An interpretative phenomenological analysis of the experience of couples' recovery from the psychological symptoms of trauma following traumatic childbirth.

Globally, a large proportion of birthing mothers, and a to a lesser extent their partners, experience birth trauma each year, and yet access to adequate post-natal trauma support is rarely available. Untreated birth trauma has been shown to negatively impact the family in terms of the parents' relationship with one another, and long-term negative consequences for the child. Despite a drive towards integrating mental health support into maternity services and a call to provide mental health support for couples rather than solely the birthing mother, there is little research exploring what birthing couples find helpful in recovery from birth trauma. The current research interviewed six couples using an Interpretative Phenomenological Approach in order to explore their understanding of what supported their recovery from birth trauma. Four themes were identified: 'We need validation', 'Feeling paper thin', 'This is a system failure' and 'Birth trauma is always going to be a part of you'. The data describes an understanding of parents' feelings of vulnerability and loss of trust in services to provide support following birth trauma. Further, parents' need for validation and repositioning of control away from healthcare professionals when considering the availability and knowledge of the support options available is discussed. Clinical implications for supporting parents following birth trauma are explored, including an identified need for trauma informed care communication training for all healthcare professionals involved in maternity care, and the requirement for sources of therapeutic support external from the parent dyad in order to maintain the couples' interpersonal relationship.

Parenting beliefs about attunement and structure are related to observed parenting behaviours.

We compared self-reported parenting beliefs about caring for infants with observed parenting behaviours during play interactions between 32 parents and their infants. We measured parenting beliefs about the value of attunement and structure in caring for infants using the Baby Care Questionnaire (BCQ) (Winstanley & Gattis, 2013; Winstanley, Sperotto, Putnick, Cherian, Bornstein & Gattis, 2014). We used a micro-coding approach to distinguish between responsive parenting behaviours (maintaining infant attention) and demanding parenting behaviours (introducing or redirecting infant attention) (Landry, Garner, Swank & Baldwin, 1996). Attunement beliefs were positively related to responsive parenting behaviours and negatively related to demanding parenting behaviours. Structure beliefs were weakly related to demanding parenting behaviours. These results are an important first step toward identifying relations between self-reported parenting beliefs about attunement and structure and observed parenting behaviours.

Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis.

Introduction: Five to 10 percentage of fathers experience perinatal depression and 5-15% experience perinatal anxiety, with rates increasing when mothers are also experiencing perinatal mental health disorders. Perinatal mental illness in either parent contributes to adverse child and family outcomes. While there are increasing calls to assess the mental health of both parents, universal services (e.g., maternity) and specialist perinatal mental health services usually focus on the mother (i.e., the gestational parent). The aim of this review was to identify and synthesize evidence on the performance of mental health screening tools and the acceptability of mental health assessment, specifically in relation to fathers, other co-parents and partners in the perinatal period. Methods: A systematic search was conducted using electronic databases (MEDLINE, PsycINFO, Maternity, and Infant Care Database and CINAHL). Articles were eligible if they included expectant or new partners, regardless of the partner's gender or relationship status. Accuracy was determined by comparison of screening tool with diagnostic interview. Acceptability was predominantly assessed through parents' and health professionals' perspectives. Narrative synthesis was applied to all elements of the review, with thematic analysis applied to the acceptability studies. Results: Seven accuracy studies and 20 acceptability studies were included. The review identified that existing evidence focuses on resident fathers and assessing depression in universal settings. All accuracy studies assessed the Edinburgh Postnatal Depression Scale but with highly varied results. Evidence on acceptability in practice is limited to postnatal settings. Amongst both fathers and health professionals, views on assessment are mixed. Identified challenges were categorized at the individual-, practitioner- and service-level. These include: gendered perspectives on mental health; the potential to compromise support offered to mothers; practitioners' knowledge, skills, and confidence; service culture and remit; time pressures; opportunity for contact; and the need for tools, training, supervision and onward referral routes. Conclusion: There is a paucity of published evidence on assessing the mental health of fathers, co-mothers, step-parents and other partners in the perinatal period. Whilst practitioners need to be responsive to mental health needs, further research is needed with stakeholders in a range of practice settings, with attention to ethical and practical considerations, to inform the implementation of evidence-based assessment.

The Applicability and Performance of Tools Used to Assess the Father-Offspring Relationship in Relation to Parental Psychopathology and Offspring Outcomes.

Introduction: Father-infant interactions are important for optimal offspring outcomes. Moreover, paternal perinatal psychopathology is associated with psychological and developmental disturbances in the offspring, and this risk may increase when both parents are unwell. While, the father-offspring relationship is a plausible mechanism of risk transmission, there is presently no "gold standard" tool for assessing the father-offspring relationship. Therefore, we systematically searched and reviewed the application and performance of tools used to assess the father-offspring relationship from pregnancy to 24-months postnatal. Methods: Four electronic databases (including MEDLINE, PsycINFO, Maternity and Infant Care Database, and CINAHL) were searched. Selected articles included evidence of father-offspring relationship assessment in relation to parental perinatal psychopathology and/or offspring outcomes. Data was extracted and synthesized according to the following: (i) evidence supporting the performance of tools in terms of their psychometric properties when applied in the context of fathers, (ii) tool specific characteristics, and (iii) study specific methodological aspects in which the tool was embedded. Results: Of the 30,500 records eligible for screening, 38 unique tools used to assess the father-offspring relationship were identified, from 61 studies. Ten tools were employed in the context of paternal psychopathology, three in the context of maternal psychopathology, and seven in the context of both maternal and paternal psychopathology, while nine tools were applied in the context of offspring outcomes only. The remaining nine tools were used in the context of both parental psychopathology (i.e., paternal, and/or maternal psychopathology) and offspring outcomes. Evidence supporting the psychometric robustness of the extracted observational, self-report and interview-based tools was generally limited. Most tools were originally developed in maternal samples-with few tools demonstrating evidence of content validation specific to fathers. Furthermore, various elements influencing tool performance were recognized-including variation in tool characteristics (e.g., relationship dimensions assessed, assessment mode, and scoring formats) and study specific methodological aspects, (e.g., setting and study design, sample characteristics, timing and nature of parental psychopathology, and offspring outcomes). Conclusion: Given the strengths and limitations of each mode of assessment, future studies may benefit from a multimethod approach to assessing the father-offspring relationship, which may provide a more accurate assessment than one method alone.