The effectiveness of a family-centered maternity program in promoting a positive feeling toward the infant and in preparing the mothers for their new role was evaluated. Seventy-three married primiparous women completed measures of anxiety and depression as well as a series of questionnaires relating to their attitudes toward pregnancy, the baby, and the hospital experience. Statistical analyses revealed that the women in the family-centered maternity program, when compared with those in the traditional program, had a more positive attitude toward their babies while in the hospital. In addition, they reported having received more experience in caring for their babies and more help from the hospital personnel in preparing for the mothering role.
A follow-up carried out on an average 12.5 years after hospital contact of 151 patients with a former diagnosis of anorexia nervosa (AN), aimed at reproduction outcome. None of the 11 males had children. Fifty of the 140 women had given birth to a total of 86 children, which is approximately one third of the expected fertility. Involuntary childlessness was of the same size as found in the background population. The rate of prematurity among the offspring was twice the expected and perinatal lethality six times the expected. Mentally the mothers did well, both during pregnancy and the post partum period. They breast-fed their children for the same mean time as did other women, and the development of the children did not differ from that found in a background population. More women in the group of mothers than in the group of non-mothers had better scores of all-round functioning at follow-up.
A two-year cohort of children of parapartum mentally ill mothers born in Stockholm during the mid-70s was studied with regard to mental development, somatic growth and social outcome. The observation period covered the pre-school-age period and the study was based on Well-Baby-Clinic (WBC) data. The findings were compared with those of matched controls. Nearly 40% of the children of the mentally ill mothers, compared to 3% of the controls, did not live with their biological mothers during the pre-school ages. No difference was found in somatic growth between the index and control children. However, more index children--especially those of addicts and neurotic or temporarily insufficient mothers--than controls suffered from developmental (p less than 0.05) and behavioural (p less than 0.001) disturbances. Fifteen per cent of the index children compared to 5% of the controls were judged by the staff of the WBC to be in need of treatment for psychological problems (p less than 0.01). The results of the present study emphasize the fact that children of mentally ill mothers constitute a high-risk group regarding mental and behavioural development. The study supports earlier research reports claiming that, while parental mental illness constitutes an important indicator of psychiatric risk for the children, the main risk stems from associated psychosocial disturbances in the family.
Psychiatric residency or practice is difficult to combine with motherhood. The experiences of 82 women psychiatrists surveyed in the last year (47 residents and 35 staff doctors) are reviewed in a number of related areas--the difficulties of pregnancy, maternity leave, child rearing and the conflicts between motherhood and practicing psychiatry. Part-time residency is explored from both the resident's and hospital's perspective. Suggestions to make practice or residency more compatible with child rearing are discussed. Other issues such as work-based day care, realistic tax credit for child care expenses, and the difficulties of obtaining reliable and good home help and child care are reviewed. There are numerous conflicts for women psychiatrists who work while their children are young and these problems need to be acknowledged and addressed by the profession. It is noteworthy that as well as a supportive spouse and good child care, the attitudes of colleagues and supervisors and the need for good role models were frequently cited as being critical to the success of combining a psychiatric career with motherhood. As more women enter the profession (approximately 50% of psychiatric residents in Canada are now female, and more than 50% of them plan to combine children with their profession at some stage of their career) the need to find creative and workable solutions to these problems becomes more pressing.
Due to staff shortages in the maternity department postnatal women had to be discharged from the postnatal wards on the third day post delivery. They were given the option of discharge home on the third day following birth with domiciliary visits from a public health nurse, or transfer to another ward which was staffed by children's nurses. Previously early discharge home had been optional. Using semi-structured interviews over the telephone the effects of 'voluntary' and 'involuntary' early postnatal discharge on women's experiences of early discharge and breast feeding rates were studied in a sample of 230 women. Women discharged 'involuntarily' were more dissatisfied with early discharge and had more problems (e.g. fatigue) than women discharged 'voluntarily'. Early postnatal discharge should remain an option and should not be made compulsory.
The neonatal health and family situation of infants admitted for institutional care were evaluated retrospectively. Based on the criteria for admission they were classified into four groups: handicapped infants; infants of mothers with psychiatric illness or mental retardation; infants of alcoholic or drug-addicted mothers; and infants of mothers with various social dysfunctions. Mentally disturbed and addicted mothers were to a large extent multiparae. One-fourth of them already had children in foster care. The mentally disturbed mothers had a raised frequency of pregnancy and delivery complications. Compared to the general population, the gestational age and birth weight were significantly lower in all groups, and the number of preterm babies was twice as high. The majority of infants at risk for parental failure due to mental disturbance or addiction can be identified in the maternity ward. Deficient maternal behaviour in the maternity ward and the occurrence of previous children in foster care are important risk factors in predicting maternal incapability for parenting.
This study examined mothers' perceptions of the most stressful situation their children experienced during hospitalization and how they and the children responded in these situations. The mothers described four types of situations; the most prevalent were intrusive procedures and separation events. The most frequent coping behaviors they described were seeking others, eliciting help, controlling, and self protection behaviors. The predominant strategies the mothers used to help their children were Providing Comfort and Providing Information. The mothers' emotional responses to their children's behaviors included both pleasant and unpleasant affective states. Implications for practice and research are addressed.
Country-wide neonatal screening for alpha 1-antitrypsin deficiency (ATD) was discontinued due to clinical observations of negative psychological effects on the parents. In a subsequent systematic study, hypotheses of long-term negative effects on the parents' views of the child's health and on the parents' relationship to the pediatric services were tested by comparing these characteristics in parents with a child with ATD versus control parents, studied through interviews in the home. The identification of the ATD was found to have had negatively influenced the parents' view of the child's general health, but no evidence was found of increased parental anxiety regarding the child's current health or emotional dependence on medical personnel, of increased (reported) usage of pediatric services, or of more negative attitudes toward the pediatric services.