Women's experience of birth and early mothering following assisted conception

• Key Centre for Women’s Health in Society

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06 March 2007ABSTRACT


There is emerging evidence that after infertility and assisted conception women are at increased risk of early parenting difficulties. The aims of this study were to characterize postpartum psychological functioning of women conceiving through assisted reproductive technology (ART) and to identify factors that may be associated with early parenting difficulties defined as: postpartum psychological distress, low maternal confidence and admission to residential early parenting services. A prospective longitudinal study of the experiences of childbirth and early mothering was conducted in a consecutive cohort of women recruited in pregnancy from two large ART centres in Melbourne in the state of Victoria, Australia. All women who had a viable pregnancy verified by ultrasound at six weeks gestation between July and December 2001 and sufficient English to complete questionnaires were invited to participate. In early pregnancy they completed a structured telephone interview regarding their sociodemographic circumstances, reproductive history and infertility. The extent and outcome of their ART treatment was ascertained by scrutiny of medical records. Postal questionnaires including standardised self-report measures assessing mood, perception of quality of the relationship with the partner, personality, satisfaction with life, infant temperament, mother-infant attachment, maternal separation anxiety, and experience of motherhood were completed three, eight and eighteen months after the birth. Of the 239 women eligible for participation 183 (77%) accepted. Of these, six miscarried and six withdrew from the study during pregnancy. Of the 171 remaining participants 152 (89%) returned all three postnatal questionnaires, exceptional recruitment and retention rates for studies of this kind. The study sample was representative of all women who gave birth after ART in Australia and New Zealand at the time in terms of age, cause of infertility, parity, multiplicity, mode of delivery, length of gestation and babies weight at birth. Data were compared, where possible, with population data and data from community based studies of parturient women. On available indicators, participants’ socioeconomic circumstances were significantly better than those of comparison groups. Participants were significantly older when they gave birth, more likely to be delivered by caesarean section and to have twins, and to feel disappointed with the experience of the birth than comparison groups. At three months, the proportion of participants breastfeeding was lower than in comparison groups. Participants in this study had a three-fold higher risk of early parenting difficulties necessitating admission to residential early parenting services in the first 18 months after the birth compared with other Victorian mothers (17% versus 6%, p