attachment Scale and the Maternal Adjustment and Maternal Attitudes questionnaire. Results: In our work, we encountered 107 pregnant victims (52.4% of all outpatients) of domestic violence. The results showed that victims of domestic violence had a poor relationship with the foetus (M = 97.4, SD = 8.1), but not to the point of statistical significance. In these same patients, we also detected minor adjustments and attitude shifts towards pregnancy (M = 117, SD = 14.2) and this result was statistically significant when compared with women who did not experience domestic violence. Conclusion: Our results suggest that women who are victims of domestic violence are more likely to have a lower attachment with the foetus when compared with women who do not suffer domestic violence. Additionally, the victims showed more negative attitudes towards pregnancy and the foetus when compared to non-abused women. [ABSTRACT FROM PUBLISHER]

Objective: The aim of the study was to compare changes in state anxiety and mood dimensions in pregnant women after a session of physical exercise and relaxation. Methods: This study used a quantitative comparative design to compare two groups of pregnant women aged 22–38 years: (1) 46 women participated in physical exercise for pregnant women and (2) 46 women participated in relaxation session. Emotional states were assessed with the UWIST Mood Adjective Checklist and State–Trait Anxiety Inventory. The measurement of emotional states was done immediately before and after the classes. Results: The main time effect was observed in all emotional states assessed: the level of state anxiety and tension arousal decreased and the level of hedonic tone and energetic arousal increased. The main group effect was significant only for energetic arousal (higher level in the exercise group). Analysis within the groups found significant time effect for energetic arousal only in the exercise group. Conclusions: Both a relaxation session and one-time physical exercise can improve the emotional comfort of pregnant women. Relaxation training will probably bring more benefits to women having higher levels of anxiety or depression, while physical exercise can be particularly useful for women having problems with fatigue and decreased energy levels. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current study was to verify whether maternal orientation differences are associated with specific care-giving practices and maternal subjective well-being in accordance with theory.Background: The facilitator orientation, characterised by infant-led care-giving, is proposed to promote immediate responsiveness to the infant coupled with a maternal desire to nurture, whereas the regulator orientation, typified by a mother-led care regime, is proposed to prioritise infant socialisation and maternal needs. However, empirical research linking maternal orientation to maternal care-giving practices and satisfaction in the mothering role is limited.Method: Two hundred and seventy-four mothers of infants 4–7 months old answered an online questionnaire to classify maternal orientation, explore care-giving practices specific to infant sleep, and assess each woman’s current experience of mothering.Results: As predicted, more facilitator tendencies were associated with more frequent hands-on infant settling, more flexible timing for infant sleeps, and a closer mother–infant proximity at night, even after controlling for demographic influences and feeding type (breast milk and/or formula). In contrast, maternal orientation did not explain differences in maternal subjective well-being. Those with more facilitator or more regulator tendencies were equally satisfied with their mothering role.Conclusions: A need to tailor support services to each mother’s philosophy to baby care is implicated. [ABSTRACT FROM PUBLISHER]

Background: Fatigue is a common health concern reported by mothers of infants and young children, yet little is understood about how fatigue may impact on parenting. Objective: The aim of the study was to explore the associations between fatigue, parenting self-efficacy (PSE) and parenting satisfaction, where parenting stress mediates this relationship. The moderating influence of several contextual factors was also assessed. Method: A sample of 1022 Australian mothers of children aged 0–6 years completed a survey on fatigue, well-being and parenting. Results: Path analysis revealed that the relationship between fatigue and PSE was fully mediated by parenting stress, while the relationship between fatigue and parenting satisfaction was partially mediated by parenting stress. Child gender, employment status, family structure and socio-economic status did not moderate these relationships. Conclusion: Fatigue is a serious health concern for mothers that has potential to adversely affect their level of parenting stress, parenting beliefs and behaviour. Implications for the provision of information and support to manage parent fatigue are discussed. [ABSTRACT FROM PUBLISHER]

Aim: Infant sleep behaviours, particularly night wakings, have been identified as one of the most common concerns of parents. Despite this, few empirical studies have examined how mothers distinguish between normative and problematic infant sleep behaviours. Methods: In this study, we examined infant and maternal factors associated with maternal perceptions of infant sleep problems in an internet sample of Canadian mothers with 6- to 12-month-old infants whose infants wake at least one night a week. Results: While infant sleep behaviours accounted for 24% of the variance in maternal perceptions of infant sleep problems, including additional infant and maternal factors in the model accounted for 43%. Factors significantly associated with maternal perceptions of infant sleep problems were infant sleep behaviours (i.e. frequent night wakings, difficulties initiating sleep), difficult infant temperament, poor maternal daytime functioning and poor maternal sleep quality. Contrary to expectations, infant daytime functioning was not predictive of maternal perceptions of infant sleep problems. Conclusions: Our findings support a focus on the family, rather than the infant, when assessing and treating infant sleep problems [ABSTRACT FROM AUTHOR]

There is ongoing debate regarding whether the child-bearing years, including the postpartum period, are a time of increased risk for mental health problems in women. Comparisons of the mental health of mothers and childless women have inconsistent findings. This is probably attributable to differences in the kinds of mothers and non-mothers investigated, and variations in the conceptualisation of mental health, but suggests that firm conclusions about the relationship between motherhood and women's mental health remain less clear than claimed. This study investigated the relationship between motherhood and mental health in a population-based, cross-sectional survey of a broadly representative sample of 569 women aged 30-34 years living in Victoria, one Australian state, in 2005. It was found that the rates of mental health conditions in mothers, including those who had given birth in the preceding year, were no higher than in women without children. Further, mothers reported significantly better subjective well-being and greater life satisfaction than childless women. These data suggest that being a mother is associated with enhanced mental health for women, and challenge the view that the child-bearing years are a period of diminished psychological well-being for women. [ABSTRACT FROM AUTHOR]

Postnatal depression carries a significant health burden for mothers and their offspring. However, the majority of screening or treatment studies for postnatal depression have been carried out on white or European populations and clinicians have been appropriately cautious about applying these findings to different cultural groups. This study describes the development and use of a Bengali version of the Edinburgh Postnatal Depression Scale (EPDS). Forty-eight Bangladeshi postnatal women in both Bangladesh and England were interviewed by a Syhletti/Bengali-speaking psychologist. The translated version of the EPDS was presented in the usual way, along with a standardized interview about the degree of social support and a translated version of the General Health Questionnaire (GHQ). Although one item of the EPDS presented some translation difficulties, the majority of items obtained reasonable semantic equivalence and were successfully rated by the women in the study. Preliminary examination of the psychometric properties of the scale suggested adequate reliability for the scale. Higher EPDS scores had both a significant positive association with less social support and higher scores on the GHQ. While this is not a screening validation study of the Bengali version of the EPDS, the findings do provide preliminary evidence that postnatal depression screening programmes may be an appropriate and inexpensive method of identifying postnatal distress in Bangladeshi women. [ABSTRACT FROM AUTHOR]