Parental distress during the transition to parenthood: a prevention perspective

Studying parental distress is important from both a parental as well as child health perspective. In this dissertation, we focused on describing and preventing parental distress, thereby including both mothers and fathers. Results showed a relatively high prevalence of maternal symptomatology after birth, which has a chronic character (Chapters 2 & 3), and is associated with children’s internalizing problems in early adolescence (Chapter 3). Universal prevention – aimed at all pregnant women – seems to be effective in preventing maternal depression, anxiety, and stress (Chapter 4). However, the included interventions asked for a relatively high amount of effort from mothers as well as facilitators, which makes them expensive, potentially hindering the large-scale implementation necessary for universal prevention. Therefore, we aimed to develop a low-intensity psychoeducational prevention program, which could be implemented at a relatively low cost (Chapters 5 & 6). We found no evidence of the effectiveness of this intervention as stand-alone treatment in preventing parental distress and enhancing caregiving quality. Since parents did consider the received information useful and valuable, we recommend offering the information booklet as part of routine care for pregnant women and their partner. More research into the effectiveness of easy to implement and low-cost universal prevention on parenting distress is necessary, focusing on: 1) the inclusion of partners and the tailoring of interventions to the potential different needs of mothers and fathers; 2) the inclusion of (observational) outcomes with regard to parent-infant interaction to determine the effectiveness of interventions on parents’ sensitive responsiveness, parent-infant synchrony and subsequent child development; 3) the effect of universal prevention of parental distress on children’s behavior and development observed over longer periods of time and at different levels (i.e. social and cognitive); 4) other measures of parental distress beyond depression; and 5) the effectiveness of low-intensity universal prevention programs among parents varying in demographic characteristics and psychosocial history. Importantly, providing parents with up to date and scientifically validated information about the first months postpartum might fill a gap in the current available sources of support for expecting parents. Therefore, increasing attention for translating scientific knowledge into easily accessible information for parents could be a potentially valuable tool in the prevention of parental distress.