Professor Jeanette Milgromab, Ms Jennifer Ericksena, Ms Doreen Powerc
a Department of Psychology, The University of Melbourne
b Parent-Infant Research Institute, Austin Health
c Northern Hospital
beyondblue Victorian Centre of Excellence
Project completion year
This project further developed an initial pilot study funded by beyondblue. Towards Parenthood is a program to prepare new parents for parenthood, through addressing areas of adjustment not covered in most existing antenatal classes. In particular, the program addresses issues such as fostering antenatal attachment and problem solving to meet the demands of a new baby. It also provides coping skills for mood and stress, and strategies for improving partner communication.
Towards Parenthood consists of a self-directed workbook for soon-to-be parents, supported by regular telephone contact by trained therapists. The program builds and reinforces key service partnerships between health professionals around the care of perinatal women, including creating a safety net for vulnerable pregnant women.
The intervention was evaluated with 143 pregnant women – 43 with a high probability of depression and 100 with a low probability of depression. Women and their partners were randomly allocated to receive either the Towards Parenthood intervention or routine care.
Participants who received the intervention reported significantly lower levels of depression postnatally than participants in the routine care condition. Treatment effects in the same direction were also found for anxiety and stress, after controlling for antenatal anxiety and stress scores respectively.
A significant relationship was found between antenatal depression scores and change in depression for participants in the intervention condition, but not for participants in the routine care condition. This indicates that participants with higher levels of depression at baseline who received the intervention showed larger reductions in depression symptoms over the course of the study.
Participants with a high probability of antenatal depression at baseline reported higher parenting stress postnatally. Of the participants with a high probability of depression, those who received the Towards Parenthood intervention reported less parenting stress than those who received routine care, with their scores falling below the threshold for clinically significant levels of parenting stress.
Taken together, the findings support the hypothesis that Towards Parenthood is an effective intervention antenatally for reducing parenting stress. It appears particularly helpful in the parent domain, which includes subscales such as parent feelings of self-competence and attachment to the infant. Towards Parenthood is also effective in reducing postnatal depression, anxiety and stress, and is particularly effective for those who may be depressed antenatally. This is an interesting finding as many antenatal prevention programs for postnatal depression have not been effective.
Implications for policy, practice and further research
A preparation for parenthood program that focuses on the psychological rather than practical and physical aspects of pregnancy and early parenthood has the potential to improve both postnatal mood and parenting stress for all women, irrespective of whether they experience depressive symptoms during pregnancy. With the Federal Government implementing universal screening for depression during the perinatal period, there is an opportunity to promote the emphasis of antenatal care of women to focus not just on depression but also on parenting. Future research needs to focus on engaging partners more and investigating whether communication between health professionals can be strengthened.