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THE IMPACT OF PREVENTIVE PRENATAL
EDUCATION ON POSTBIRTH
FAMILY ADJUSTMENT

By

Carol Jean Ducat

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Psychology

1980

ABSTRACT

THE IMPACT OF PREVENTIVE PRENATAL
EDUCATION ON POSTBIRTH
FAMILY ADJUSTMENT

By

Carol Jean Ducat

Birth of a first child appears to be a time of develop-
mental crisis and reorganization for married couples.

Prior research suggested that lack of preparation for the
degree of disorganization after birth and a subsequent drop
in marital satisfaction is common for first-time parents.
The present study assessed the ability of prenatal education
classes to better prepare couples for the emotional adjust-
ment to their first child's arrival.

Two 10-week prenatal curricula were constructed. The
traditional (T) curriculum focused on medically oriented
education for pregnancy, labor, and delivery while the
exPerimental (E) curriculum supplemented an abbreviated
version of medical and physical content with materials aimed
at emotional preparation for parenting. Materials added
only to the E classes included communication skills, a
decision-making model, information about the impact of a
child on the marital dyad, and preparatory planning for
postbirth changes. Sixty-six volunteer couples were

recruited from applicants for enrollment in local prenatal

Carol Jean Ducat

education classes. After recruitment, these couples were
randomly assigned to type of curriculum and to pretest or
no pretest conditions.

Mailed questionnaires and semi-structured telephone
interviews were completed by one-half the couples before
prenatal classes and by all accessible participants at
1 month and 1 year postbirth. Measures included marital
satisfaction, communication frequency and satisfaction,
decision-making satisfaction, adjustment to life changes,
sexual adjustment, degree of discrepancy between the eXpecta-
tions and the reality of how parents divided childcare
tasks,2nuiparental attitudes toward the baby. These were
condensed into five scales: (a) Communication/Decision-
Making/Marital Satisfaction, (b) Crisis Adjustment, (0)
Sexual Adjustment, (d) Discrepancy Between Actual and
EXpected Division of Tasks, (e) Attitude Toward the Baby.
Monitered were such potentially-confounding variables as
socio-economic status, type of marriage relationship
(traditional versus companionate roles), difficulty of the
pregnancy, attitudes toward own parents, and attitudes of
parents and instructors toward the prenatal classes.

Of the 66 couples, 33 completed pretesting, 38 completed
the 1-month postbirth observation, and 39 provided data when

their children were 1 year-old. Seventeen couples provided

Carol Jean Ducat

data at all three observations. Compared to E couples,
T couples tended to have more traditional role marriages
(p 5:.08),to view their marital satisfaction as higher
(p .S .06), and to view their own parents more positively
(2 5-02).

From prebirth to 1 year after birth, E couples tended
to increase slightly in marital satisfaction while T couples
generally declined or dropped. This change was in the
predicted direction, however, a 2 x 2 (education X pretest)
multivariate analyses of variance MANOVchWLmonth and 1-year
data revealed no statistically significant differences
(p 5,.05) between the two groups of couples. A repeated
measures MANOVA of the 17 couples with data from all three
observations also revealed no significant differences between
treatment groups. At 1-month postbirth, however, both T and
E couples reported significant disruptions in daily routines
(p 5;.05). Post hoc regression analyses revealed that
increased postbirth marital satisfaction for both husbands
and wives was significantly related to a more traditional

view of marriage roles and to a less pleasant pregnancy

 

eXperience. Positive pggtbirth change in marital satisfaction
for new fathers was linked with more satisfactory prgbirth
decision-making procedures.

Lack of significant treatment group differences was

attributed to such research difficulties such as: (a) low

Carol Jean Ducat

receptivity toward the new curriculum due to timing and
presentation, (b) near-significant pretreatment differences
between groups, (c) the impracticality of a valid,
nontreated control group, and (d) inadequate statistical
power due to small sample size.

Recommendations for future research emphasized the
need for evaluation of the role of statistical significance
where small samples and intergroup differences are likely.
Additional research was suggested to identify: (a) optimal
times for intervention, (b) alternative forms of intervention,

and (c) methods of enhancing recipients'receptivity.

DEDICATION

Dedicated to my parents Mary and Arthur
Coakes, who instilled and encouraged my

desire for education.

ii

ACKNOWLEDGEMENTS

This research would have been impossible without the
support and cooperation of many people. R

My committee members were extremely helpful. John
Hurley provided nondirective support in my decision to
undertake this study. He further remained available for
countless hours of consultation. Ralph Levine freely offered
time and assistance with statistical analyses. Lucy Ferguson
and Bill Davidson likewise remained available and
supportive.

Cooperation of the EXpectant Parent Organization was
critical in providing access to subjects, developing class
materials and presenting the curricula. Special thanks
belong to Carol Buzzitta, Babbette Clough, Joann Reisig,
LeeAnn Roman, Andrea Schewe and Mary Ann Sesti. The many
new parents who shared their reactions and gave of their
valuable time are also greatly appreciated.

~Support in funding, materials, computer time and
printing were donated by the Ingham County Board of
Commissioners and the Michigan State University Cooperative
Extension Office and Department of Psychology.

Undergraduate research assistants in many instances

worked under personal time pressures to complete tasks of

iii

interviewing and data tabulation. Their enthusiasm for the
task was refreshing in times of discouragement. Special
thanks go to Beth Dick and Sheryl Goldberg.

Finally, my family and friends provided much-needed
support both emotionally and physically. Their support
ranged from understanding of my discouragement, to timely
exortations to continue the work, to provision of relief
from the parenting role so that my energies could be

focused on completion.

iv

TABLE OF CONTENTS

Page

LIST OF TABLES . . . . . . . . . . . . . . . . . . . . viii

LIST OF FIGURES . . . . . . . . . . . . . . . . . . . ix
Chapter

I. INTRODUCTION . . . . . . . . . . . . . . . . . 1

Crisis Theory . . . . . 3

Pregnancy as a Developmental Crisis . . . 7

Parenthood as a Developmental Crisis . . . 1a

A Sociological View of the Discrepancies . 28

A Parting Shot . . . . . 31

Education and Preventive Mental Health . . 36

Hypotheses . . . . . . . . . . . . . . . . 40

II. METHODOLOGY. . . . . . . . . . . . . . . . . . 43

Overview . . . . . . . . . . . . . . . . . 43

Subjects . . . . . . . . . . . . . . . 45

Subject Assignment . . . . . . . . . . . . 46

Treatment Conditions . . . . . . . 47

Instructor Selection and Training . . . . 48

Controls for Research Design . . . . . . . 49

Assessment Procedures . . . . . . . . . . 50

Statistical Analysis . . . . . . . . . . . 55

III. RESULTS . . . . . . . . . . . . . . . . . . . 57

Scale Construction . . . . . . . 57

Pretreatment Equivalence in Groups . . . . 61

Equivalence in Classroom Treatment . . . . 63

Tests of Hypotheses . . . . . . . . . . . 64

Post Hoc Analysis . . . . . . . . . . . . 67

Chapter Page
IV. DISCUSSION . . . . . . . . . . . . . . . . . . 73
Illustrations of Families EXperiencing
Great Life Changes . . . . . 75
Implications for Prenatal Education . . . 80
Limitations and Difficulties of This
Study . . . . . . . . . . 81
Statistical Limitations . . . . 82
Comparability of Treatment Groups . . 87
Design Difficulties . . . . . . 88
Extent and Timing of Treatment . . . . 89
Presentation of the New Program . . . 92
Discussion of Post Hoc Analyses . . . . . 94
Overview of Research . . . . . . . . . 100
Formulating the Problem . . . . . . . 100
Locating Subjects . . . . . . . . . 101
Designing the EXperiment . . . 103
Identifying Variables for Measurement. 104
Maintaining the Relationship with the
Sponsoring Organization . . . . . 106
Locating Funds . . . . . . . . . 108
Conducting the Treatment . . . . . . . 108
Collecting Data . . . . . . . . . . . 109
Analyzing Data . . . . . . . . 111
Suggestions for Future Research . . . . . 113
BIBLIOGRAPHY . . . . . . . . . . . . . . . . . 118
APPENDICES . . . . . . . . . . . . . . . . . . 124
APPENDIX A Introductory Letter 124
APPENDIX B Research Contract . 125
APPENDIX C Background Information 127
APPENDIX D - Course Content for T and E 128
APPENDIX E - Curriculum Workshop . 134
APPENDIX F Class Topic Checklist 136
APPENDIX C Instructor Evaluation Form 137
APPENDIX H Instructor Reports . . 138
APPENDIX I Questionnaires 139
APPENDIX J Interviewer Training 166
APPENDIX K Outline of Telephone
Interviews . . 168

vi

APPENDICES (Continued)

APPENDIX L

APPENDIX M
APPENDIX N

APPENDIX O

APPENDIX P

APPENDIX Q

APPENDIX R

Interscale Correlations

for Original Communication,
Decision-Making and Marital
Adjustment Sub-Scales Before
Creating Combined CDMA
Interscale Correlations at
Each Time of Observation .
Item Content for Scales

Scale Items' Reliabilities
and Correlations with Own

and Other Scales . . . . . . .
Summary of Alpha Coefficients
for Each Scale at Each
Observation . . . . . . . . .
Correlations Between Husbands'
and Wives' Scale Scores at
Each Time of Observation .
Regression Analysis Summary
Tables . . . . .

vii

Page

172
173
177
181

190

191
192

LIST OF TABLES

Table Page

1 Average g-Scores for Couples with
Complete Data . . . . . . . . . . . . . . . 68

viii

Figure

LIST OF FIGURES

Time Flow of EXperimental Procedures

Percentage of T and E Subjects Attending
Each Class Period . . . . . .

Average Z- Scores on Communication/
Decision-Making/Marital Adjustment
(CDMA) Scale for Couples with
Complete Data . . .

Average Spanier Dyadic Adjustment Scores

for All Data Collected at Each
Observation . . . . . .

ix

Page
44

65

85

86

CHAPTER ONE
INTRODUCTION

"I remember as a student I delivered a child to a
36-year—old woman. It was her first child
although she had been married for many years and
she expressed no joy in this. She was glad it
was over, she wished she could have had an
abortion. Would she like to know if the child
was all right? No. The next day I asked her how
she felt about things. She said she was stuck
with it. I remember this. It's been fifteen
years, but I still shudder to think of what's
happened to that child." (Silverman & Silverman,
1971. p- 24)

"From Tampa, Fla.: I am 40, my husband is 45.

We have two children under the age of eight. I
was an attractive, fulfilled career woman before
I had these kids. Now I'm an exhausted, nervous
wreck who misses her job and sees very little of
her husband. He's got a 'friend,’ I'm sure, and '
I don't blame him. Our children took all the
romance out of our marriage. I'm too tired for
sex, conversation or anything else. Sign me--Too
Late For Tears" (Ann Landers, 1976)

"And finally, one day it dawned on me that I
actually did feel guilty for having failed
completely as a mother. This sense of failure
seemed to invade every other aspect of my life.

I almost felt unsuccessful as a person. As soon
as I realized this, my spirits began to lift. Of
course I had failed-~I had set goals for myself
that were impossible to achieve...My preparation
had not been to eXpand my knowledge, but to plan
for a kind of 'fairy tale' existence." (Harrison,

1976)
Current literature abounds with reports of disappointed
parents. The implications of these unhappy parents for the

mental health of their children are sobering. In fact,

casual observation of community mental health programs

would indicate an increasing number of children and parents
seeking psychiatric help. Even more distressing is the
apparent shortage of mental health workers who are competent
to assist in such problems (Blau, 1969; Miller, Hampe,
Barrett & Noble, 1972). What can be done to alleviate this
condition?

Response to the situation can generally take one of
two forms--increase the number of mental health workers or
decrease the number of mentally ill through prevention.
Extensive training and use of paraprofessional mental
health workers is an example of the former reaction. While
such responses have been surprisingly effective (Carkhuff,
1968), they have the quality of the actions of the captain
of a leaky ship who stocks up on life preservers and
inflatable rafts before setting to sea.

Just as the ship captain might more effectively take
preventive action, the field of mental health might do
(well to inspect its theoretical framework for potential
mental health "leaks". Gerald Caplan (1961) has been a
leader in this area both by introducing the concept of
prevention on a wide scale and by investigating some of
the principles involved. The family is quickly becoming a
central focus of such discussions, both as an incubator for
mental distress and as a support system in times of stress.

The general focus of this study was the evaluation

and prevention of mental stress in young families. The

intervention was focused on the birth of the first child,

an easily pinpointed event.

Crisis Theory

In general, crisis has been described as an event in
a person's life which disrupts his/her usual equilibrium
and confronts him/her with a situation in which previous
coping behaviors are no longer adequate. Some of the
earliest work done in this area examined a person's reaction
to bereavement in disaster settings (Lindemann, 1944).

Not only would uneXpected events such as disasters
fall under the crisis heading; but according to definition,
any event for which the individual's usual coping behaviors
are no longer adequate could be termed a crisis. Accord-
ingly, some writers have eXplored the concept of development-
al crises occurring at significant change points in a
person's normal life eXperiences. For example, entry in
school for the five-year-old (or nursery school for the
three-year-old) is a life eXperience for which previous
habitual behaviors may no longer be adequate. Erickson
(1968) Spoke of this type of change when he said, "When the
human being, because of accidental or developmental shifts,
loses an essential wholeness, he restructures himself and
the world by taking recourse to what we may call totalism."
(p.81)

An important dynamic of such adjustments has been

illuminated by Parkes (1965) who, while studying 21

psychiatric patients who had lost a spouse within six
months of treatment, found that the intensity of grief
began to decline in one to six weeks and was minimal after
six months. This dynamic becomes crucial in the treatment
of people adjusting to crisis as it is during this time

of reorganization that a person is more anxious and open
to therapeutic intervention (Sifneos, 1972). Crisis
theory further asserts that the new coping behaviors
developed during this time of stress may result in better
or worse psychological adjustment than that which existed
before the crisis (Argles & Mackenzie, 1970).

Even more important, successful resolution of a crisis
has been seen as increasing an individual's coping ability
in later stressful situationse-not only has his/her self-
esteem been boosted, but his/her general ability to approach
a second crisis has been augmented by success (Parad &
Caplan, 1960; Caplan, 1961; Sheehy, 1976).

Eliot (1955) stated that if the problems created by a
crisis remain unsolved or become intensified, they are
likely to lead to maladjustment in the form of breakdown,
overt conflict or intermittent crisis situations. In his
opinion, successful resolution of these problems should
include (a) thorough catharsis, (b) acceptance of elements
beyond control, (c) relaxation of tensions, (d) reorientation
to new situation, (e) ability to use one's eXperiences as
fully as before the crisis and (f) re-establishment of

stable habits, self—control, etc.

These same individual crisis principles have been
applied to the family. Hill (1949) noted that within the
family structure itself (that is, ignoring other external
natural disasters or nationally imposed disasters, such as
war) there are three subtypes of crisis: (a) those of
accession (e.g., births), (b) those of dismemberment, and
(c) those characterized by demoralization (e.g., non-
support, infidelity, alcoholism, etc.). Hill (1965) further
refined his definition of crisis by Specifying three general
characteristics which interact to influence the outcome of
a crisis: (a) the stressful event, (b) the resources of the
family, and (c) the definition the family gives to the event,
i.e, do they define it as a threat. Hill described a crisis
as a disorganization in role patterns or a conflict over
ownership of roles. In family terms, this is comparable to
the earlier definition of crisis as a situation in which old
patterns of behavior (in the case of the family, "roles")
are no longer effective.

Once again, as in the case of individual crisis theory,
families can be seen as eXperiencing developmental crises.
Scherz (1969) has outlined these developmental points as
occurring: (a) with new marriage, (b) at birth of first
child, (c) at child's development of mobility (independence),
(d) at child's entrance in school, (e) during child's
adolescent identity struggle (see also Weiner, 1966),

(f) when children have all left home (see also Bruehl, 1971),

and (g) at old age.

Rappaport (1963) has looked at the tasks of early
marriage in great detail. She defined intrapersonal tasks,
such as preparing oneself for the new role of husband/wife
and accomodating patterns of gratification which have been
used premaritally to the new married patterns. She also
defined interpersonal activities, such as establishing
mutually satisfying patterns of dealing with outsiders and
dealing with decision-making.

Scherz attempted to define some of the tasks and
conflicts as emotional separation versus interdependence,
closeness or intimacy vs distance, and self-autonomy vs other
responsibility. Additionally, he defined some tasks as
specific to a given maturation point. For example, during
engagement and early marriage, both partners must develop
ways of separating from their original families and finding
new ways of remaining connected with the original family
without detracting from the new, beginning family.

Rappaport & Rappaport (1968) spoke more generally about
such transition periods. "...there is set up around each
of these major transition points a period of crucial flux
both within the individuals themselves and in the inter-
personal relationships. Previous patterns of behavior are
at least in part inappropriate to the new situation and new
patterns are called for. During the period of relative
'unorganization' which is inherent in these transitions,

there may emerge new patterns of social behavior which soon

become crystalized into relatively stable patterns; in
addition, individuals may review and have 'another chance'
at reorganizing their individual patterns of motivation,
perception, eXpression, defence and behavior in general.”
(p. 33) Note the similarity between these conditions and
the commonly accepted definition of crisis.

With regard to the potential adjustment to such
situations, Parkes (1971) made a similar statement.
Rejecting the terms "crisis" and "stress", he called such
events "psycho-social transitions" and defined them more
specifically as major changes which occur over a relatively
short period of time, are lasting in effect, and affect the
individual's "assumptive world" (that is, a person's
perceptions or eXpectations of his world). Parkes further
noted that such major transitions can affect all members of
the family and necessitate the restructuring of the family

unit.

Pregnancy as a Developmental Crisis

 

Let us now narrow our focus to the specific develop-
mental crisis of parenthood. Pregnancy, of course, is the
first step in this process of becoming a parent.

The effect of pregnancy on the mother has been an
area of intense focus. In 1951, Caplan reported the outcome
of small discussion groups for pregnant women. He noted

that eXpectant mothers seem to be more concerned with their

emotions and with emotional problems than at other times

in their lives. In later work Caplan (1961) observed that
pregnant women seemed more susceptible to stress. This
observation was made in light of pregnant women's responses
to psychological tests. He found that, much like the
adolescent test protocol, the normal protocol for a pregnant
'woman was indicative of psychosis, even for women who had
no previous history of mental health difficulties. In

such tests and the interviews which followed, expectant
mothers' dream-like fantasies increased while old conflicts
surfaced again. There seemed to be a weakening of external
supports to the ego, mood swings, changes in appetites
(including sexual), introversion and passivity, and changes
in ego-id equilibrium. Caplan hypothesized that these
changes might be caused by hormonal changes, role changes,
or social-economic worries. He further noted that shortly
after pregnancy, the seemingly psychotic material was
repressed and the mother not only returned to normal but
also forgot that she had eXperienced the stresses described
above. In this case, each subject was used as her own
control.

Along the same lines, Schwartz (1975) examined the
reactions of five social caseworkers who were experiencing
their first pregnancies. Several of these workers found
their pregnancy arousing conflicts and doubts that they had

not previously eXperienced. Although some of the conflicts

centered around loss of professional identity or the respons—
ibility of leaving clients, some of them involved simply
what was described as a younger, inexperienced feeling on

the part of the caseworker as she functioned in her job.

Wenner & Ohaneson (1967) used open-ended interviews
to study women's adjustment to their pregnancies. Fifty-two
women were seen weekly in a therapy-type setting. These
researchers noted that some women evidenced a loss of
emotional stability during their pregnancies. Motivation
for the pregnancy appeared to play a role in the degree of
disturbance eXperienced.

Colman & Colman (1973) reported observing a similar
change in pregnant women. They found their subjects to be
emotionally labile and inclined toward discussing sub-
jective eXperiences. The pregnant women further showed a
greater accessibility of dream material and a greater need
for reassurance. After birth the women were observed to
return to a more external orientation and normal behavior
in other aSpects. These researchers speculated that it is
logical for women to be internally oriented during preg-
nancy since they are likely to be acutely aware of inner
bodily changes.

All the above studies shared a common difficulty in
their lack of control groups of nonpregnant women with
which to compare the data generated. Perhaps just the

psychological focus in a therapeutic setting changed the

10

emotional vulnerability of the women under study. However;
the number of studies and commonalities in their findings
does lend informal support to the belief that pregnancy,
the first step in becoming a parent, is a time of emotional
stress for women.

While historically very little has been said about the
father's reaction to pregnancy, it is now receiving greater
attention. Certainly there are logical reasons for an
eXpectant father to be reacting to impending parenthood. On
a more superficial (and sexist) level, he may be reacting
with pride in his accomplishment. In addition, if his wife
is behaving in the manner indicated above, the husband is
forced to change his behavior to interact with her.

A number of studies support the above contention. Col-
man & Colman (1973) reported that although men usually do
not readily admit to their own emotional upheavals,
eXpectant fathers with whom they worked were indeed eXper-
iencing such disturbances in response to the pregnancy. In
interviewing 20 eXpectant fathers, Obrzut (1976) found 70%
initially eXpressing ambivalent feelings toward fatherhood.
An indication that at least some expectant fathers adapted
dysfunctionally is reported by Hartman and Nicolay (1966)
who found that within court cases examined at a psychiatric
clinic, eXpectant fathers were disproportionately represented
in the population of those who had committed sexual offenses,

particularly offenses of a regressive or acting—out nature.

11

EXpectant fathers find themselves faced with the possi-
bility of increased financial strain. Since our culture
defines this function of providing for the family as the
husband's role, such a strain could influence the father's
self-confidence. This may particularly be the case when a
working wife terminates her employment leaving the family
dependent on one income. One study of young, upwardly
mobile, eXpectant fathers by Bernstein & Cyr (1957)
concluded that only two-fifths of the 31 fathers interviewed
expressed open delight at the coming birth. The remainder
felt only resigned to the birth or somewhat unhappy about
it. The dissatisfaction was particularly related to timing
and financial strain. In our present society, one wonders
if it is indeed possible to be financially prepared for
raising a child. In 1971 the average middle-class family
could eXpect to spend $25-30,000 (excluding college education)
in raising each of its children (Silverman & Silverman, 1971).
Current projections are undoubtedly higher.

A study of 60 primiparae and their husbands was
undertaken by Liebenberg (1967). His subjects were a
relatively homogeneous group of middle class, college-
educated parents. He noted that his normal fathers displayed
some degree of personality disturbances such as exagger-
ated dependency, acting-out, reactivation of unresolved
parental problems, somatic symptons, and sexual disturbances.

That researcher was impressed with the husbands' ability to

12

use a counselor for support and insight during the preg-
nancy period. He also noted that the husbands' participation
in counseling almost uniformly facilitated communication

and closeness between husband and wife.

Certainly any father who is already eXperiencing
psychological instability is more likely to be sensitive to
the potential, perhaps unconscious, conflicts his child's
birth may involve. Curtis (1955) verified such a reaction
in three groups of military men where each group had
experienced a different degree of psychological adjustment
prior to pregnancy. In those cases, the added stress of the
change in life may have increased the father's current
psychological problems.

LaCoursiere (1972) focused discussion on the dependency
needs of the husband. As the wife withdraws her attention
and focuses on herself, her fetus, and finally the baby,
the husband is hypothesized to lose her attention. Thus,
the husband, particularly if his own dependency needs were
met inadequately in childhood and he has sought their
fulfillment in the marital relationship, may eXperience
frustration and anger toward his wife and/or child. Freeman
(1961) has observed this dimension of hostility in eXpectant
fathers. If this reaction causes guilt in the father,
depression may ensue. Whether such feelings are repressed
or eXpressed, they would create difficulties for the new

father.

13

Further support of the increased stress on eXpectant
fathers can be found in the incidence of violence during
pregnancy. Gelles (1974 & 1975) reported an exploratory
study in which, of 80 families interviewed, 55% reported
at least one incident of the husband's acting violently
toward his wife. Nearly one-quarter of these violent
episodes occurred while the wife was pregnant. Interviews
with the women who eXperienced beating during pregnancy
implicated the husband's sexual frustration, the stress of
family transition and changes in activities, biochemical
changes in the wife predisposing her to be more critical or
depressed, and the defenselessness of the wife as possible
triggers for the violence.

In a lighter vein, husbands' indentification with the
pregnant wife is obvidus in some of the so-called "primitive"
customs of couvade. In its simplest form, couvade consists
of the father reacting to his child's delivery by either
experiencing the labor symptoms or by secluding himself
for a short time after his child's birth and restricting his
diet almost as if he were giving birth. It is possible that
modern man has not given up couvade but'has merely become
more sophisticated in his expression of it. In fact,
incidence of this phenomenon has been found by some
researchers (quoted in Panter & Linde, 1975) to be as high
as 20%. Several authors (Hartman & Nicolay, 1966; La-

Coursiere, 1972; Trethowan & Conlan, 1965; and Trethowan,

14

1968) have observed the occurrence of physical symptoms

in eXpectant fathers which resemble those of the pregnant
woman. They noted loss of appetite, nausea, gastrointes—
tinal symptoms, and vomiting. Toothaches have also been
noted to be unusually prevalent in eXpectant fathers. More
unusual and quite uncontrolled observations of an eye
specialist (Inman, 1941) and a psychotherapist (Abenheimer,
1946) related specific eye disorders, particularly styes
and tarsal cysts, to what was termed an "unusual preoccupa-
tion with birth". Trethowan, using a sample of 548
expectant and noneXpectant fathers, observed that symptoms
peak during the third and ninth month of pregnancy. He
further described a correlation between these symptoms and
anxiety about the wife's pregnancy.

Hott (1976) partially supported her view of the
sequence of problems eXperienced by expectant fathers by
turning to popular music. She noted a succession of Paul
Anka's recent hits, beginning with "You're Having My Baby",
proceeding to "You're a One-Man Woman and I'm a Two-Timing
Man", and ending in "I Don't Like to Sleep Alone".

Our poor eXpectant fathers are thus seen as the
battleground for untold conflicts which they nobly bear in

silence--and maybe even in ignorance.

Parenthood as a Developmental Crisis

 

But how about parenthood itself? Can it be legitimately

called a crisis for married couples? This is a subject of

15

many conflicting views. First this report will examine the
literature supporting the crisis viewpoint and then the
objections to it.

In 1957, LeMasters published some of the first
empirical data exploring the effect of a child's birth on
parents. Forty—six primiparous parents with children under
five years-old were interviewed using a rather unstructured
approach. The parents were restricted to middle-class
couples between the ages of 25 and 35. No control group was
employed. Interview datawere collected to indicate degree
of crisis as none, slight, moderate, extensive, or severe.
(The rating was arrived at by agreement between the parent
and the interviewer.) Crisis was defined as any "sharp or
decisive change for which old patterns are inadequate."
Eighty-three percent of LeMasters' new parents reported 5
extensive or severe crisis in adjusting to the first child.
They observed that extensive or severe crisis eXperience
was the norm for the sample. They further noted that these
couples did not have a history of maladjustment. All 38
couples reporting a large degree of crisis did appear to
have romanticized views of parenthood and felt that they
had little, if any, preparation for parental roles. Some
of the mothers interviewed were actually bitter about their
lack of training.

LeMasters eXplained his results by pointing out several

possible factors: (a) parenthood may be the real "romantic

complex" in our society; (b) adolescents are not prepared

16

in any formal way for parenthood; (c) there is increased
complexity in a triad as opposed to a dyad; and (d)
parenthood may mark the final transition to adulthood.
LeMasters concluded that even when the final adjustment to
parenthood is healthy, as in nearly all the cases he studied,
parents are confronted with a crisis upon the birth of

their first child.

A major limitation of the LeMasters' study was its
lack of a control group. Perhaps childless couples between
25 and 35 Years of age also experience a sense of re—organi-
zation and adjustment but are forced to find something other
than a child to blame it on. Recent observations by
Sheehy (1976) have indicated that developmental crises occur
in general during this age group.

Next, only a general restriction was placed on the age
of the first child at the time of the parental interview.
The child could have been as old as 5 years allowing many
intervening variables other than childbirth to have affected
the parents' responses.

Furthermore, the sample was obtained by informally
identifying new parents rather than by attempting to
obtain a representative cross section. Perhaps those parents
who most readily agreed to be interviewed were those who
experienced more problems, or perhaps those parents most
readily identified informally were those having trouble with

their young child.

17

Finally, in the joint assessment of degree of crisis,'
parents could have been cued by interviewers‘ eXpectations
that childbirth caused crisis.

In 1963, Dyer published results of a second study
which further supported LeMasters' positon of crisis at
.parenthood. Again Dyer limited his sample to middle-class,
unbroken marriages. His couples were contacted within two
years of the birth of their child. Thirty-two couples were
polled with separate questionnaires administered to both
husband and wife. A Likert—type scale was devised to
measure the extent to which a child's arrival constituted
a crisis in the following areas of family life: (a) husband-
wife division of labor, (b) husband-wife division of
authority, (c) husband-wife companionship patterns, (d)
family income and finances, (e) home-making and house-work,
(f) social life and recreational patterns, (g) husband and
wife mobility and freedom of action, (h) child-care and
rearing, (1) health of husband, wife, and child, and (j)
extra-family interests and activities. Dyer reported the
following distribution of crisis scores for the couples
studied: No crisis--none; Slight crisis--9%; Moderate
crisis--38%; Extensive crisis-—28%; and Severe crisis--25%.
While this distribution was more moderate than the one
LeMasters found, it essentially did support the belief that
couples eXperience crisis upon the birth of a child.

Dyer's research can be criticized along similar lines

to those applying to leMasters‘ findings. Improvements were

18

made in limiting the age of the oldest child. Also by
presenting a more Specific focus on ten areas of family
life, the couples' responses would have been less easily
influenced by a "halo" effect or by interviewer bias and
expectation. Again, the method of obtaining a sample was
questionable since community residents were simply asked to
supply the names of first-time parents.

On the other hand, while the samples in the two studies
above may not have been representative, they did indicate
the existence in typical communities of couples eXperiencing
stress with the advent of a child. It is the extent of
these feelings in the general population which can most
easily be questioned.

Unpublished work by Feldman (1965) compared couples
with children to couples without children. Feldman found
childbearing couples: (a) displaying significantly less
verbal communication with each other, (b) talking about
children more than about themselves or their relationship,
(0) feeling less close to each other as a result of conver-
sations, (d) having lower marital satisfaction, (e) having
a higher value of marriage, (f) having less marital inter-
actions, and (g) being more responsive to conflict.

Later, Feldman (1971) examined middle-and upper-
middle class couples in both a cross-sectional and a
short-term longitudinal study. In both approaches, repre-

sentative samples of urban couples were used. First, in a

19

cross-sectional approach, Feldman studied the changes in
marital satisfaction and other variables over the life cycle.
He found a curvilinear relationship with high happiness

or satisfaction occurring in the early years of marriage
and in later years after childrearing and with low points
being when the last child began school and when the family
had teenagers. In the same cross-sectional study, compari-
sons were made between those couples who had a child in the
home and those who never had children. Those with children
had a significantly lower level of marital satisfaction
than those without, even though there was no statistical
difference in the length of marriage for the two groups.
This surprise finding led the author to undertake a more
detailed longitudinal study of the effects of becoming
parents on a marriage.

Feldman compared three groups of married couples over
anine-month period. The main study group was composed of
primiparous couples. A control group was composed of couples
withoutchildren and a third group, to test for the effects
of replication of parenthood, included couples having
their second child. Measurements occurred at 5 months
prepartum and 5 weeks and 5 months postpartum. The following
findings arose from that study: (a) While the majority of
couples decreased in satisfaction upon the birth of their
child, some couples, particularly those with a differenti-

ated marital relationship rather than a companionate one,

20

did increase their marital satisfaction. (b) In those
marriages with improved satisfaction as a result of
childbearing, the mother's attitude emerged as important

in that high maternalism and/or high eXpectation on the
mother's part that her husband would take part in many of
the child-rearing tasks were positively related to increase
in satisfaction. (0) A negative attitude toward pregnancy
was related to a positive shift in satisfaction after the
birth of the child. (d) Both primipara and multipara
eXperienced the crisis of parenthood with multipara
demonstrating an even greater negative effect. (e) The
changes related to children werelowered marital satisfaction,
perceived negative personality change in both partners, less
satisfaction with home, more instrumental conversation,
more child-centered concern, more warmth towards the child,
and lower sexual satisfaction. (f) Consensus between
husband and wife on child-rearing attitudes was signifi-
cantly related to marital satisfaction (as compared with
consensus on wife's career orientation). All the above
findings are supportive of the viewpoint that becoming a
parent puts strain on the marital relationship and may be
viewed as a crisis.

Finally, Rollins and Feldman (1970) reported their
review of the research involving marital satisfaction over
the family life cycle. Although their study examined
variables over the entire family life, several interesting

findings emerged. In general, while husbands appeared to

21

be less affected by stage of life in their subjective
evaluation of marital satisfaction, wives reported a sub-
stantial decrease in general marital satisfaction and a
high level of negative feelings related to marital inter-
action during the child-rearing and childbearing stages of
the family. Thus, for whatever reason, wives became signi-
ficantly dissatisfied beginning in the childbearing portion
of their lives. Whether this dissatisfaction could be
directly attributed to the birth of children or not, the
dissatisfaction did coincide with the presence of children
and was likely to be subjectively attributed to the
children by their mothers.

The group of studies by Feldman corrected some of the
deficiences discussed in earlier research. First, control
groups entered the picture allowing more conclusive data to
be obtained. Next, additional variables, such as style of
marriage and maternal attitudes were pinpointed as affecting
the couples' adjustment. Some of these variables were even
associated with increases in satisfaction. And finally,
results were confirmed in both cross—sectional and short-term
longitudinal studies.

Several studies of the relationship between marital
satisfaction and number of children have been done. Hurley
and Palonen (1967) were the first'u:study this relationship.
They defined a factor called child density as the number

of living children divided by the number of years married.

22

In a sample of 40 university student couples, they found a-
significant inverse relationship between child density and
quality of the marital relationship. Thus, the higher the
ratio of children to years married, the lower the marital
satisfaction. These findings were incidentally replicated
by Tinker (1972) who found a -.35 correlation between child
density and marital satisfaction. It should be noted that
these studies were confined to university couples who had
been married an average of less than six years.

Figley (1973) attempted to replicate the above results
on a sample which included couples at all stages of family
life cycle. Using two measures of marital satisfaction, he
concluded that there was no significant relationship between
child density and satisfaction. However, Figley did note:
(a) a dramatic decrease in marital adjustment and communi-
cation occurring during the child-rearing period and (b) a
low point reached just before launching children.

Finally, Miller (1975), intrigued by these conflicting
results, broke child density into its component parts of
total number of children, number of children in the home and
years married in an attempt to see if any of these factors,
plus child density and child spacing, could be seen to
relate to satisfaction. Miller used both a Likert-type
marital satisfaction scale and a conventionalization or
social desirability scale. He again included couples at all

stages of the life cycle. While Miller found no relationship

23

between child density and marital satisfaction, he did find

a significant negative correlation between child density

and social desirability. In his words, "perceived perfection
in mates and marriages decreases as child density increases"

(p. 347). One might say that marital "romanticims" had been
affected by increased numbers of children.

Ryder (1973), using a longitudinal approach toward a
sample of newly-married couples, examined the differences
between childless and childbearing couples after one to
three years of marriage. He found that wives with children,
as compared those without, were significantly more likely
to report that their husbands did not pay enough attention
to them. After correcting his data for skew, Ryder found
that child-rearing husbands were also significantly more
likely to make this complaint and that childbearing wives
also felt significantly more marital dissatisfaction than
those without children.

While the above studies all contribute some partial
support for the belief that the marriage relationship can
be adversely affected by the presence of children, there
are in addition a number of somewhat contradictory findings
which are reported below.

Hobbs (1965) was the first to raise questions about
LeMasters' and Dyer's research. His research had several
stated objectives: (a) to discover if LeMasters' findings

would generalize to a probability sample of first-time

24

parents, (b) to search for variables which were predictive-
of difficult adjustment to birth of a child and (c) to
perform some preliminary work on the measurement of crisis.
Hobbs used questionnaires to investigate a 50% random sample
of white, urban, first-time parents located through public
health records in Greensboro, North Carolina. Usable
questionnaires were obtained from 65% of this sample.
Babies' ages ranged from 3 to 18 weeks. Crisis was measured
by a checklist of 23 items to which aparent could respond
"none, somewhat, or very much bothered by" this item.

Crisis was defined as the total extent of ”bother" reported.
Mothers' crisis scores were significantly higher than
fathers'; however, there was no significant correlation
between husbands' and wives' scores. All in all, Hobbs
reported 86.8% eXperiencing "moderate" crisis. (All 13
persons with college degrees in this study fell in the slight
crisis classification.) Using some obscure manipulation of
his data, i.e., somehow classifying his parents into a
slight-moderate and an extensive-severe group, Hobbs
identified four variables which appeared to be related
significantly to the degree of crisis eXperienced. First,
as family income increased, there were fewer fathers in

the extensive-severe category. Second, mothers' crisis
scores were related curvilinearly to income with low and
high income mothers eXperiencing significantly more crisis

related to the birth. Next, when babies were ill, there

25

were more fathers in the extensive-severe group. Finally,-
when mothers had extra help in the home (other than self
and husband), there were five times as many in the extensive-
severe category as in the slight-moderate. Hobbs concluded
that a clearer definition of crisis must be developed. He
also suggested a semi-longitudial follow-up of couples after
the birth along with clearer assessment of the character-
istics of the couple prior to the birth.

In a later study using both interviews and a checklist,
Hobbs (1968) found essentially the same extent of crisis
as with the checklist approach in his previous study. The
interview approach, however, resulted in a more even
distribution of subjects across the none, slight and
moderate categories with 3.7% of the fathers and 18.5% of
the mothers reporting a severe crisis. As a result of
this study, Hobbs concluded that the techniques of data
collection used may be a critical factor in research
findings. He furthermore concluded that "On the basis of
the present investigation, it would seem more accurate to
view the addition of a first child to the marriage as a
period of transition which is somewhat stressful than to
conceptualize beginning parenthood as a crisis for the
majority of new parents" (p.417). Thus, Hobbs did not
disagree that there is stress in becoming a parent but
rather was doubtful as to the magnitude of the stress.

In 1974, Russell attempted to clarify some of the

above contradictions through further research. Sampling

26

20% of all Minneapolis city residents experiencing legiti--
mate births during a one year period, she succeeded in
obtaining a response rate of 57.9% of the mothers and
53.4% of the fathers. A questionnaire consisting of Hobbs'
checklist of degree of "bother" plus an additional checklist
,aimed at pinpointing gratifications of parenthood was used.
Russell focused much of her work on these gratifications.
She found education and occupation prestige to be inversely
related to gratification scores of parents. Placing mother
and father roles high on a list of identities was positively
related to gratification. (This result could be eXplained
by the possibility that fathers who took the time to prepare
for parenthood had higher eXpectations for the gratifications
of fatherhood and therefore worked harder at gaining
jpositive emotional eXperiences with their children.) She
also found that only 7.5% of the women and 5.5% of the men
felt their marital relationship had deteriorated since the
baby's birth, although, of the items checked for gratifica-
tion, the source of the pleasure was more likely to be a
personal one rather than benefits to the husband-wife
relationship.

She noted that interview techniques generally seemed
to result in a higher degree of reported crisis, her
eXplanation being that responses to a questionnaire may
underrepresent those eXperiencing more stress who tend not

to return their questionnaires. Russell speculated that

 

27

effective communication partially underlies the negative
relationship found between crisis and the variables of
marital adjustment, planned pregnancy and conception after
marriage.

Meyerowitz and Feldman (1966) used a short-term
longitudinal approach to investigate the reactions of 400
primiparous couples. Couples were interviewed during the
fifth month of pregnancy, at five weeks after delivery and
at five months after delivery. Results were reported
descriptively. During pregnancy, a general decline in
marital satisfaction, more pronounced for the wife, was
noted. One month after delivery, couples described their
relationship during pregnancy as a low point not to be
matched again. When the child was 5 months old, couples
'reported their marital satisfaction to be higher than
pre—pregnancy levels, but they anticipated the beginning of
a steady decline in satisfaction. In contrast to this
verbally expressed satisfaction, the mean percentage of time
the couples reported "things are going well" dropped V
steadily over the three interviews from 85% to 65%. Further-
more, with the arrival of the child, disagreement over
child-rearing decreased while there was an increase in
complaints related to the marital relationship, i.e.,
sexual incompatibility, inability to express feelings to
the spouse, unshared leisure time and inability to discuss

the husband's work. Thus, when asked directly how the baby

 
 
 

28

had affected them, respondents generally agreed that the
baby improved the marital relationship, but the responses
to more Specific questions did not seem to support this
belief. These findings, of course, raised the question of
how honest couples feel they can be when asked a straight-
forward question about how childbearing affects a marriage.
Implicit societal norms would certainly dictate that having
children should enhance the marital relationship although
they don't say how. Therefore, the couples above perhaps
dutifully stated that children had enhanced their marriages
while their responses to more specific questions indicated

a decline in satisfaction.

A Sociological View of the Discrgpancies

The discrepancies in research could be attributed to
a number of variables. The researchers themselves (Hobbs,
1965; and Russell, 1974) have pointed to factors such as
the difference in samples studied, age of child at time of
study and research techniques. Further culprits were
hypothesized to be the definition of crisis, the lack of
control over history and the gratifications of parenthood
which may outweigh the stresses reported. This writer
favors a more sociological eXplanation, i.e., that the
eXperience of parenthood is greatly affected by social class.

As early as 1952, Winch stated that the American

middle-class suffers the greatest penalties for parenthood.

29

The economic drain and time constraints of children may
limit participation by parents in social and work activities
which sometimes facilitate upward mobility. Middle-class
parents are likely to believe that some advantages are
necessary for their children, e.g., perfectly straight
teeth or eXpensive educational toys and to worry unduly
when these are not available.

Parents today are surrounded by messages that they
are totally responsible for their children's mental health
and growth. Yet, the beliefs about effective child-rearing
have changed rapidly, leaving parents with a confusing
array of possibilities, most of which conflict with the
style in which their own parents raised them.

One general observation which can be made is that
those studies reporting higher crisis scores and greater
declines in satisfaction (Dyer, 1963; Feldman, 1971; and
LeMasters, 1971) have included upper-middle and middle-class
couples, while researchers who were careful to examine
representative cross sections in urban areas (Hobbs, 1965;
and Russell, 1974) found less crisis or conflicting
information.

Jacoby (1969) examined the differences between
parenting in a middle-class as opposed to a working—class
setting. First, middle-class standards were described as
higher, causing parents to see themselves with more responsi-
bilities for their child's mental and physical well-being.

This same predicament was also noted by LeMasters (1970).

30

Second, Jacoby hypothesized that working-class mothers
placed greater value on having children as their major
source of self-validation. Middle-class women were seen
as more likely to receive primary gratifications from their
jobs. This could be true for both parents in light of
Russell's (1974) findings that education and occupational
prestige were inversely related to gratification in parent-
hood. Related to this hypothesis, the professional careers
of middle-class parents were more likely to be disrupted
by the arrival of a child (even if that only meant less
sleep and poorer ability to function), thereby disrupting
the usual source of self-esteem for these parents.

Next, the middle-class husband-wife relationship was
hypothesized to be more strongly established as affectively
positive at time of birth. This was attributed to different
eXpectations of what a marriage should be and also to the
fact that middle-class couples tend to bear children later
in life, thus allowing their relationship more time to
establish itself as a dyad prior to birth of a child.

An additional possibility was that working-class
mothers have had more eXposure to the care of young children
(as they came from larger families) and are more comfortable
and more realistic about parenthood.

And, finally, Jacoby asserted that the subjects may
not have been totally honest in their responses. Possibly

the working-class parents felt they would be admitting to

31

weakness if they shared concerns about adjustment;
possibly they were more committed to socially desirable
responses. Or, perhaps they did not understand the goals
of the researchers as clearly as their middle-class
counterparts who might have been more prone to cooperate with
the researchers' eXpectations.

In any case, the sociological differences noted above
appear to this writer to be the most comprehensive and

logical explanation for conflicting research results.

A Parting Shot

The question still remains even after the many
investigations within the last few decades, is parenthood
a crisis in the family life cycle? Even with the conflicts
in research, a very strong case for the incidence of added
stress during pregnancy and early parenthood can be made.

A number of authors have noted that the birth of a
child can sometimes trigger mental illness for the father
(Freeman, 1961; Ginath, 1974; Jarvis, 1962; and Wainwright,
1966). Stress was hypothesized to relate to a number of
possible factors. Ginath noted the possibility of the
occurrence of rivalry with the child, fear of incest,
replays of infantile conflicts, or a narcissistic eXpectancy
for the child to fulfill the father's frustrated dreams. He
further pointed out the significance of parenthood as

a maturational factor. Wainwright (1966) included some of

32

the above factors and added preoccupation with financial
responsibility and homosexual fears and fantasies.

In women, evidence has also been found for increased
stress with childbearing. Pugh, gt. gl., (1963) studied
the rate of admission to a state mental hospital for women
in relation to their reproductive status. They found the
rate of first admissions for women who (a) were pregnant,
(b) had delivered a child within 279 days, or (c) were both
pregnant and recently delivered to be higher than expected.
Results bordered on significance. When only first admissions
for psychotic reactions were examined, the difference in
admission rates for women eXperiencing pregnancy or
recent motherhood became significantly greater than eXpected.
The researchers noted that the highest risk appeared to
be during the first three postpartum months. I

Zemlick and Watson (1953) reported on mothers'
attitudes during pregnancy, delivery and six weeks after.
A general conclusion they drew was that mothers who reported
an extremely accepting attitude during pregnancy may have
been repressing true feelings. Their implication was that
normal feelings for a mother or eXpectant mother may be
viewed as socially unacceptable. To the extent that those
feelings had been repressed somatic disturbances during
pregnancy may have been exacerbated. After birth, these
feelings may have expressed themselves in over-protection

and anxiety. 0n the other hand, Zemlick and Watson saw

33

mothers who expressed attitudes of rejection toward
pregnancy and motherhood as being more likely to meet
clinical criteria of good prenatal and parturient adjustment.
Of course, one does not know what criteria were used Clin-
ically to determine adjustment, and one would also assume
that the rejecting attitudes of these mothers were of a
slight or moderate degree and not extreme.

If marital disagreements or conflicts are viewed as
stressful, then findings that college student parents
ranked care and discipline of children next to sex among
those problems on which they had failed to reach satisfactory
adjustments (Landis & Landis, 1948) are deserving of
attention. For couples married younger than those mentioned
above, similar findings were noted. The most frequent
conflict involved one parent seeing the other as giving in
too easily while the latter judged the former as too strict.
Also noted was the countermanding of one spouse's order by
the other.

The above observations would lend support to the
premise that parenthood is indeed a crisis-like period for
beginners. Added to those observations are a number of
informally gathered reports.

In contacts with mental health workers, this writer has
elicited case examples of increased psychological difficul-
ties coinciding with pregnancy and birth. Informal polling

of colleagues led one clinician to conclude'Uuit, of the

34

cases seen for marital counseling in the small community
health clinic where she worked, a large proportion of
couples pinpointed the emergence of their marital diffi-
culties near the time of a child's birth.

In informal contacts with this writer, nurse educators
in the Lansing area expressed doubts that their training
really provided a parent with any better tools for
adjusting after the baby arrived. Although the classes
may have attempted to inform the parents of possible
stressors, the information was usually presented in lecture
format with a grin-and—bear-it attitude that would have
prevented internalization and effective planning. Few, if
any, programs have aimed at helping parents internalize more
emotional material or at teaching skills or techniques for
dealing with the problems that may arise. For example,

one commonly used film While You're Waiting (The Mott

 

Foundation, 1967) depicted a couple moving through their
pregnancy. The film did not idealize pregnancy and
realistically presented the couple misperceiving each
other's intentions and feelings. A usualclassroom reaction
was for couples to chuckle at the miscommunication and for
instructors to admonish the couples to "talk to each other".
However, there was no classroom discussion of how to
communicate effectively. In the face of this void, more
progressive and clinically oriented educators have begun
recognizing new parents' emotional needs and searching for

ways to meet them.

35

Expectant parents themselves have left prenatal parent
education classes wondering if they were really prepared
for parenthood. They have often felt doubtful that any
class could prepare them. New parents, when approached in
a supportive, empathic way, were quite aware of the added
stress and responsibility they were facing and of the fact
that their lives were disrupted by the new family member.
Frequently a period of loss of contact and communication
between the parents was described. Even for parents who
appeared to be making a satisfactory adjustment, the general
attitude was often one of "We had no idea it would be like
this!"

Popular literature has reflected this emerging concern.
There has been an increase in articles dealing with the
effect of children on family relationships. Two recent
articles which have occurred are "Now That You've Had Your
Baby: How to handle relationships with your husband,
parents, and in-laws" (Panter & Linde, 1975) and "How Much
Should a First Baby Change a Marriage?” (Spock, 1976).

Informal reports, such as the ones above, again go no
further to "prove" the existence of a parental crisis.
However, without debating that issue further, it is easy to
find acceptance of the necessity of role changes associated
with beginning parenthood. The new roles are highly
unlikely to have been eXperienced in the recent past by the

first—time parent except in cases where caring for younger

36

brothers and sisters has occurred. Simply by virtue of
the fact that the role is new and unpracticed, parents
would be eXpected to experience initial difficulty with it.
The added possibility that the actual nature of the role is
uneXpected and may even directly contradict romanticized
eXpectations of parenting compounds the situation. Role
changes are frequently accompanied by anxiety about per-
formance of the role. The inherent stress, whether to a
lesser or greater extent, is obvious in a casual examination
of the situation.

The situation was nicely summed up by Bernstein and
Cyr (1957): "Although many of these problems can no
doubt be considered 'normal' and eventually self-adjusting,
and are frequently mitigated by deep feelings of satisfaction
in parenthood, the arrival of a baby can nevertheless set
tensions in motion in the mother and father, separately or
in relation to each other, which can have serious consequences

for the new family." (p. 479)

Education and Preventive Mental Health
Up to this point, information supporting the existence
of increased stress in families associated with the birth
of a child has been presented. The focus of this study,
however, was an investigation of prenatal parent education
as a potential tool for reducing this family stress. Let us

turn to a review of the effectiveness of education in

reducing the difficulties associated with becoming a parent.

37

The nursing profession has usually assumed the role of
educating eXpectant parents. In general, the rationale
behind the approaches used in many prenatal classes has
been to provide information aimed at reducing the usual
fear of the unknown found in a new situation. Such informa-
tion has aimed at a re-definition of labor and delivery and
a concurrent change to a more positive, less anxiety-ridden
attitude on the part of the couple. It has also involved
Specific training in techniques or tools to be used during

the birth process. The Miracle 9: Birth (Brigham Young

 

University, 1974), another parent education film, summed
the approach up by enumerating the importance of: (a)
realistic eXpectations, (b) positive attitudes and (c)
supportive techniques.

Until recently, prenatal education has focused on
medical information and training for labor and delivery.
Three typical approaches have been used as tools or
supportive techniques: (a) hypnotic pain control, (b) the
Read method which involves relaxation and (c) the psycho-
prophylactic method (commonly referred to as LaMaze) which
involves focusing attention by maintaining an active role
in the birth process. A representative research finding of
Ithe efficacy of the approaches has been presented by Huttel
(1972), who compared 31 primiparous mothers who had
received training in a modified LaMaze approach with 41

control mothers who had received no training. Prepared

38

women required significantly less medication and were
judged by hospital staff to demonstrate more self-control
during labor and delivery.

Chertok (1967), after an extensive review of the
literature on the subject, concluded, "At the present time,
the advantages of prepared confinement are no longer a
matter for doubt. These advantages are of two kinds:

(a) those concerned with the mental health of the expectant
mother and (b) those concerned with supressing pain in
childbirth" (p. 705). Recently the mental health aspect
has been receiving increasing support. Wueger (1976) noted
the importance of pregnancy as a starting point for dis-
cussing eXpectations, desires and feelings about parenthood.
Hott (1976) also supported the belief that eXpectant parent
classes should begin to include more about feelings and
parenting.

Education has been seen as a helpful tool in other
family settings. For example, Thomas, Chess, and Birch
(1968) reported a high degree of success in informing
parents (and when possible the child himself) about specific
temperamental characteristics of the child and methods of
dealing effectively with those characteristics. Such
information helped parents modify their behavior so that it
did not contribute to an escalation of problems.

Along similar lines, Shapiro (1956) reported success in

modifying parental attitudes toward children by exposing

39

parents to a series of discussion-type meetings. The more-
sessions parents attended, the greater was their attitude
change as reflected in questionnaire scores. Of course,
those parents who were motivated enough to attend may have
been examining their attitudes already and may have changed
whether eXposed to the class or not.

In the past, our culture has tended to place a high
value on education. Prominent presidents have been portrayed
diligently studying their lessons by firelight. Education
may be losing its favored place, though. The current trend
toward teacher accountability may be one indication of a
disillusionment in the heretofore unquestionned influence
of education. Furthermore, the successful approaches
described in the brief review of education above were
surely matched, in actual practice.by unpublished failures.
Therefore, the above review probably overstated education's
efficacy in precipitating change. However, education still
may be a potential vehicle for change with which many
people might be positively impacted at a low cost and in a
relatively short period of time. Therefore, it was considered
deserving of continuing investigation in the present
research.

This study then proposed to modify expectant parent
education in an attempt to help parents better deal with

the effects of a new baby on family members and relationships.

Through the course, greater emphasis was placed on the

 

40

emotional impact of pregnancy for each of the parents as
well as its impact on their relationship. Information
about general effects of a baby on the marital relationship
(previously unknown to couples or perhaps even misrepre-
sented) was discussed. Further input included suggestions
for dealing with the predicted changes. Specific communi-
cation and decisionamaking skills were presented within

the context of pregnancy. Also included was sexuality, a
subject which, according to Clark (1974), has remained a
major concern for expectant and new parents.

The question became whether knowledge plus specific
tools presented in the brief format of eXpectant parent
training could be effectively utilized by parents during the
critical adjustment period after birth. The hope of this
research was summed up by Parkes (1971) in his discussion
of psycho-social transitions: "...there is the possibility
that adequate advance planning, preparation and training
can transform what is potentially a major change...into

quite a minor transition." (p. 113)

Hypotheses

 

Hypothesis One: Psychological, relationship-oriented,
prenatal education (E) was predicted to facilitate better
postbirth marital adjustment than more traditional, medi-
cally oriented prenatal education (T). Adjustment was

measured through the Spanier Dyadic Adjustment Scale and

self-report questionnaire items.

41

Hypothesis Two: Psychological, relationship—oriented,
prenatal education (E) was eXpected to affect couples'
postbirth decision-making process more positively than a
more traditional, medically oriented education (T). Positive
decision-making was measured through self-report of the
occurrence of significantly more mutual decisions, as

opposed to decisions made by only one partner, and of

significantly higher satisfaction with family decisions.

Hypothesis Three: Psychological, family—oriented, prenatal
education (E) was predicted to more positively enhance the
communication patterns of new parents than traditional,
medically oriented prenatal education (T). Communication
patterns were measured through self-report on questionnaires
tapping the frequency of discussions between spouses, the
satisfaction of the Spouses with that communication, and

evidence of specific times set aside for discussion.

Hypothesis Four: Psychological, relationship-oriented,
prenatal education (E), as opposed to more traditional
prenatal education (T), was eXpected to positively affect
beginning parents' perceptions of the extent of crisis and
of their adjustment to it. These data were collected
through questionnaire items which tapped the responents'
perceptions of their confidence and general satisfaction

after birth as compared to before the birth.

42

Hypothesis Five: Psychological relationship-oriented,
prenatal education (E), as compared to traditional, more
medically oriented education (T), was expected to reduce the
degree of discrepancy between how couples thought their new
family life should be and how it actually was. Such
discrepancies in attitudes toward children have been found
to be related to the child's later psychological adjustment
(Broussard & Hartner, 1970; and Broussard, 1975). The
research questionnaire tapped such discrepancies in parents’
perceptions of the disruptiveness of the child and also in

the Spouses' perceived participation in child care.

Hypothesis Six: Psychological, relationship-oriented,
prenatal education (E) was eXpected to enhance couples'
postbirth sexual adjustment more than traditional, medically
oriented prenatal education. E education provided
information about potential sexual difficulties following
birth along with suggestions for coping with them.
Questionnaire items tapped subjects' own satisfaction with
sexual relations and their perceptions of the spouses'

satisfaction.

CHAPTER II

METHODOLOGY

Overview

Two forms of education were presented to groups of
eXpectant parents who had sought training. One form (T)
encompassed the physical aspects of pregnancy and birth
which have been traditionally covered in such classes;
the other form (E) augmented the traditional information
with additional information and skills aimed at facili—
tating the psychological adjustment of new parents.

Subjects were couples who independently completed
questionnaires and were also interviewed by telephone on
two or three occasions. One-half of the couples eXperienc—
ing each form of education were pretested (with an interview
and questionnaire) prior to attending eXpectant parent
classes. All subjects were asseSsed 4-8 weeks postpartum
and again 1 year after the birth (see Figure 1 for time
flow).

Thus, the design was a Solomon Four-Group Design, as
described by Campbell and Stanley (1963), in which the
"control" group received a treatment composed of traditional
eXpectant parent education as opposed to the revised educa-

tion received by the eXperimental group. The advantage of

43

44

FIGURE I

Time Flow of EXperimental Procedures

September 1976

October 1976

November 1976

December 1976

January 1977

March 1977
April 1977

May 1977
September 1977

October 1977

November 1977

April 1978
April 1978

Initial contacts with October class parti-
cipants and random assignment of volunteer
Ss to treatment conditions

Training of instructors

Pretesting of half of October class parti—
cipants

Treatment began for October class partici-
pants (Instructors 1 and 4 teaching T,
instructors 2 and 3 teaching E)

Initial contact with January class partici-
pants and random assignment of volunteer Ss
to treatment conditions

Pretesting of half of January class parti-
cipants

October class participants ended treatment
January class participants began treatment
(Instructors 1 and 4 teaching E, instructors
2 and 3 teaching T)

Began first posttesting of October class par-
ticipants (4-8 weeks after birth of child)

January class participants ended treatment

Began first posttesting of January class par-
ticipants (4-8 weeks after birth of child)

Continued first posttesting to completion

Began second posttesting for October class
participants

Continued second posttesting

Began posttesting for January class parti-
cipants

Completed collection of all posttest data

Began processing of data and writing results

45

the design for this study lay in its ability to check for
effects of pretesting and of interactions between pretesting
and treatment.

General areas tapped by the assessment included marital
satisfaction, satisfaction with the child, degree of roman-
tic eXpectations of parenthood, marital communication

patterns, decision making and crisis adjustment.

Subjects

Subjects were 66 volunteer couples selected from those
couples who had enrolled for a 10-week prenatal education
class offered by Expectant Parents' Organization located in
Lansing, Michigan. All parents were primiparous. Of the
66, 33 were pretested, 38 completed the 1-month follow-up
and 39 Provided data when their children were 1 year-old.
All three observations were obtained from 17 couples.

One couple was eliminated due to their child's severe
health problems which involved prolonged hospitalization.

Background information was obtained on all 66 original
couples. Their ages ranged from 18 to 46 years with an
average of 25.5 years. Average educational attainment was
2 years past high school; however, individuals' education
ranged from ninth grade through eightyears beyond high school.
Income for the couples varied from $4,000 to $38,000 with an
average annual income of $18,6000. Couples had been married

an average of 3.2 years. One couple was unmarried at the

46

time of pretesting while the upper limit was 9 years of
marriage. Ten percent of spouses had eXperienced divorce
prior to their current marriage. On the Spanier Dyadic
Adjustment Scale, the average prebirth score for the 33
pretested couples was 118. Seventy-four percent of these
subjects had dyadic adjustment scores within one standard
deviation of Spanier's (1976) average for married persons
(i = 14.8, a‘= 17.8). While such a subject pool was not
representative of the total population of parents eXpecting
their first child, it was probably representative of
caucasion middle-class couples who seek special training

during their pregnancies.

Subject Assignment

 

After submitting their enrollment request forms,
those couples who would normally have been assigned to
classes beginning in October 1976 (due dates between
January 20 and February 20) or classes beginning in January
1977 (due dates between April 20 and May 20) were asked to.
participate in this research. A letter was mailed requesting
their participation in a study designed to assess and improve
the training in eXpectant parent programs (see Appendix A,
p. 124, for a copy of the letter). One to two weeks later,
couples were contactedby telephone to answer any questions
they had and to determine their willingness to participate.
Those couples who agreed to participate were randomly

assigned to either T or E educational conditions. The

47

couples were then allowed a preference (when possible) of
class night within the condition assigned. Couples who

were unable to attend the nights of their assigned treatment
condition were eliminated from the survey and enrolled in
the class night of their choice. Once assigned to a class
night, random assignment to pretesting or no pretesting
occurred. Random assignment was done in a manner which
stratified couples with respect to the time of application
for education. A contract (see Appendix B, p. 125) stating
the conditions of the evaluation and signed by the researcher
was mailed for the couples' signatures. Background demo-
graphic information was requested with the return of the

contract (see Appendix C, p. 127).

Treatment Conditions

The first group of couples began classes during
October with four instructors who had been trained in both
educational approaches. Two instructors employed the
traditional programs and two employed the new program.
In January, the second group of parents, selected as
described above, began classes with the same instructors,
each instructor employing the opposite educational approach
from that used in the October groups.

In the past, the focus of most expectant parent train-
ing performed by the EXpectant Parents' Organization had

been physiological aspects of pregnancy and delivery.

48

Participants had traditionally been instructed in the use
of relaxation techniques for use during birth, maternal and
child health, and labor and delivery room procedures. In
addition, past training sessions had been taught by several
different instructors, each presenting information in her
areas of eXpertise. Pregnancy, labor and delivery, and
child-care had been the focus for a Six-week class. Then
an optional two-week class in breastfeeding and an optional
four-week class in breathing and relaxation for childbirth
were offered.

The present study involved two educational approaches.
T left the traditionally presented information intact, but
reduced the program to ten weeks taught by the same instruc-
tor. In the same ten-week period, E included an abbreviated
form of the majority of information traditionally presented
plus additional information areas designed to better prepare
couples emotionally for pregnancy and beginning parenthood.
Additional areas covered included effects of pregnancy and
parenting on the marital relationship, decision-making
skills, communication tools, identification of and adjustment
to family stress, and realistic expectations for the new
family unit (see Appendix D, p. 128, for brief content
summaries of T and E). Parent manuals were used to supple—

ment class materials.

49

Instructor Selection and Training

All instructors were trained in both educational
approaches before the study began. In the past, instructors
had received updating and new program information at monthly
meetings which they were required to attend. As a result,
all instructors had received a review of the traditional
eduCational materials in their monthly meetings. In addi-
tion, instructors who had not taught the subjects of breast
feeding or breathing and relaxation for birth were required
to observe an eXperienced instructor teaching those classes.

Training for the new program (E), which merely added
to the basic program (T) described above, occurred in a
single weekend workshop consisting of 12 hours of training
(see Appendix E, p. 134, for agenda).

Volunteer research instructors were selected after the
training workshop. Volunteers were requested to make a
commitment to teaching each educational approach at least
once. Instructors were limited to four registered nurses
who had attended the weekend workshop and were willing to
follow the research design along with its limitation on
course content and to teach the subjects outlined in each of

the two instructors' guides.

Controls for Research Design

 

The teaching manuals for both approaches were used

by instructors to guide their classroom approach and

50

structure. Furthermore, the researcher observed selected
weeks of classes to determine if course content was pre-
sented without contaminating T classes with E information.
As a further assessment of class materials, couples were
asked to complete a checklist of class topics covered
throughout the course on the final night of class (see
Appendix F, p. 136, for a copy of the topic checklist).

In an attempt to control, or at least to observe,
instructor differences in presenting the different programs,
brief evaluation forms for each class period were filled
out independently by the husband and wife. These evaluations
requested subjects to use a four-point scale to rate the
instructor's knowledge, enthusiasm, comfort and abilities
when presenting topics. They also provided attendance
records for the couples (see Appendix G, p. 137, for a
copy of the instructor evaluation form).

On a personal level, every attempt was made to remind
instructors that there was no clear evidence of the
superiority of one program over the other. Instructors
were asked their personal opinions about the two programs
so that the effect of those opinions could be monitored
(see Appendix H, p. 138, for monthly instructor report).
Instructors' opinions were solicited on five occasions:
(a) before beginning, (b) half-way through the October
classes, (0) after completing October classes and before

starting the January class, (d) half-way through January

classes and (e) after completing January classes.

51

Furthermore, prior research (particularly that of
Feldman, 1971) suggested that subjects should be assessed
for: (a) the type of marriage relationship they possess,
i.e., companionate versus differentiated and (b) the
degree of the wife's comfort or discomfort during pregnancy.
Therefore, a four—item scale suggested by Feldman as an
indication of marriage style was incorporated in all
questionnaires along with an item about pregnancy discomfort
which appeared in the pretest and first posttest.

Due to the ever—present influence of modeling on
human behavior, a person's perceptions of his/her own
childhood experiences and his/her own parents' skills in
child-rearing may have an effect on that person's perception
of self as a parent and ability to adapt to parenting.
Therefore, this area was briefly tapped in the questionnaire
by asking subjects to evaluate the parenting ability of
their own and their spouses' parents.

A new baby places an additional financial strain on
a family which may be compounded by loss of one parent's
income. Given societal role assignments, this strain might
particularly influence the father or "provider". Financial
strain may be additive with the usual family adjustment sur-
rounding birth and was therefore monitored through the
questionnaires.

Similarly, baby temperament may be a factor which

affects parental adjustment. An easy—going, non-irritable

52

baby would certainly cause less disruption than a fretful
baby who over-reacts to minor stimulation and change.
Therefore, in the final questionnaire, parents were asked
to rate their child's temperament along nine dimensions.
Motivation for parenthood is another variable which may
affect a couple's adjustment to the newborn by influencing
the gratifications that parents obtained from their new
roles. For example, a parent motivated by the desire to
protect and care for a child would be eXpected to eXperience
different rewards from early baby care than a parent
concerned with living up to socially acceptable goals by
bearing a child. Thus, motivation for parenthood was
assessed using categories developed by Rhodes (1974).
Finally, demographic data were gathered prior to class
participation to insure that treatment groups did not differ
unduly along those lines. These data included a check on

the length of marriage and time spent living together.

Assessment Procedures

 

All couples were asked to complete the total evaluation
procedure on two or three different occasions. The husband
and wife each completed the procedure independently. Evalu-
ation occurred for half the participating couples before
they began education classes. All couples were then assessed
4 to 8 weeks after the birth of their child and again

approximately 1 year after birth.

53

The Spanier Dyadic Adjustment Scale (Spanier, 1976) is
a 32-item scale designed to tap the four areas of dyadic
satisfaction, dyadic consensus, dyadic cohesion and affec-
tional eXpression. The scale was designed by pooling all
items ever used in marital adjustment scales, eliminating
duplicate items, judging items for content validity and
administering the approximately 200 remaining items to a
sample of middle- and working-class married couples and a
sample of recently divorced couples.

Validity of the Spanier scale was examined in three
ways. Content validity was established by three judges
who eliminated items not considered to be: (a) relevant
measures of dyadic adjustment, (b) consistent with nominal
definitions suggested by the author for adjustment and its
components, and (c) carefully worded with appropriate
fixed choices for answers. Criterion related validity was
established by eliminating all items for which the means did
not discriminate between the married and divorced sample
(95.001). Construct validity was established by comparing
the Spanier scale with the widely used Locke-Wallace
Marital Adjustment Scale. The correlation between these
scales was .86 for married and .88 for divorced respondents.
Internal reliability consistency was assessed using Cronbach's
Coefficient Alpha. Total scale reliability was found to be
.96. The Spanier Dyadic Adjustment Scale was incorporated

totally as the first 32 items of each questionnaire.

54

Inquiries about motivation for parenthood were included
in the first posttest questionnaire and in phone interviews.
Rhodes (1974) established five general positive motivations
for parenthood (altruistic, fatalistic, narcissistic,
instrumental and conformity responses) and six general
negative motivations (responsibility, freedom, physical
discomfort, economic and ecological constraints, personal
inadequacy and dislike of children). Rhodes' classifica-
tions and descriptions were used to score the responses
obtained.

Additional elements in the self-administered question-
naire were designed to examine communication and decision-
making patterns, companionate versus differentiated marriage
patterns, eXpectations of the baby and the Spouse as a
parent, attitude toward own parents, financial changes,
sexual adjustment, crisis adjustment, and baby temperament.
Husbands' and wives' questionnaires were essentially the
same (see Appendix I, p. 139, for copies of the husbands'
questionnaires).

The telephone interview was conducted by undergraduate
psychology students who received course credit for their
involvement. Interviewers were trained in the use of open-
ended and pursuit questions to elicit information in the
desired areas. They were further instructed in the use
of empathy and paraphrasing in order to establish rapport

with parents and to check the accuracy of the answers they

55

recorded. Answers were written in as much detail as possible
by interviewers both during and immediately after the phone
interview. Approximately 10 percent of the interviews were
done jointly with one interviewer listening on an extension
line. These joint interviews were done to maintain con-
sistency in interviewer behavior. Appendix J (p. 166)
contains an outline of the interviewer training program.'
The interview was only semi-structured to facilitate
the emergence of uneXpected information and variables.
While occasional scaled responses were requested from the
subjects during the interview, for the most part only a
general topic outline was covered with spontaneous responses
being recorded. Interviewers took part in establishing
the final format and questions for each interview (see
Appendix K, p. 168, for topic outlines of the telephone

interviews).

Statistical Analysis
The hypotheses proposed the investigation of differ-

ences between treatment groups along the lines of marital
satisfaction, mutual involvement in and satisfaction with
family decision-making, communication frequency and satis-
faction, perceived adjustment to crisis or change, the
discrepancies between "should” and "actual" in a parent's
preceptions of his spouse's child-care behavior, attitudes

toward the baby, and sexual adjustment. Scores obtained

56

by each couple in the above questionnaire categories were
compared at posttest one and at posttest two using a 2x2
multivariate analysis of variance with presence or absence
of pretesting and eXperimental condition as factors. In
addition, a repeated measures multivariate analysis of
variance was performed on the data of those couples who

supplied complete information.

CHAPTER THREE
RESULTS

Scale Construction

As noted earlier, scales were to be constructed for
seven areas of interest using the information collected
from individuals' questionnaires and interviews. These
included scales of communication, crisis adjustment, marital
adjustment, decision-making, discrepancies in views of how
tasks should be and actually were divided, attitudes toward
the baby and sexual adjustment. A correlation matrix was
generated among all items thought to be rationally related
to these scales. Final scales were determined by examining
items at all three observation periods (pregnancy, 1 month
after birth, and 1 year after birth) and selecting those
items which correlated highly with their own, as opposed to
other, scales and which contributed to their scale's alpha
level (see Appendix N, p.177, for a complete description
of scale items and Appendix 0, p. 181, for each item's
correlation with its own and other scales). Some less
reliable items were retained in the final scales due to
their rational value in predicting the hypotheses. (E.g.,
an item asking if regular times were set aside for communi-

cation correlated with its own scale .28 although its

57

58

reliability was only .03. This item was retained because
much of the class content for the experimental group was
geared toward such planning on the couples' part, it did
not correlate highly with other scales, and it did not
reduce the alpha of its own scale.)

As the scales were developed, the three scales of
communication, marital adjustment and decision-making were
observed to be substantially intercorrelated (minimum 3 =
.56, p 5;.05; see Appendix L, p.172), suggesting that these
three scales tapped the same characteristics. In addition,
items from these scales tended to be inconsistent from one
observation period to the next, sometimes correlating more
highly with the communication scale, sometimes with decision-
making and sometimes with marital adjustment. For example,
in an early scale analysis, item 8 of the final combined
scale correlated most highly with decision-making for the
pretest (g = .50) but at 1 month correlated most highly with
communication (3 = .62) and at 1 year with marital adjustment
(g = .58). Therefore, these three original scales were
combined for analyses (see Appendix M, p.173 for interscale
correlation for the final five scales at each observation).

Examination of interscale correlations for the three
subscales (see Appendix L, p. 172) which were combined to
form the Communication/Decision-Making/Marital Adjustment
Scale raises questions about the decline in interscale

correlations from prebirth to 1-month and 1-year observations.

59

The 5' transformation was applied to test the significance:
of differences between those correlations (see Edwards,
1950). From prebirth to both 1 month and 1 year, the
decrease in correlation between communication and marital
adjustment was found to be significant (p S .05). The
correlation between communication and decision-making also
dropped significantly from prebirth to 1 year (p S .05).
The correlation of marital adjustment and decision-making
did not differ significantly between observations.

Questionnaire information since it was more available
and consistent, was the only source of items for the final
scales. The sole exceptionto this was the Attitude Toward
Baby Scale which gained most of its information from
interviews.

Five final scales of Communication/Decision-Making/
Marital Adjustment (CDMA), Crisis Adjustment (CRADJ),
Discrepancy Between Actual and EXpected Division of Tasks
(DISCR), Attitude Toward Baby (ATTBA) and Sexual Adjustment
(SEXADJ) resulted. Appendix N, p. 177, contains a complete
description of scale items. Appendix 0, p. 181, enumerates
each item's reliability and correlation with its own and
other scales. A brief verbal description of each scale
follows.

CDMA was a 15-item scale. Its average alpha over the
three observation periods was .84 (see Appendix P, p. 190

for a summary of alpha coefficients for each scale at each

60

time of observation). Its general content included frequency
of and satisfaction with communication, degree of mutuality
in and satisfaction with the decision-making process, and
the total score for the Spanier Dyadic Adjustment Scale.
CRADJ was a seven-item scale with average alpha = .77.
It tapped the parent's perception of change and disruption
in the family due to the baby. Lower CRADJ scores denoted
less disruption and hence were positive. DISCR was a six-
item scale (average alpha = .73) consisting entirely of
items in which the subject was asked to rate both how
tasks of baby care should have been divided in the family
and how they actually £333 divided. The absolute difference
between these two answers denoted the discrepancy between
the responent's ideal image and view of reality. Again
lower scores denoted more positive feelings. In almost
all cases of differences, participants felt the husband
should be sharing more equally in child care. ATTBA was
a 15-item scale (alpha = .66) tapping positive and negative
reactions toward the baby's presence and the degree to which
parenthood was perceived as more or less difficult than
eXpected. High scores denoted more positive attitudes.
SEXADJ was a four-item scale with an average alpha of .83
which assessed the respondent's perceptions of how feelings
of affection and sexuality were eXpressed in the marriage.
For most scales, the range of possible answers for
individual items differed. In addition, a subject may have

omitted one item but answered all other. To equalize item

61

weight, all items in a given scale were set to a common
base. To allow utilization of scales with missing items,
the average score for all aVailable items in that scale
was designated as the scale score. These scaled raw
score averages were converted to g-scores for statistical

analyses of the hypotheses.

Pretreatment Equivalence in Groups

It was anticipated that random assignment to treatment
groups would guarantee equivalence between groups before
treatment. To check this assumption, pre-birth variables
were grouped into three general areas of socio-economic
variables, perceptions of family and pregnancy, and
outcome scale scores; and multivariate analyses of variance
(MANOVAs) were performed comparing the two treatment groups.

Socio-economic variables included levels of education
for husband, wife and their parents, income, length of
marriage and whether the couple had lived together. The
MANOVA on these variables was not significant (p 5;.39)
indicating that the two treatment groups did not differ
appreciably in socio-economic status.

Perception of family and pregnancy included both spouses'
views of their marriage style (companionate versus differ-
entiated), the couple's perceptions of their own parents'
adequacy in raising children, and the couple's perception of

the degree of discomfort eXperienced by the wife during the

62

first two trimesters of pregnancy. A MANOVA indicated
that the two groups did not differ significantly along
this dimension (p 5 .11). An interesting trend in the
univariate F-tests for each of the above variables was
that the couples' views of their own parents' adequacy
differed significantly (p S .02), with T couples perceiving
their parents more positively than E couples. In addition,
there was a trend for T couples to perceive their marriages
in a more traditional style than did E couples (Xi = 15.56,
IE = 14.63, 25. .08).

Pretreatment outcome scale scores included CDMA,
CRADJ, and SEXADJ. A MANOVA performed on those scale
scores indicated that prior to treatment, groups did not
differ appreciably on those outcome measures (p,é .11).
However, another interesting trend surfaced in the univariate
F-tests performed on the variables. T wives had significantly
higher CDMA scores (p E .04) than E wives before treatment;
and a similar trend (p £;.08) existed for T husbands. A
closer look at couple scores on the Spanier Dyadic Adjust-
ment Scale alone revealed a similar but sharper difference
(p é..01). Furthermore, the variance on both the CDMA and
the Spanier scale was significantly greater (p 5;.05) for
the couples receiving relationship-oriented education (E).
Thus, prior to treatment, the T subjects had marital adjust-
ment scores which were both higher and more homogeneous

than those of E subjects.

63

In summary, when multivariate analyses were performed'
comparing T and E groups prior to treatment, none of the
three areas of socio-economic status, perceptions of family.
and pregnancy outcome scale scores showed significant
differences. Univariate F-tests, however, revealed
pretreatment differences with couples receiving physiolo-
gically oriented classes showing more positive views of
their own parents, better marital adjustment and less

variance in adjustment scores.

Equivalence in Classroom Treatment

 

In the present study, treatment approaches were
eXpected to differ in classroom content while dimensions
such as attendance and perceptions of instructors would,
hopefully, be comparable. To assess differences in class
content, couples were asked in the last class period to
complete a checklist of the topics which were covered in
the class series (see Appendix F, p. 136, for a copy of the
checklist). The topics which were to be covered only in
E sessions were analyzed by summing the number of those
topics checked by each parent completing the checklist.
These total scores were then subjected to a t-test. T
subjects were found to score significantly lower (p $;.001)
on this total than E subjects. Thus, the content of the
treatments differed as eXpected.

To check for differences in other classroom variables,

a MANOVA was performed comparing T and E subjects on their

64

attendance and on their ratings of instructors' knowledge of,
enthusiasm for, comfort with, and ability to present each
day's topics. This MANOVA was not significant (p S .07)
suggesting that these classroom variables were comparable
for both treatment groups. However, T subjects averaged
higher class attendance (XT = 7.75 classes, XE = 6.66
classes); and except for the final class, a lower percentage
of total E subjects attended each class period than their

T counterparts. The difference was particularly notable

in the initial three class periods when rationale for the
relationship-oriented approach had been heavily emphasized
(see Figure 2).

Thus, treatment for the two groups differed as eXpected
along the lines of the information covered in the classes
although it did not significantly differ for such classroom.
variables as attendance and rating of instructors. Couples
receiving relationship-oriented (E) class content tended

toward higher absenteeism than did T couples.

Tests of Hypotheses

 

It was hypothesized that relationship—oriented prenatal
education (E), as opposed to prenatal education presenting
only more traditional physiological information (T), would
result in the following postbirth differences in the family:

--higher marital adjustment (hypothesis one),

--more positive decision-making processes (hypothesis

two),

65

FIGURE 2

Percentage of T and E Subjects
Attending each Class Period

100 j
80 -
Percent of 60 4
SS Attending _
40 -
20_.———.——--OT
- ‘———4———£ E

 

 

66

--more frequent and satisfying communication patterns
(hypothesis three), '
--better adjustment to the developmental crisis of
beginning parenthood (hypothesis four),
--more positive attitudes toward the baby and toward
the spouse's role in child-care (hypothesis five), and
--better sexual adjustment (hypothesis six).
Hypotheses one, two and three were combined in the CDMA
scale. Hypothesis four was measured by the CRADJ scale.
The scales of ATTBA and DISCR both tested hypothesis five;
and SEXADJ was employed to measure hypothesis six.=
"Subjects" consisted of couples. Statistical analyses
were run using both the husband's and wife's scores on all
scales as the components of each subject's score. Thus, for
example, at the 1-month observation, each subject's score
consisted of both the husband's and wife's individual scores
for CDMA, CRADJ, DISCR and SEXADJ. Although, as could be
eXpected, husbands' and wives' scores were highly correlated
(p 5 .05 for every scale except CRADJ at 1 month), the
multivariate technique is able to take such relationships
between variables into account (see Appendix P, p.190, for
correlations between husbands' and wives' scale scores at
each observation).
All hypotheses were tested simultaneously using 2 x 2
(treatment group by presence or absence of pretesting)

multivariate analyses of variance for both the 1-month and
1-year observations. No significant differences were found

between treatment groups at either time period.

67

Further repeated measure MANOVAS were run using
attendance and the three prebirth scale scores (CDMA,

CRADJ and SEXADJ) as covariates in an attempt to control

for the trends in differences between treatment groups at
pretesting. Once again, no significant treatment effects
were found.

In a second series of statistical tests, a repeated
measures design was used to examine the scores of the 17
couples for whom there were data at all three observations.
Once again, no significant differences were found between
treatment groups. However, g1; couples changed signifi—
cantly in scores from pretesting to the 1-month posttest
and from the 1-month posttest to the 1—year follow-up.

The major variable accounting for the change was the CRADJ
scale, which showed more disruption in the couples' family
lives immediately after birth than during pregnancy or at

1 year postbirth. (see Table 1, p. 68, for average g-scores
of these couples at each observation.)

The null hypotheses could not be rejected at the .05

level of significance.

Post Hoc Analyses

 

An attempt was made, using multiple regression analyses,
to determine which pretest variables were predictive of
more positive postbirth marital adjustment. To accomplish

this, data from all couples, regardless of treatment condition,

68

TABLE 1

Average g-Scores for Couples with Complete Dataa

 

 

 

Scale Time of Prebirth l-month 1-year
Observation
0" e d7 8 o” 9%
CDMA T .270 .176 .007 .037 -.147 .127
E —.280 -.406 .084 -.175 -.090 -.225

CRADJ T - 128 .139 .198 .161 .207 .147
E .083 .163 .362 .137 .197 .066
SEXADJ T .166 .066 .376 .092 “.065 .107
E -.522 -.394 -.491 -.360 -.568 -.730
DISCRb T -.204 -.209 .078 .114
E -.206 .149 .254 .386
ATTBAb’C T -.227 -.o77
E .188 -.080

 

a y = 17 (9 Ts and 8 Es)
Scale not administered prebirth.

0‘

C Scale not administered at 1-month postbirth.

69

were utilized. Since the Spanier Dyadic Adjustment Scale
has been established as internally reliable and externally
valid, it was used to calculate four change scores, one

for each individual husband and wife at 1 month and at 1
year after birth. (Note the shift from considering the
couples as units to considering husbands' and wives'

scores separately.) The regression analyses were performed
to identify predictors for these change scores.

A total of 30 couples had complete questionnaire data
for both the pretest and the 1 month follow-up; and 28
couples had complete data for the pretest and 1 year follow
up, with 17 couples common to both groups. Demographic
data and all pretest questionnaire items for both husband
and wife were considered as potential predictors of change
in marital adjustment. In addition, change scores for
both husband and wife on each of the three outcome measures
common to all observations (CDMA, CRADJ and SEXADJ) were
considered.

Before attempting the regression analysis, items to be
considered as predictors had to be reduced to a manageable
number. Accordingly, correlations were computed between
each potential predictor item and the Spanier change scores
obtained for husband and wife. Only those items which were
significantly correlated (p S, .05) with the Spanier change
score were included in a given regression analysis. Finally,

those items selected for analysis were examined with regard

70

to their relationships to each other. Where high correla—-
tions existed between potential predictor items, they were
combined to create a single composite variable.

For example, five questionnaire items, two requiring
both husband and wife to indicate the percentage of time
s/he had felt satisfied with the marriage relationship,
two requiring both husband and wife to indicate the percent-
age of family decisions with which s/he had felt satisfied,
and one requiring the wife to indicate the percentage of
time things had been going well, were all significantly
correlated with both husbands' and wives' Spanier change
scores at 1 month and at 1 year. Therefore, these items
were selected for further analyses in predicting each of
the four change scores examined. In addition, each of
these five items correlated highly with each other.
Therefore, they were averaged as a composite variable for
purposes of the regression analyses.

The final variables used for each regression analysis
along with summary tables of the analyses can be found in
Appendix R (p. 192). Cut-off points are indicated in the
summary tables by solid lines for the point at which the
significance of the prediction begins to increase as new
variables are added and by dotted lines for the point at
which the combined predictors are no longer significant
at p g;.05.

The following are observations of these data and trends:

1. Positive postbirth marital adjustment for the wife at

71

1 month, husband at 1 month, and husband at 1 year corre-

lated negatively with what might be termed a general expres-

 

sion of family well-being during pregnancy. This expression
of well-being was composed of the variable described above

as a combination of percentage of time things have been

going well, percentage of decisions agreed with, and
percentage of time satisfied with the marriage relationship.
2. Postbirth marital adjustment at 1 month for both

husband and wife was positively related to a number of
factors that suggested traditional attitudes toward family
roles. These included the wife's belief that she should
predominantly arrange for baby care when she must be away,
the wife's eXpectation that the addition of a child would
cause great changes in her lifestyle, the husband's report

of less time spent daily in conversations, the wife's

report of less consulting with her husband when decisions
were made and the husband's belief that his wife should

feed the baby more often than he.

3. The husband's postbirth marital adjustment at both 1
month and 1 year related positively to satisfactory

prebirth decision-making. This decision-making included both
husband's and wife's reports of higher satisfaction with
their own and their spouse's participation in decision-making,
husband's reports of a higher degree of joint decision-
making and wife's reports of a greater degree of satisfaction

with decisions about parenting.

72

4. No pretest variable satisfactorily predicted the wife's
change score for 1 year at p 5_.05. The best predictor

was her eXpectation of a great deal of change in her rela-
tionship with her spouse (R S .068).

5. The following three relationships appeared unrelated

to the trends identified above or to each other: (a) An
inverse relationship existed between how well the husband
thought his wife's parents did raising her and the husband's
positive marital adjustment at 1 month. (b) A positive
correlation existed between the husband's adjustment at

1 month and how much he expected the new baby to change

his sleeping and eating habits. (c) The wife's degree of
satisfaction with her job situation during pregnancy was
negatively related to her husband's positive marital
adjustment at 1 year.

In summary, the regression analyses would indicate
that postbirth marital adjustment for first-time mothers
and fathers, related positively to a marriage with more
traditional roles, but related inversely to more positive
views of the pregnancy eXperience. Also new fathers
eXperienced improved marital adjustment after birth if a
satisfactory decision-making procedure existed before birth.
Significant predictors of the mother's marital adjustment

change when her child was 1 year old were not found.

CHAPTER FOUR
DISCUSSION

All couples in this study, regardless of treatment,
changed significantly in scores from pretesting to
1 month postbirth and from 1 month postbirthfimal year
postbirth. Furthermore, the changes were such that at
1 month postbirth, couples' scores were significantly
different from their scores at prebirth and at 1 year
postbirth. The major measure contributing to that change
was the Crisis Adjustment Scale (CRADJ) which was highest
at the 1-month observation. The CRADJ scale asked the
couple to describe how much change was anticipated (pre-
birth) or actually had occurred (postbirth) in a number of
household routines such as eating and sleeping, relationship
with spouse, sexual relationship, leisure time, etc. This
result then revealed, not uneXpectedly, that after 1 month
a new baby had impacted family routines signifiCantly more
than the parents eXpected and that 11 months later the
disruptions had been significantly reduced. The foregoing
information would support use of a crisis model to describe
the family process of integrating a child. According to
repeated measures analyses, the severity of the event was

uneXpected by the couples, and they adapted to the changes,

73

74

over time returning to a more normal, predicatable
routine.

Supporting the proposition that the family changes
occurring at birth may have a long-term effect on the
marital relationship were the serendipitous findings of
significant declines in correlations between elements of
the marital relationship. Within the CDMA scale, the
subscale correlations of communication with decision-making
and marital adjustment decreased significantly from pre-
birth to 1 year (see Appendix L, p. 172). A similar, but
nonsignificant, decline occurred in correlations between
husband's and wife's scores for CDMA and CRADJ (see Appendix
Q. p. 191). These findings suggested that the birth of a
child may have contributed to overall disorganization and
loss of congruence in several aspects of marital adjustment
and in spouses' level of agreement about their marital
satisfaction. There were indications that these correlations
might be slowly increasing again both for spouses' degree
of agreement and for the relationship between communication
and marital satisfaction although the data were insufficient
to confirm that trend.

In light of the above findings, the perspective
researcher would be advised to extend follow-up measurements
well past the initial postbirth changes if long-range
conjectures about family changes are desired. The parent-to-

be might use this information for anticipatory planning

75

and for encouragement while attempting to survive the
immediate postbirth confusion and the potentially longer-

lasting marital disruption.

Illustrations of Families Experiencing Great Life Changes

A look at the characteristics of those research
parents who eXperienced the greatest life changes was
thought to be potentially enlightening. Accordingly, four
couples were identified who had 1 month posttest crisis
scores in the top 10 percent as determined by individual
scores and the couples' composite scores.

Couple A had been eXperiencing difficulties before the
prebirth interview. They had been married only 1 month
before discovering the pregnancy. At the prebirth inter-
view, the couple was seeing a marriage counselor and had
apparently separated. The husband stated that marriage and
a pregnancy were "too much at one time." Marital problems
became compounded with physical ones as the baby's birth
was late and attempts to induce labor failed. Finally,
labor began spontaneously but complications led to a
Caesarian section after which the infant was kept in
intensive care. Mother and infant did not see each other
for two days. Further financial burden was added by the
mother's medical eXpenses which were not covered by insurance
and required the father to work at two jobs. At 1 month

postpartum, both husband and wife eXpressed dissatisfaction

76

about the time they had to talk. The baby's crying was
identified as a stimulus for marital conflict. This
couple, then, eXperienced a series of difficulties concurrent
with, and related to, their child's birth. These diffi-
culties added to the degree of crisis and change they
eXperienced.

Couple B had been married 2 years before this planned
conception. Both husband and wife worked with children
and had many detailed eXpectations about parenthood. The
mother, who worked with handicapped children, expressed
intense prebirth fears that her child might be defective.
After a difficult 23-hour labor, the baby was taken by
Caesarian section. The husband described labor and delivery
as "crude" and "a difficult job for hospital staff."
Once the baby was home, both parents were startled by the
difference between the child and their eXpectations. The
mother was surprised at the extent of her infant's social
responses but disappointed at the amount of time required
and the restrictions placed on her by child-care. The
father felt that his wife was eXperiencing fulfillment in
her maternal role, but he was disappointed and repeatedly
eXpressed a longing for the infant to grow up so he could
enjoy it more. He felt his wife was overly tired and vented
her anger on him for ”not doing his share." He was also
surprised by his frustration and anger at hearing the baby

cry. Neither parent felt household routine had returned to

77

normal by 2 months after birth. This couple, then, in
addition to a difficult labor and delivery, eXperienced
violations of many specific eXpectations of their new
baby and their shared parental role.

Couple C had been married 5 years and conceived after
3 years of attempting to have children. It was necessary
for them to consult a fertility specialist during that
time. A miscarriage had occurred before the successful
pregnancy. Both husband and wife had Specific eXpectations
of the rewards and costs of the coming baby. The husband
had prepared himself by doing volunteer work with infants.
Delivery involved a Caesarian section that "panicked"
the mother. (Did she consider it another failure after her
miscarriage and the need for a fertility specialist?) She
had expected a boy rather than a girl. When first seeing
her infant after birth, she didn't like it. The infant
was described as crying a great deal. Both parents stated
that they had eXpected changes with the baby but the demands
and the extent of the change were greater than anticipated.
They repeatedly stressed the necessity of placing the
baby's needs first. So these parents also found themselves
facing a crying baby who violated their eXpectations.

Couple D was surprised to learn of their pregnancy since
the mother had been told that she was not ovulating. Their
discussions during pregnancy were psychologically and

developmentally oriented and included thoughts about the

78

baby, each partner individually and their relationship.
They appeared to value marital communication and to rely
heavily on it during the first trying months of parenthood.
The father had eXpected and wanted a boy rather than a girl.
Their child required much more attention and time than they
had anticipated as she was born with heart problems and
without a thyroid gland. (In fact, this couple was elimin-
ated from statistical analysis because of the severity of
health problems which necessitated cross-country trips to
Special clinics.) The mother stated she had eXpected

"more enjoyment and less worry."

In each of these cases the new baby violated parental
eXpectations and hopes. The uneXpected situations included
health problems, excessive crying, wrong sex, and more
demands for time and care than was eXpected. Three out of
four eXperienced Caesarian births, while the incidence of
C-sections in the total subject pool was only 9%.

The Caesarian birth is a deviation from the normal
vaginal delivery for which the parents have specially
prepared themselves through prenatal classes. C-Sections
are often based on potential health hazards for the baby
and/or mother. Anesthetics and surgical procedures usually
result in separation of the mother and infant for a period
of time after birth. Klaus and Kennell (1976) have empha-
sized the importance of early contact in facilitating

attachment. Lack of early contact, while not precluding

79

attachment, may limit the contributions of biological
mechanisms, such as hormonal changes, and may contribute
to initial reactions such as Mother C's statement that she
didn't like her baby when she first saw it.

Many hypotheses could be made about the cause of the
violations of these parents' eXpectations. Was it lack of
opportunity for initial attachment? the constitutional
nature of the children? lack of adequate educational
preparation? inability of the parents to incorporate
negative experiences? excessive emphasis on being the
"good" parent? fear of inadequacy as the child did not
develop as eXpected? In any case, it is encouraging that
1 year after birth, these parents did not, on the average,
describe their children's temperaments much differently
than did the total sample. Thus, those early perceptions
did not necessarily carry on through the children's
lives. In fact, probably over time the physical problems
began to correct and parents learned to cope, allowing them
to adjust their self-concepts. Mother D eXpressed tre—
mendous relief Simply from diagnosis of her baby's ailment.
Mother A illustrated the impact of a difficult infant on
her parental self-concept when she indicated that she began
to feel much better about herself once the baby was doing

well.

8O

Implications for Prenatal Education

The above findings have implications for later
parenting classes. First, it appeared that parents gener-
ally had inaccurate expectations of the disruptiveness of
a new baby. They may have also had false expectations about
early rewards in parenthood (certainly several of the
couples scoring high on CRADJ at 1 month did). Prenatal
classes could strive to correct these misconceptions and
to provide anticipatory guidance for the realities of new
parenthood. Parents could be informed of the time-limited
nature of the disruptiveness surrounding beginning parenthood.
Parents could likewise be warned of the severity of the
disruption in an effort to promote better anticipatory
planning.

Research results indicated the importance of better
preparation for the possibility of a Caesarian birth. The
local prenatal groups and health department currently
provide some information and special films for couples
who have planned Caesarian births. However, in the present
study, parents with uneXpected C-Sections who had attended
the usual prenatal classes complained that they were
unprepared. Part of the lack of preparation undoubtedly
stemmed from the attitude that "it won't happen to me”.
With the growing incidence of Caesarian births, parents
may need information about the likelihood of this event,

the details of what will happen, and the manner in which

81

they can help each other create a positive experience

during and after the surgery. Classes may need to emphasize
the brevity of labor and delivery in comparison with the
many subsequent years of parenting. EXpectant parents

often anticipate that the birth eXperience will be a peak
emotional eXperience. Prenatal classes usually increase
this eXpectation, rather than tempering it with more
realistic views. Certainly birth can be a beautiful
experience for parents, but it can just as easily prove to

be exhausting and frightening.

't ' n 'f

This eXperiment was not successful in obtaining
statistically Significant differences between treatment
.groups. The most conservative conclusion to be drawn from
the lack of Significance was that the implementation of
this particular psychologically oriented educational
experience was not powerful enough to affect a family's
adjustment to a first child in a Significantly different
manner from a more typical, medically oriented prenatal
education. In light of this a major issue to be examined
is whether statistical significance should be given such a
powerful role in determining the effectiveness of human
services. Even moderate trends toward differences in preven-
tive research may be sufficient reason to continue and

refine a program. A small trend identified in a short-term.

82

longitudinal study may amplify over succeeding years into
a major difference. Furthermore, the benefits of even
small psychological advantages are difficult to price.

This experiment was beset with many difficulties in
execution and in statistical analysis. Without some of
those difficulties, Slight trends in data might have
assumed statistically significant proportions. Such
dificulties should be taken into account in evaluating this
human service program. Enumeration of those difficulties

follows.

Statistical Limitations

First, the number of subjects for whom data could be
collected was small. At 1 month postbirth, 38 subjects
were available (19 couples in both T and E), while the
1-year follow-up examined data for 39 couples (20 in T and
19 in E). For the repeated measures analyses, only 17
couples (9 TS and 8 ES) had complete data. Such small
samples required substantial differences in outcome
measures to achieve statistical significance. For the
above cell sizes, differences between treatment groups
would have had to be large (.4 and .5 standard deviation)
for a reasonable chance of finding existing Significant
differences (Cohen, 1969).

Next, pretreatment MANOVAS did not reveal statistically

significant differences between treatment groups although

83

the two groups were not clearly comparable when pretest
and classroom variables were examined. AS noted in the
results section, the group that received psychologically
oriented education (E) tended to have lower marital ad-
justment as measured by the CDMA scale. When only the
Spanier Dyadic Adjustment Scale was examined, this difference
was significant. Further difficulty in establishing
statistically Significant differences between the two
treatment groups evolved from their wide range in scores.
The psychologically oriented group (E) had a significantly
greater variance in CDMA prebirth scores than did their
physiologically educated counterparts (T). Hence, the
standard deviations for E couples (.27 for husbands'
scores and .58 for wives') were virtually so great
(eSpecially in comparison with the standard deviations of
the T subjects which were .14 and .16, respectively) as

to preclude the finding of Significant differences even
though the mean CDMA score was .25 points lower for T than
for E.

It is interesting to note that this Significant
'difference in CDMA score variance did not recur in the
posttest observations. Perhaps the psychologically
oriented education truncated extreme positive and negative
scores. (The effect was not caused by attrition of couples
who scored at the extremes.) Perhaps couples with very

positive marital satisfaction Scores were negatively

84

influenced by the educational approach and/or the eXperience
of beginning parenthood while couples with very low marital
satisfaction eXperienced the opposite effect. Or perhaps
those couples at the extremes merely regressed toward the
mean. There was no clear evidence that either of these
conjectures was more probable than the other.

Figure 3 shows marital adjustment by treatment group
and sex for those 17 couples with data from all three
observations. For the combined Communication/Decision-
Making/Marital Adjustment (CDMA) scale, E husbands and wives
increased from prebirth to 1 month while T husbands and wives
decreased. The same changes occurred to a lesser degree
from prebirth to 1 year.

A similar trend emerged when Spanier Dyadic Adjustment
Scale scores were averaged at each observation time for all
subjects with data at the time of observation (see Figure 4).
Once again, from prebirth to 1 year, T husbands and wives
decreased Slightly in marital satisfaction while the E
subjects increased. In addition, from prebirth to 1 month,
T decreases and E increases were even more marked for both
sets of data. Thus, data trends, while not significant, did
support the first hypothesis that psychologically oriented
prenatal education can promote more positive postbirth

marital adjustment than physiologically oriented education.

85

FIGURE 3

Average Z-Scores on
Communication/Decision-Making/Marital Adjustment (CDMA) Scale
for Couples with Complete Data*

.30
.20
.10
.OO
g-scores
-.10
-.20
-.30

—.40
Prebirth 1 month 1 year

mam
Noose.

 

 

4L

Time of Observation

* for T, N = 9; for E, N = 8

86

FIGURE 4

Average Spanier Dyadic Admustment Scores
for all Data Collected at each 0bservation*

125
‘T
120 __
F T Q
Spanier L T 6‘
Dyadic Adjustment '—
E 9
Score
115 ._
r
E 0‘
110

 

 

1 #1 41
I

Pre-birth 1-month 1-year

Time of Observation

* N's, ranging from 16 to 27, waried with time of
measurement, treatment group and sex.

87

Comparability of Treatment Groupg

In spite of random assignment to treatment, several
statistically nonsignificant trends were noted in the
pretreatment measures. These included tendencies for
couples receiving physiologically oriented education (T)
to view their own parents more positively. to view their
marriages as having more traditional roles, and to display
higher levels of marital adjustment than did E couples.
All of these trends likely worked against confirming the
stated hypotheses. First, as parents tend to raise their
own children in the way in which they themselves were
parented, one would eXpect those parents with more posi-
tive views of their own parents to have felt more positively
toward themselves in a parenting role. Hence, this attitude
toward their own parents may have promoted a more positive
parenting self-concept for T parents. This positive self-
concept could have generalized to outcome measures of
perceptions of children and spouses. Second, marriages
having traditional roles, as compared to those with a
companionate style, were found by Feldman (1971) to be more
likely to increase in marital adjustment following birth.
The addition of children was postulated to create an
opportunity for more role fulfillment for the wife. Note
that T wives, with their more traditional view of marital
role, were the only group that increased in Spanier Dyadic

Adjustment scores from 1 month to 1 year postbirth (review

 

88

Figures 3 and 4). Thus, again, the tendency toward a
traditional role in T couples would have worked against the
hypothesis that couples receiving psychologically oriented
education would eXperience better postbirth marital
adjustment. And finally, higher pretreatment marital
satisfaction scores for T Subjects decreased the possibil-
ity of E couples surpassing the T high scores at post-
birth. Thus, all tendencies toward differences in treat-
ment groups prior to classes may have hindered establishment

of significant posttreatment differences.

Design Difficulties

A major drawback in the present research design was
the absence of a true control group. Both treatment groups
requested and received prenatal education classes. The
couples, by seeking prenatal education, behaviorally
demonstrated a belief that information could assist them
in coping and a value of preparing for future events.
Participation in any prenatal education program (or merely
the intent to do so) may have been enough to stimulate
forethought and planning for coping effectively with a
life change.

According to the literature review, middle-class
couples would be eXpected to decline in postbirth marital
satisfaction as compared with prebirth measures; however, the

present research did not find a significant decline in marital

89

satisfaction for couples receiving prenatal education of
either a medically oriented or psychologically oriented
nature. Review of Figures 3 and 4 shows, except for T
wives, a decline in marital satisfaction from 1 month to

1 year. The fact that these trends were inconsistent and
statistically nonsignificant may indicate that parents who
chose to attend prenatal classes, compared to the general
population of those not seeking prenatal education, were
somewhat better prepared to adapt after birth regardless

of the nature of their classes.

Extent and Timing of Treatment

Many factors may have weakened the impact of the
innovative psychologically oriented training program. Ten
2-hour classes (or more accurately, the six to eight class
periods attended by the typical couple) may have been
insufficient time to cause significant behavioral or
attitudinal changes. Furthermore, the maximum class time
originally planned to be devoted to psychological aspects
of pregnancy and parenthood was 9 hours (less than 50
percent). In practice, unfamiliar psychological materials
were often condensed, reduced or even eliminated by
instructors when faced with time pressures.

The timing of an educational program so that its
audience is maximally receptive to materials may be crucial.

At the time of eXpectant parent classes, couples' concerns,

90

as elicited through agenda-gathering during the initial
class period, were focused mainly on the whys and hows of
labor and delivery and the physical well-being of infant
and mother. In fact, of the 102 mothers and fathers
interviewed immediately after birth, 67 indicated that
preparation for labor and delivery was the most helpful
part of their classes and/or that they would have liked to
spend more class time on that area. Only two parents would
have preferred less time on the topic. Furthermore, 20 of
the 49 E parents made negative remarks about decision-making
or relationship-oriented class content, suggesting less of
that content and/or stating a dislike for it. Only nine
parents requested more family-oriented material or viewed
it as a significantly helpful part of the class. Negative
comments ranged from a belief that couples should have
worked-out personal problems before becoming pregnant to
comments that the instructor did not have the background to
teach those skills or was uncomfortable and presented this
material unclearly. One father felt that the emphasis on
the change in the marriage made couples more apprehensive--
he would have preferred more positive classes.

After birth, in the midst of many life-style changes,
couples may have been more receptive to information on
emotional adjustment to beginning parenthood. For example,
one mother laughed when asked what she would leave out of

the classes and then commented that while attending classes,

91

she felt family relationships should not be included.

She then added that after birth she had recognized the

value of the topic. In a 3-month follow-up of 29 primi-
parous and 19 multiparous couples who had attended prenatal
classes, Tiedge (1978) found 70 percent reporting that
relations with their spouse were strained, different or not
going well. The overall tendency for most subjects to
decline in measures of marital satisfaction from 1 month to
1 year after birth (review Figures 3 and 4) would also
indicate that research subjects for the present study
experienced increased postnatal stress. Further support

for higher postnatal receptivity to psychological issues

can be found in the final interview when parents were asked
if they would have been interested in attending a discussion
group for new parents after birth. Of 78 parents interviewed,
there were 39 “yes", 16 "maybe", and only 17 "no" responses
(6 parents were not asked). Parents were asked when such a
group would optimally be offered, and a wide range in child's
age (from newtxuv1 to 3 years) was suggested. Responses
clustered at birth to 3 months, 6 to 7 months, 1 year, and

2 1/2 years. While "discussing parenthood" is certainly a
less emotion-laden topic than discussing family relation-
ships, the two areas could be expected to interact with each
other. In any case, the vast majority of research parents
identified their needs and difficulties with regard to
parenting as being subsequent to the first 6 months of the

child's life.

92

Thus, with regard to timing of material, these
eXpectant parents appeared most receptive to learning
about labor and delivery-~an unknown and imminent event.
After birth, as their child matured, parents became increas-
ingly preoccupied with the parenting role (and probably
with more psychological, family-oriented issues). There-
fore, a prenatal class may have been an inappropriate time
to eXpect couples to be receptive to psychologically

oriented materials.

Presentation of the New Program

Another major variable concerned the discomfort of
instructors in presenting the new program. A11 instructors
eXpressed or displayed discomfort when presenting information
about declining marital satisfaction after the birth of a
child or the negative aspects of parenting. One wrote,
"I felt very uncomfortable presenting such negative facts
to the couples re: parenting and the marital relationship.
I think class #10 ended on a positive note...but I felt
strongly the anxiety from the couples when the negative
aSpectS were discussed." The cause of her discomfort was
verbalized by another instructor who said, "I don't like
to tell them bad news. This is supposed to be a happy time
in their lives."

This discomfort persisted despite the instructors'
eXpressed commitment to the rationale behind such information.

Of 18 comparisons of the two approaches which were collected

93

from the five instructors at various times during their
participation, 14 placed the psychologically oriented E
approach as somewhat better or far superior to T; three
were neutral; and one classed the traditional approach (T)
as somewhat better. (This last instructor later rated
the E program higher.)

The conflict felt by instructors in their attempts to
present new, sometimes anxiety-provoking, material to
which they had eXpressed a commitment is also clear in the
following series of quotes from one instructor's evaluation
reports. (The first quotes are as she taught the psycho-
logically oriented curriculum.) "The whole presentation has
me up-tight and I realize the tremendous amount of studying
and rehearsing that will be necessary..." "The decision-
making process has me stumped and I am apprehensive with
regards to presenting something I don't 'own' yet. Wish
we could modify it." (The next quotes are after finishing
the new curriculum and while teaching traditional and
familiar content.) "The modified program was difficult
to incorporate into my own words. It definitely put a lot
of pressure on me as an instructor. I understood the basic
concepts but the presentation of the materials did not flow
easily and I felt the couples perceived it also." "The
idea of communicating with each other as a couple is an
important issue... I feel bad I can't let them know about
the stresses currently in their life and the ways we feel

one can cope with them."

94

Given both the instructors' discomfort with and the
parents' negative reactions to the more psychologically
oriented material, an interaction may be hypothesized with
instructors presenting material with low self—confidence,
parents reacting negatively to the material, instructors
then feeling even less comfortable, etc. The spiral
effect created by such an interaction would certainly have

obstructed a positive, effective exposure to E class content.

Discussion of Post Hoc Analyses

Two major trends identified in the post hoc analyses
provided further substantiation and extension of Feldman's
(1971) short-term, longitudinal findings. He found
positive marital adjustment at 5 weeks and 5 months post-
partum to be related to a traditional marriage style and
to a negative perception of pregnancy. The finding of
the present research further substantiated Feldman's
evidence by correlating positive change on a well-validated,
multi-item marital adjustment scale with husbands' and
wives' prebirth variables. At 1 month both husband and wife
were likely to eXperience more positive marital adjustment
if they had viewed their relationship in a traditional role
style. At 1 month for both husband and wife, and at 1 year

for the husband, marital adjustment related inverser to

 

perceptions of general well-being during pregnancy. Thus,

the present data extended Feldman's finding to the father as

95

well as the mother. A discussion of these two relationships
and the remaining findings of the regression analyses
follows.

Human perceptions of well-being are usually relative
to the conditions surrounding them. The degree of general
life satisfaction perceived by a person at any given time
may be directly dependent on the level of satisfaction
existing just prior to that time. Hence, an inverse
relationship between positive pregnancy attitudes and post-
birth attitudes is understandable. The eXpectant parent
who prized pregnancy may be generally more disappointed by
the stresses of beginning parenthood than the parent who
had a less pleasant pregnancy eXperience. This phenomenon
may be especially applicable to the first-time mother who
may have received deferential treatment and Special nurtur-
ance from her family and social group during her pregnancy.
The woman who particularly enjoyed that Special care, for
whatever reason, is faced with the opposite circumstances
when she must nurture her own child and when her family and-
husband turn their attention to the newborn.

Still missing is information concerning couples'
level of marital adjustment and general well-being before
pregnancy. Do couples become pregnant in an attempt to
correct an already unsatisfactory situation? If so, their
very positive reaction to pregnancy may be a result of

renewed hope which would likely turn to disillusionment

96

under the stresses of beginning parenthood. On the other
hand, high pregnancy satisfaction could be simply a
continuation of pre-pregnancy dyadic adjustment which is
disrupted by the intrusion of a baby.

The present research found a positive relationship
between a traditional marriage style and postbirth marital
adjustment. A traditional marital relationship is one in
which the role eXpectations establish the wife as primarily
responsible for home management and child~care while the
husband provides financial and physical resources for the
family. This contrasts with a companionate marriage style
in which the husband and wife tend to share the same tasks
and roles and to value this shared orientation over well-
delineated, separate roles. In the case of a traditional-
role marriage, the wife's role is incomplete until she has
children to care for. Hence, both husband and wife might
be eXpected to find their marriage more congruent with
their role eXpectations, and therefore more satisfying,
with the birth of their first child.

Additionally, the regression analyses revealed a
tendency for father's poStbirth marriage adjustment to be
related to prebirth decision-making adjustment. If fathers
are eXpected to articulate with the larger society for
their families, decision-making may be an important aspect
of that role. A smoothly functioning prebirth decision-making

procedure should be an asset which carries over to the

97

postbirth period, thus enhancing the husband's satisfac-
tion with his family life. Conversely, unsatisfactory
decision-making prior to birth may deteriorate further
under the added stresses of the new postbirth roles.

It is surprising that no pretest item significantly
predicted change in the wife's marital adjustment at 1 year
after birth. One might postulate that a new mother eXper-
iences much more change in her family role than does her
spouseu Since she usually is the parent assuming most
responsibility for infant care. (This postulate is
supported by the research variable which came close to
significance, p g .068, as a predictor of more positive
marital adjustment, i.e., the wife's expectation of great
change in her emotional and sexual relationship with her
husband.) Most likely the marital relationship does
indeed change, and the wife's anticipation of that change
can contribute to her adjustment. But that change may
be based on so many individual characteristics that its
direction and magnitude are unpredictable. For example,
the new mother's family and life goals would be eXpected
to contribute to her adjustment. Does she value the parent-
ing role as a life goal? Her own developmental stage would
affect adjustment. Has the new mother established her
identity separate from that of a mother or wife? Her
relationship with her own mother (the parental model) may

come sharply to the foreground. Do old childhood conflicts

98

return to haunt her as her baby grows? The list seems
endless, making the levels of adjustment varied and
unpredictable.

The additional relationships identified by the
regression analyses rest on the slender thread of single
questionnaire items. Thus, they offer a weaker base for
Speculations and, in some cases, are difficult to rational-
ize.

It is understandable that the husband's marital satis-
faction at 1 month related positively to the degree to
which he eXpected the baby to change his sleeping and eating
habits. Even in a marriage where the wife provides the.
majority of child-care, a new baby would be likely to
disturb the Sleeping habits of the rest of the household,
and to the extent that the infant's needs disrupt the
mother's usual routines, she might be unable to keep
meals on schedule. Getting meals may be symbolic of having
needs met for the husband. In any case, his anticipation
of such changes would help him better adjust without
blaming his wife and eXperiencing subsequent loss in
marital satisfaction.

The remaining two relationships are not so obvious.

Why would the husband's marital change have been negatively

 

related to how well he thought his wife's parents did
raising her and to how satisfied his wife was prenatally

with her job situation? Regarding the latter relationship,

99

if the wife's prenatal employment satisfaction is indi-
cative of her over-all job satisfaction, then the birth of
a child for the satisfactorily employed woman may interfere
with her job situation and diminish her related sense of
self-esteem after birth. For the woman who dislikes her
job, the baby provides relief from the job plus an alter-
native source of self-esteem (motherhood). In this study,
then, the husband's marital adjustment at 1 year may have
been a reflection of his wife's general satisfaction with
her role at that time. If this were true, a similar
relationship would have been unlikely at 1 month simply
because most mothers did not eXpect to be employed that soon
after delivery.

A violation of the husband's expectations may eXplain
the relationship identified between his perceptions of his
wife's parents and his marital satisfaction at 1 month.
Perhaps the husband who sees his wife's parents very
positively eXpects similar excellence from her and is
disappointed by her ineXperience and inability to live up
to his expectation, particularly during the disruptive
period immediately following birth. Similarly, the‘
husband eXpecting poor performance from his wife may be
pleasantly surprised by her unexpected adequacy. Dis-
appointment or pleasure at a spouse's abilities would likely
be reflected in the husband's marital satisfaction.

In summary, post hoc analyses generally supported

earlier studies which showed a positive view of pregnancy

100

and a companionate marriage style to be related to lower
marital satisfaction in the initial postbirth year. New
evidence showed the father's postbirth adjustment to be
related to satisfaction with decision-making procedures--
another potential support for the importance of traditional
family role eXpectations--and to his eXpectation of disrup-
tion in Sleeping and eating patterns. The new mother's

1 year postbirth adjustment was less predictable.

Overview of Research
At this point, a brief chronicle of the events involved
in this research may give the reader some perspective on
the complexity of longitudinal, eXploratory research as

well as some issues and problems specific to this study.

Formulatingpthe Problem

I became interested in the area studied for both
professional and personal reasons. Professionally, an
interest in preventive mental health was the end result of
several years of clinical training. The necessity of
producing a research-oriented dissertation for completing
a doctoral program was a further pressure which could not
be ignored. Personally, I had reached a decisive stage in
my own life cycle with regard to childbearing and parenting.
This led to informal observations of other couples in the
process of integrating children with their families and

lifestyles.

101

My further interest in beginning parenthood was
greatly stimulated by beginning a literature review which
increasingly indicated potential major difficulties for
the couple adjusting to the birth of a child. Contrary to
popular social myths, instead of adding joy to the marital
relationship, the advent of children appeared to decrease
marital satisfaction! The question which began to form,
then, was whether some type of preventive action might
lessen the effects of beginning parenthood on marital
satisfaction. The feasibility of investigating the question
immediately rested on a long-term research commitment

and on accessibility of a subject pool.

Locating_Subjects

 

A ready-made, easily accessed population was thought
to be available through prenatal education groups.
Accordingly, the two local groups, The Association for
Shared Childbirth (ASC) and the EXpectant Parent Organiza-
tion (EXPO) were contacted. An ASC representative was
discouraging. She gave no indication of support for
. integration of preventive materials with the prenatal
classes themselves. She further pointed to the poor
attendance of their postbirth presentations. The ExPO
president, on the other hand, was enthusiastic about using
the prenatal classes as a preventive treatment. She had

been informally discussing similar changes with a professor

102

who had recently become a father. They had been consider--
ing such classroom strategies as presenting more realistic,
balanced pictures of parenthood and providing decision-
making and stress reduction techniques to eXpectant parents.
Thus, serendipitous timing provided a potential source of
subjects and the impetus to progress to considerations of
measurement and design.

Use of a control group was a major design difficulty
in this research. A "true" control group in the present
study would have consisted of parents who asked for prenatal
education, were unable to obtain it, and were willing to
participate in the follow-up. This might well have produced
a source of error since highly motivated couples would have
undoubtedly sought education elsewhere (through other
prenatal groups and reading). They then would have become
prenatally educated "false" controls or would have had to
be dropped from the control group. Either option would
have altered the composition of the control group making
it no longer comparable to the treatment group. In addition,
the type of couple who would have volunteered for research
follow-up after being refused education would have
differed from the volunteer couple that knew it would
receive education. Even if the preceding were not the case,
differential drop-out rates would have been likely, with
couples who were refused education being less motivated to

complete the follow-up. And finally, given ethical and

103

financial concerns, the EXpectant Parent Organization, out:
of its own commitment to prenatal education, would not
have cooperated with research proposing to turn away a
portion of its applicants.

If the difficulty in recruiting a "true" control
group was fraught with problems when the initial subject
pool was to be gathered from the same source (i.e., couples
requesting prenatal education), the difficulties in
recruiting a control group comparable to the treatment
group from another source appeared insurmountable. Accord-
ingly, the present research was conducted as a comparison
of two different types of educational treatment, one which
covered the more usual prenatal topics of identifying and
coping with physiological changes during pregnancy and birth
and one which replaced some physiological content with
methods for identifying and coping with emotional changes.
The fact that all subjects received some treatment likely
lessened the overall differences between groups on outcome
measures, thus making statistically Significant results

less likely.

Designing the Experiment

The details of the eXperimental design have been
presented in the methodology section. A rigorous eXperi-
mental design requiring random subject assignment, assessing
possible effects of exposure to testing procedures, and

alternating instructors' assignment to treatment groups

was selected to insure the strength of any findings.

104

Identifying Variables for Measurement

Next identification of specific hypotheses and methods
of measuring outcome were considered. Marital satisfaction,
along with change or the degree of crisis eXperienced, had
already been clearly identified in the literature review.
Other outcome measures were chosen to examine the impact of
specific content areas in the revised curriculum. These
included decision-making processes, extent of communication,
attitudes toward baby, eXpectations of the spouse's role
and sexual adjustment. Only in the area of marital
satisfaction did a well-validated measure already exist--
the other scales required construction. It should be
noted that the additional outcome measures were often
selected based on the interests and needs of the cooperating
persons in EXPO. In research requiring such extensive
commitment and cooperation, involvement of personnel in
planning was considered crucial. This became even more
obvious as the research progressed.

Methods of collecting the data and timing of the
observations were the next concern. A forced-choice question-
naire was selected as it Could be sent and returned by mail.
It also facilitated the administration of the Spanier Dyadic
Adjustment Scale as part of its contents. As less
structured information would be valuable in an eXploratory
study, semi-structured interviews were also chosen. They
allowed the flexibility required to gather spontaneous

responses and uneXpected information while still "guiding”

105

the interview content so that similar areas were addressed-
by all couples. Undergraduate psychology students provided
a potential source of interviewers. While face-to-face
contacts may have provided more nonverbal information, the
feasibility of transporting interviewers or motivating
parents to transport themselves to such interviews was low.
Consequently, telephone interviews were selected as an
acceptable medium. Such interviews avoided transportation
difficulties and also provided parents with a somewhat
anonymous situation for self-disclosure. Times for measure-
ment were selected such that the first postbirth observation
might gather data on reactions to the crisis while it was
still occurring or fresh in the parents' minds. One year
was thought to be a time by which full adjustment to the
role change would.have occurred and parents might have a
perspective to Share about their adjustment.

Of course, the issue of control of extraneous variables
raised its head. Several sources of uncontrolled effects
which might influence outcome measures included: (a) person-
ality and history of the subjects, (b) human resistance to
change and reaction to unmet expectations as a result of
the new curriculum, (c) classroom variables including
instructors' attitudes, (d) differences in interviewers, and
(e) characteristics of the new baby. As these variables
could not be directly controlled, except perhaps by

matching, which causes other difficulties, they were

monitered; and random assignment of subjects was retained

106

as the tool for initial equalization of treatment groups.
The effects of unpredictable human variability were a
constant concern, and as already noted, those effects on

this research could not be adequately controlled.

Maintainingpthe Relationship with the Sppnsoripg Organization

Cooperation of ExPO instructors was critical to the
success of this study. Good management techniques dictated
that involvement of instructors in planning would have
increased their commitment to presenting new class content
and evaluating its impact. While participation and input
were solicited from instructors, most did not actively
participate. Reasons for nonparticipation were varied.
Instructors were paid by the hour for classroom time. They
were not reimbursed for nonclassroom activities such as
preparing materials or attending curriculum meetings.
Furthermore, instructors had already been becoming resentful
of the extra demands EXPO was placing on their time even
before introduction of the research. Consequently, in
Spite of efforts to solicit instructor input, only three
highly committed nurses were actively involved in designing
the new curriculum.

Meanwhile, intensive ongoing efforts focused on the
development of two parents' manuals and curriculum guides
for standardization of educational treatments. The three
interested instructors (including the organization

president), the professor mentioned earlier, and myself

107

were involved in those efforts. I had to rely on the three
instructors to design teaching materials and lesson plans
for the traditional physiological information. As this
material was familiar to all EXPO nurses, the three
instructors relied on brief outlines and explanations
obtained from old instructors' guides to construct their
materials. To make psychological content less threatening,
I produced a detailed teaching guide for those class sessions.
This limited instructor involvement in developing unfamiliar
psychological curriculum contributed to major problems
during the instructor training session outlined in Appendix
E (p. 134). Extensive, detailed guidelines for presenting
psychological information dwarfed the terse, informational
outlines provided for physiological content. Additionally,
training content for the instructors' workshop focused
mainly on unfamiliar topics--of course, the new emotional-
relational content. Consequently, instructors attending the
workshop found themselves faced with what appeared to be an
overwhelming amount of new content and very little familiar
material. Resistance to the new material was heightened by
this discrepancy.- Furthermore, some instructors were highly
committed to particular content areas, e.g. breast-feeding,
labor and delivery exercises, etc., which they felt were
slighted by the new approach. Hence, although the original
plan had been to try to convert all instructors to the new

content and new parent manuals, the end result of the

108

workshop was four instructors who volunteered to teach
the new content and old content one time each for the

research.

Locating Funds

 

Funding supports were necessary to defray typing and
printing costs of the parent manuals, to provide instructors
with pay incentives for participation in training, and to
pay postage and supply eXpenses for the questionnaire and
interview follow-up. Support of the Michigan State Univer-
sity Cooperative Extension Service was gained for typing
and printing of parent manuals. The Ingham County Board of
Commissioners provided grant funds for postage, instructor
re-imbursement, and printing supplies. The Michigan State
University Department of Psychology provided envelopes,
stencils and paper for the questionnaires and interview
forms. All of these contacts required time and paperwork.
Given multiple funding sources, it appeared to be advan-
tageous to be able to demonstrate cooperation from other

funding groups to any potentially resistant source.

Conducting the Treatment

 

Classes began with high levels of anxiety on the part
of instructors. The degree of tension can best be described
by the behavior of one instructor 15 minutes before her new
class was to begin. She was nearly frantic about whether
all the materials were there, whether her class would

respond, and whether She could adequately provide leadership

109

for group discussion. The surprising aSpect was that this-
teacher was the only one who had always led her class in a
discussion style in the past and who, for scheduling reasons,
was pg: involved in the research. Her reaction was typical
of research instructors and may have been an outlet for
more extreme tensions which they were unable to express
directly.

Samples of class sessions were observed from behind
a one-way mirror. Classroom atmosphere, unexpected class-
room events, and deviations from curriculum were recorded in
a log book. This provided opportunity to at least moniter
some of the many uncontrollable human factors already

mentioned above.

Collecting Data

 

As the beginning of data collection approached,
interviewers were recruited and trained. Interviewers
proved themselves to be conscientious and enthusiastic for
the most part; however, they required monitering to see that
they completed their assigned interviews and that their
interviews covered the designated areas. For the latter,
it was sufficient to assign occasional joint interviews in
which one interviewer listened to another's call and
provided feedback. To insure interview completion, it was
necessary to maintain regular contact with each interviewer
regardless of how reliable that interviewer seemed. One

interviewer, after 8 months of consistent work stopped

110

interviewing and did not inform me of her difficulties

until it was too late to collect the remaining data.

Finally, I was available by phone at any time the interviewers
initiated contact. These phone contacts proved helpful in
allowing interviewers to review their own skills and approach
and also in providing support after a difficult interview.
Difficult interviews ranged from the minor case of a

resistant interviewee to more extreme cases of spontaneous
abortions of the current pregnancy or revelations of rather
severe emotional difficulties by the interviewee.

The task of data collection was arduous. First, the
birth of the child had to be identified. In addition to
relying on parents to send postcards as notification of
the birth, newspaper birth announcements were read and
phone contacts initiated if the due date was several
weeks past. Once the birthdate was known, questionnaire
mailings and interviews were attempted. Suddenly parents
found they had little time to complete the observations.
Parents complained about the repetitiveness of questionnaires.
They also claimed insufficient time. Delinquent question-
naires were followed by one or two postcard reminders and
in some cases by a phone call.

Interviews were more readily completed as many of the
parents enjoyed talking about their eXperiences in great
detail. This was less true at the 1—year follow-up; however,
the majority still loved to talk! This is not to imply that

scheduling and completing the phone interviews was easy.

111

Often parents were very busy, were difficult to reach at
home, and had trouble scheduling a convenient interview
time. In addition, the interviewers themselves were
influenced by time pressures as well as by personal
reactions to some parents. Accordingly, interviewers
were aked to write a brief description of their reactions

to each interview and interviewee.

Analyzinngata

Analysis of the more structured questionnaire data was
relatively straightforward as answers were transferred
directly to computer forms. Classification of the open-
ended interview data was a complex task. Initially, an
attempt was made to create general categories of responses
to each open—ended question. Responses were so varied,
however, that the number of categories often reached 20 to
30 per question, making this process too unwieldy. Eventu-
ally, interview data were classified primarily on 2- or
3—point scales--either yes-no options or classifications
such as none-some-great. For example, a parent's answers
were classified as indicating "a great deal of", "some" or
"no" concern about finances. Even though inter-rater
reliability was possible under these circumstances, the
valuable variability of the unstructured responses was
drastically reduced. In the final analysis, use of inter-
view data was avoided. That wealth of information remains

untapped.

112

Finally, a full 3 1/2 years after the initial steps
were taken in this research, as the data analysis and
writing draw to a close, the time-consuming nature of the
study becomes inescapable. The would-be researcher may
adequately assess his/her commitment at the beginning of
a project, but it is unlikely that accurate judgements of
time and effort can be made. In a society changing as
rapidly as ours, it may even be difficult to predict that-
the researcher will wish to continue at the same job or
residence for the duration of a longitudinal study.
Unpredictable life changes may occur for the researcher,
just as they influence the subjects of the study. (I had
first-hand eXperience of beginning parenthood while still
analyzing data.) Even an intense interest in the topic
is likely to become satiated and change to other areas over
a long period of time. However, the work can be challenging
and the findings fascinating even without the blessings of
statistical significance.

A sense of humor can help, and it is in this vein that
several of Murphy's Laws (Dickson, 1979, p. 123) are offered
for the reader's enjoyment:

"If anything can go wrong, it will;

"Nothing is ever as simple as it seems;

"Everything takes longer than you eXpect:

"If you see that there are four possible ways in which
a procedure can go wrong, and circumvent these, then a fifth

one, unprepared for, will promptly develop; and

113

"Nature always sides with the hidden flaw."

17‘
«L

Suggestions for uture Research

It is difficult to document the prevention of poor
mental health. Without even beginning to address such
thorny issues as the components of positive mental health
and their measurement, how does one prove that something
missing would have been present had it not been for a
brief experimental manipulation? Yet, this is the task
for preventive mental health efforts; and if we are not
prepared to abandon preventive programs as a method for
positively impacting adjustment to developmental crises,
more research is necessary: (a) to better understand the
process of adjustment, (b) to refine programs, and (c) to
justify the continuation and eXpanSion of prevention efforts.
Some suggestions for future research follow.

First, large subject pools are preferable if statisti-
cally Significant changes are sought. The use of a power
test (Cohen, 1969) will inform the researcher of the numbers
needed. Larger subject pools will further increase the
success of random assignment in equalizing groups before
treatment. If large samples are economically unfeasible,
pretesting, if it is used at all, Should be applied to
all subjects in order to moniter similarity of groups before
starting treatment and also to provide increased statistical
power through a repeated measures design. Furthermore, an

argument can be made for the value of more intensive

114

observation of fewer subjects without aiming for statistical
differences. In this case, trends within smaller samples
might provide important information at less eXpense.

Second, subject drop-out should be carefully considered
in advance and efforts made to reduce it. These might
include minimizing the amount of time required of subjects
during poSttesting and/or maximizing the subjects' commitment
to, or rewards for, completion of the research. Rewards
might take the form of money, feedback, or subjective gains
such as increased self-awareness or ability to talk to an
interested person about an important topic. By fully
informing subjects of the details of their participation,
some drop—outs may be eliminated prior to participation.

If very few people decline to participate in an extensive
longitudinal study, perhaps the information being offered to
them is insufficient for adequate evaluation of their
commitment. In that case, information about participation
should be eXpanded and/or the commitment involved emphasized.

Assessment techniques must be carefully selected both
for their ability to tap characteristics which directly
reflect an effective intervention and for sensitivity to
subtle differences. For example, if an intervention is
aimed at increasing the amount and quality of interaction
between a parent and child, a tool measuring the amount and
quality of interpersonal interaction through direct observa-

tion is preferable to one measuring possible secondary

115

effects such as changed parental attitudes or gains in the-
child's developmental quotient.

In the event that a new technique is to be compared to
an old and established one, time should be allowed for the
new technique to be piloted and to become comfortable for
its administrator and its receiver. (This strategy might
also reduce the magnitude of any Hawthorne effect.) In the
present research, the new educational program was neither
comfortable for the instructors nor eXpected by the parents.
Had instructors been allowed to teach the material several
times before running subjects, or had psychologically
trained co-instructors been employed, the materials would
likely have been presented more confidently. Also perspec-
tive parents might have heard through informal or formal
communication that the content of the class had been eXpanded,
thus changing their eXpectations. Additionally, eXperi-
mental studies might be aimed at finding means for modifying
instructors' information and values and assessing the
effect of instructor attitude change on teaching style.

Finally, timing of an intervention so that the recip-
ient is aware of its value is likely to enhance the
intervention's success. This is particularly difficult in
preventive programs Since, by their very nature, they often
occur before a need is clear to the recipient. Thus, the
patient may be more receptive to learning about dental floss

after several painful hours in the dentist's chair. In the

116

case of the present research, postbirth education eXper-
iences might have better met the above qualifications if
parents had been approached as they were experiencing new
difficulties and needs. The first step would be to identify
timing and patterns of increased stress for parents. Then
at a time when levels of stress are rising, neighborhood-
based parent groups could be initiated or home visitors
might call on the family.

An alternative to changing the time of the intervention
is to heighten the recipients' perceived need for it. In
the present study, this might have been accomplished by
increasing the expectant parents' awareness through contact
with and observation of beginning parents and their
emotional difficulties. Other potential tools would
include presenting the findings of this and other research
and utilizing related classroom role-plays. Modes of
intensifying perceived needs might be assessed for their
relative ability to impact subjects.

The would-be researcher in this complex area should
be forewarned of the massive amount of time and energy
necessary and the likelihood of minimal immediate rewards.
Even though the researcher may feel realistically prepared
to face the difficulties, estimates of the necessary
commitment are likely to fall short of reality. Perhaps
the undertaking should be viewed as a developmental task

Similar to beginning parenthood--even the informed parent is

117

still surprised by the task's enormity. On the other hand;
just as parenthood is an inevitable part of biological
continuation, so is longitudinal research invaluable to

the understanding of psychological development.

BIBLIOGRAPHY

Abenheimer, K. M. A note on the couvade in modern England.
British Journal pf Medical Psyphology. 1946, g0,
376-377.

Argles, P. and Mackenzie, M. Crisis intervention with a
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Broussard, E. R. Neonatal prediction and outcome at
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Broussard, E. R. and Hartner, M. Maternal perception of
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Bruehl, R. G. The process of leaving home in a case of
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Clark, L. Introducing mother and baby. American Journal
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Edwards, A. L. EXperimental design ip psychological
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Erickson, E. H. Identity, Youth, and Crisis. New York:
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Feldman, H. Development pi the husband-wife relationship.
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Feldman, H. and Feldman, M. The family life cycle: some
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Gelles, R. J. Violence and pregnancy: a note on the extent
of the roblem and needed services. Famiiy Coordinator.

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Ginath, Y. Psychoses in males in relation to their wives'
pregnancy and childbirth. Israel Annals Lf Psychiat_y
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Harrison, P. The making of a motherhood myth. American

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APPENDIX A

Introductory Letter

124

APPENDIX A

$3 X y'A ' 9
as: expectant parents
32%;“ orgamzation

August 5, 1976

Dear Expectant Parents,

He are currently revising our program and assessing its ability to help
parents adjust to the pregnancy and birth of their first child. In order
to do this, we will be surveying and interviewing a number of parents

who are enrolled in our program. On the basis of the parents‘ responses.
we will be able to modify our present program so that it better meets the
needs of couples who are expecting a child.

As you are no doubt aware by now, pregnancy and beginning parenthood are
times of many feelings and changes. Your participation in this survey will
help us to better understand the adjustments necessary in becoming parents
so our program can provide information which will be helpful in dealing with
the first few months of parenthood.

Those parents who participate will be contacted on separate occasions before
and after their child is born. The survey should require only 20 to 30
minutes to fill out a questionnaire and 15 to 20 minutes in a telephone
interview for each of the contacts.

This assessment is being conducted through the cooperation of Expectant
Parents’ Organization and the Michigan State University Cooperative Extension
Service. It has been funded by the Ingham County Board of Comissioners.

Before your assignment to an expectant parent class, you will be contacted
concerning your willingness to participate in the survey. This will allow
your questions about the study to be answered and will aid us in assigning
you to a parent education group. Your participation should not only prove
helpful and thought-provoking for you as a family but also will serve to
help later couples in their pregnancy and parenthood. Results of this
survey will be made available to you upon its completion if you wish to
see them.

Your cooperation is vital to the success of this program. All responses will,
of course, be confidential. Naturally, you are free to choose not to par-
ticipate; however, if you do so decide, we ask you to indicate that decision
when you are first contacted within the next couple weeks.

Thank you for your cooperation,

Carol Ducat
2620 montego o lensing, Michigan 48912

APPENDIX B

‘Research Contract

125

APPENDIX B

*4 % *A Research: Contract ,
see expectant parents
Vim)? orgamzatIon

Expectant Parents' Organization maintains a philosophy of parent participation in
its programs and planning. The cooperation of expectant and new parents in
honestly sharing their experiences and reactions is essential to the success of
this philosophy. Those parents participating in this feedback procedure can
expect to experience the satisfaction of helping later beginning parents. More
importantly, as a result of the interviews and questionnaires used, participants
should experience an increased awareness of themselves, their families, their
feelings and their adjustments to pregnancy and parenthood.

This study is designed to assess expectant parent education classes. Two new
classroom approaches are to be tried. Parents who agree to be available to give
feedback in the program will be assigned by a lottery process to one of the new
programs. The study will obtain feedback from parents about the effectiveness

of the approaches and also provide Expectant Parents' Organization with additional
information about the process of become a parent so that the program may be
further revised to include additional relevant information. This information
will, of course, be shared with other expectant parent education programs for
their incorporation. In short, the over-all goal of this assessment is the
improvement of expectant parent education.

The feedback process is aimed at getting your input in the following areas of
family life: (l) your perceptions and expectations of your child, (2) the
effects of parenthood on your marital relationship, 3) your family's decision-
making procedures, (4) your communication patterns, 5) family changes and
adjustments necessary for you to adapt to pregnancy and the addition of a child,
(6) rewards and costs of family life.

In order to clarify our expectations of participants and so that you can better
understand what to expect of us, the following agreement is made.

The expectant couple agrees to the following:

(1) Each parent will complete a questionnaire within prescribed time limits on
two or three different occasions (before attending class, 3-4 weeks after
birth, and 6-7 months after birth).

(2) Each parent will participate in a phone interview on two or three different
occasions (before attending class, 3-4 weeks after birth and 6-7 months
after birth).

126

(3) The expectant couple will provide relevant background information (see
attached sheet).

(4) The couple will allow anonymous use of the pooled information volunteered
by all couples for the purpose of providing information to other parent
education programs .

(5) Each parent will complete brief classroom evaluations at the end of each
class period.

(6) The expectant couple will fill out and return the enclosed postage paid
card within one week of the baby's birth.

(7) The expectant couple will provide accurate and honest information.

The Expectant Parents' Organization agrees to the following:

(1) Classroom notebooks will be provided free of charge for participating
parents.

(2) Information provided by expectant couples will be kept confidential and
anonymous in tabulating results.

(3) Evaluation results will be provided within six months of the completion
of the study to those parents who desire them.

(4) Twenty hours of classroom training will be provided for participating
couples at the usual charge.

(5) Every effort will be made to schedule phone interviews at a convenient
time.

The undersigned have read the above conditions and agree to them.

 

 

 

 

DATE
Expectant Mother

DATE
Expectant Father

DATE

 

 

Project Coordinator
Phone: B4l-6845

Please fill out the enclosed Background Information sheet and sign and date this
fonm. Keep one copy of this agreement and the post card for your files. Return
one copy of this agreement and the Background Information form to us in the
enclosed envelop.

Any questions may be directed to the Project Coordinator.

APPENDIX C

Background Information

127

APPENDIX C

Background'Information
BACKGROUND INFORMATION '
Wife's Name Wife‘s Age
Hife’s Occupation wife's Race
Hife's level of education (circle highest year completed)

school grades college
6 7 B 9 l0 ll 12 l 2 3 4 MA PhD

Hife's mother's level of education (circle highest grade completed)

school grades college
6 7 B 9 l0 ll 12 ,l 2 3 4 MA PhD

Hife's father's level of education (circle highest grade completed)

school grades college
6 7 8 9 10 ll 12 l 2 3 4 MA PhD

Has wife ever been divorced? (circle one) YES NO If Yes, when?

 

Has wife had any previous children? (circle one) YES NO

First letter and first three digits of wife‘s drivers license number *
Husband's Name Husband's Age
Husband's Occupation ' Husband's Racep______
Husband's level of education (circle highest year completed)

school grades college
6 7 B 9 10 ll l2 1 2 3 4 MA PhD

Husband's mother's level of education (circle highest grade completed)

school grades college
6 7 8 9 l0 ll l2 1 2 3 4 HA PhD

Husband's father's level of education (circle highest grade completed)

school grades college
6 7 8 9 10 ll l2 1 2 3 4 MA PhD

Has husband ever been divorced? (circle one) YES NO If Yes, when?

Has husband had any previous children? (circle One) YES NO

First letter and first three digits of husband's drivers license number *
Your approximate combined yearly income:

How long have you been married?

 

Did you live together prior to marriage? (Circle one) YES NO If yes,
how long?

'This is the code number which will be used to anonymously identify your responses
in the future.

0

APPENDIX D

Course Content for T and B

Class 1
OBJECTIVES:

1. To acquaint parents with other class members.

2. To acquaint parents with total program and import-
ance of prenatal instruction.

3. To dispell superstitions and anxieties regarding
development of the baby by providing factual inform-
ation.

4. To give information of the maternal changes and
fetal development of the first trimester of preg-
nancy.

5. To help expectant parents deal effectively with
their feelings concerning this period of pregnancy.

6. To help expectant parents understand the importance
and meaning of prenatal care.

TOPICS:

l. Introductions

2. Film - While You're Waiting

3. Conception and birth control

4. The first trimester of pregnancy

Class 2
OBJECTIVES:

I. To enable expectant parents to understand the phys-
ical changes that occur in the mother and the devel-_
mental growth of the fetus during the second and
third trimester.

2. To provide information on the natural pattern of
weight gain based on fetal and maternal changes.

3. To help expectant parents identify common feelings
during this stage of pregnancy and explore ways of
dealing with these feelings.

4. To promote understanding of the importance of nutri-
tion.

TOPICS:

l. The second and third trimester

2. Nutrition

3. Film - Great Expectations

4. Exercises to relieve physical discomfort during
pregnancy.

Class 3
OBJECTIVES:

1. To provide information relevant to the parents'
choice to breast or bottle feed.

2. To encourage creativity in the choice made.

3. To encourage confidence in the choice made for

128
APPENDIX D

Course Content for T

 

 

infant feeding.

129

Class 3 cont.

 

TOPICS:
l. Breastfeeding
2. Bottle feeding
Class 4
OBJECTIVES: -
1. To assist the expectant parents to prepare for both
the physical and emotional experience of childbirth.
2. To lessen anxiety and fear of the unknown through
emphasis on the normal processes of labor and
delivery.
3. To alert each couple to the individuality of each
labor and delivery.
TOPICS:
l. Pre-labor and plans for hospital admittance
2. First stage of labor
3. Abdominal breathing
Class 5
OBJECTIVES:
1. To assist parents in preparing for the emotional and
physical experience of childbirth.
2. To lessen anxiety and fear of the unknown.
3. To practice breathing techniques for labor and
delivery.
TOPICS:
1. Active phase of labor
2. Chest breathing
3. Transition phase
4. Second stage of labor
5. Third stage of labor
6. Pushing technique
7. Summary of all stages of labor and delivery
Class 6
OBJECTIVES:
l. To allow discussion of parents' concerns about labor
and delivery.
2. To acquaint expectant parents with initial medical
treatment of their baby.
3. To allow discussion of feelings about the father in
the delivery room.
4. To acquaint couples with recovery room procedures.
TOPICS:
1. Film - Miracle of Birth
2. Fathers in the delivery room
3. Care of the infant in the delivery room
4. Recovery room

130

 

Class 7
OBJECTIVES:

1. To give parents a realistic picture of the newborn
infant's appearance.

2. To identify the needs of the new mother and infant
particular to the post partum period.

TOPICS:

l. The appearance of the newborn

2. The physical needs of the newborn

3. The physical needs of the new mother

4. Film — The Newborn

Class 8
OBJECTIVES:
1. To familiarize the couple with the hospital sur-
roundings in which the birth will occur.
TOPICS:
1. Physical aspects of the hospital
2. Tour
Class 9
OBJECTIVES:

1. To provide basic information to parents regarding
clothing and equipment that is needed in the care
of an infant.

2. To provide information to parents as to the basic
needs of an infant in the first year of life.

3. To provide information to parents as to growth and
development during the first year.

4. To help parents recognize phases of adjustment of
both parent and child.

TOPICS:

1. Equipment and clothing needs

2. Basic needs of the infant

3. Phases of adjustment

4. Attachment

5. Safety

6. Babysitters

Class 10
OBJECTIVES:

1. To motivate parents to explore various philosophies
of parenting

2. To enable parents to cope with the stresses of
leaving the hospital and assuming the roles of
parents.

TOPICS:

1. Baby temperament

2. Crying babies

3. Philosophies of parenthood

4. Child discipline

131

—

Course Content for E

 

Class 1
OBJECTIVES:

1. To help couples recognize that pregnancy, birth and
parenthood are stressful events which are represent-
ative of the many normal developmental events occur-
ring in the family life cycle.

2. To encourage the identification of the needs and
expectations of the class participants.

3. To provide a rationale and overview of the class.

TOPICS:

l. Introductions

2. Film - Adapting pp Parenthood

3. The Family Change Model

Class 2
OBJECTIVES:

1. To illustrate the dimensions of the second trimester
in relation to the family change model.

2. To understand that exercise is an essential element
in health maintenance for mother and father.

3. To provide information and practice exercises that
will help the mother reduce the discomforts of
pregnancy and prepare her body for the birth pro-
cess.

TOPICS:

l. The second trimester

2. Care of the pregnant body

3. Exercises

Class 3
OBJECTIVES:

1. To understand the relationship between stress,
tension and pain.

2. To learn a procedure for reducing tension in the
delivery room and elsewhere.

3. To learn constructive communication skills for use
in preventing or reducing stress.

TOPICS:

1. Stress

2. Communications skills

3. Relaxation techniques

Class 4
OBJECTIVES:

1. To provide information relevant to breast and bottle
feeding.

2. To provide practice in a decision-making model.

3. To promote the use of decision-making process when

appropriate.

132

Class 4 cont.

 

TOPICS:

1. Breast feeding

2. Bottle feeding

3. Film - Breastfeedipg

4. Decision-making

Class 5
OBJECTIVES:

1. To develop a better understanding of the labor pro-
cess.

2. To reduce anxiety of the unknown by providing inform-
ation.

TOPICS:

1. Preparation for birth

2. Plans for hospital admission

3. Signs and symptoms of labor

4. Stages of labor and delivery

5. Coaching role of the husband

Class 6
OBJECTIVES:

I. To develop a better understanding of the birth pro-
cess thereby reducing anxiety of the unknown.

2. To develop skills in breathing techniques that will
facilitate the birth process and also alter the
mother's perception of discomfort.

TOPICS:

1. Second state of labor

2. Anesthesia

3. Forceps, fetal monitors, c/sections

4. Chest breathing, panting

5. Film - Miracle pi Birth

6. Baby in the delivery room

7. Recovery room

Class 7
OBJECTIVES:

1. To facilitate an understanding of the physical,
emotional, and relational changes occurring during
the postpartum period.

2. To promote a positive relationship between parents
and their infant through an understanding of the
attachment process and knowledge of the infant's
needs.

3. To provide an opportunity to review and practice
breathing and relaxation skills for childbirth.

TOPICS:

l. The attachment process

2. Physical chan es in the mother following delivery

3. Emotional and relational dimensions after birth

4. Preparation for childbirth skills

133

Class 8
OBJECTIVES:
1. To familiarize the couple with the hospital sur-
roundings in which the birth will occur.

TOPICS:
1. Physical aspects of the hospital
2. Tour

Class 9

OBJECTIVES:

1. To sort out expectations of baby and his behavior.

2. To identify what behaviors are expected for the role
of mother and father.

3. To practice decision making skills in coping with
the crying baby.

TOPICS:

1. What is life with baby like?

2. What is my role as mother/father/parent?

3. Coping with crying

Class 10
OBJECTIVES:

1. To recognize that the marriage relationship is an
important factor in the health growth and develop-
ment of the family, including the child.

2. To promote awareness of common problems expressed
by new parents.

3. To review some methods of coping with these prob—
lems through re-establishing closeness between the
parents and identifying support systems outside

the family.
TOPICS:
1. Common concerns of new parents
2. Re-establishing closeness
3. Outside sources of support
4. Course summary

APPENDIX E

Curriculum Workshop

Friday, Sept. 10
7:30-8:00 p.m.

8:00-8:30 p.m.

8:30-10:00 p.m.

Saturday, Sept.

8:00-8:45 a.m.

8:45-9:30 a.m.
9:30-9:45 a.m.
9:45-11:15 a.m.
11:15-11:45 a.m.
ll:45-l:OO p.m.

1:00-2:00 p.m.

134
APPENDIX E

Curriculum Workshop

Sept. 10, 11, 12, 1976

Demonstration on how to use new projectors

Introduction, ground rules, schedule
Carol Ducat

Class 1
Introductions, "Adjusting to Parenthood"

film, Family Change Model, Research methods
and approach

Class 2

How to relate homework assignments to
second trimester

Communication and Stress

Break

Continue with Communication and Stress
Lunch

Decision Making

Classes 5 and 6
Labor and Delivery

2:00 p.m. (optional) preview of film "Great Expectations"

Sunday, Sept. 12

8:00-9:00 a.m.

9:00-9:30 a.m.
9:30-9:45 a.m.

9:45-11:15 a.m.

ll:l5-ll:45 a.m.

Class 7
Hospital Stay, Attachment

Relationship with Child
Break

Continue Relationship with Child
Role Playing

Lunch

135

llz45-lz30 p.m. Relationship with Spouse

1:30-2:00 p.m. Summary

APPENDIX F

Class Topic Checklist

136

Class Topic Checklist

ID #
Male Female (circle one)

Following is a list of tOpics which may or may not
have been discussed in your class. Please check the topics
which you remember covering during this ten—week series.

physical aSpects of pregnancy

emotional aspects of pregnancy

effects of pregnancy on the family
family change

stress

diapering a baby

feeding a baby

bottle preparation

breast feeding

family decision-making

stages of labor and delivery

exercises for labor and delivery
exercises for pregnancy

newborn characteristics

baby temperament or disposition
parenthood

effects of babies on the husband-wife relationship
maintaining closeness with your spouse after birth
infant schedutes

postpartum changes in the mother
nutrition

choosing a pediatrician

effective communication

disciplining children

coping with a crying baby

pediatrician in class as guest lecturer
equipping the nursery

child safety

APPENDIX G

Instructor Evaluation Form

137
APPENDIX G

Instructor Evaluation Form

CODE: ' CLASS:
INSTRUCTOR:

 

 

NEEKLY EVALUATION

For purposes of our survey, at the end of each class. you will be asked to quickly
rate your instructor based on how she presented the materials for that specific
class period. Please indicate your response to the following statements by
circling the word or phrase which best describes your assessment.

If you were absent for the class, please check this blank and turn in the form.
Circle one: Male Female
The instructor's knowledge about today's subject was:

 

EXCELLENT GOOD ADEQUATE POOR
The instructor's enthusiasm for today's subject was:
VERY HIGH HIGHER THAN ABOUT LOWER THAN VERY LON
AVERAGE AVERAGE AVERAGE
In dealing with today's topics. the instructor appeared:
VERY SOHEHHAT SLIGHTLY VERY ILL AT
COMFORTABLE COMFORTABLE UNCOHFDRTABLE EASE
The instructor's ability to present ideas about today's topics was:
EXCEPTIONAL GOOD ABOUT AVERAGE POOR EXCEPTIONALLY
POOR I
0--------'---'-------------'--------------"---"-.,3.“'------2 ............................
CODE: CLASS:
INSTRUCTOR:

 

__HEEKLY EVALUATION

For the purposes of our survey, at the end of each class. you will be asked to
quickly rate your instructor based on how she presented the materials for that
specific class period. Please indicate your response to the following statements
by circling the word or phrase which best describes your assessment.

If you were absent for the class, please check this blank and turn in the form.
Circle one: Male Female
The instructor's knowledge about today's subject was:

EXCELLENT GOOD ADEQUATE POOR
The instructor's enthusiasm for today's subject was: a
VERY HIGH HIGHER THAN ABOUT LONER THAN VERY LOH
AVERAGE AVERAGE AVERAGE
In dealing with today's topics, the instructor appeared:
VERY SOHEHHAT SLIGHTLY VERY ILL AT
COMFORTABLE COMFORTABLE UNCOMFORTABLE EASE
The instructor's ability to present ideas about today's topics was:

EXCEPTIONAL GOOD ABOUT AVERAGE POOR EXCESgégNALLY

APPENDIX H

Instructor Reports

Date:

138

APPENDIX H

Instructor Reports

 

Instructor's name:

 

Educational approach being used at present time:

Traditional program
Modified program

Please indicate your feelings of satisfaction with each of
the two educational approaches by checking the best answer
to complete the statements below:

At the present time, I believe the traditional educational

approach

to be

very satisfactory.
somewhat satisfactory.
neutral.

somewhat unsatisfactory.
very unsatisfactory.

At the present time, I believe the modified educational

approach

to be

very satisfactory.
somewhat satisfactory.
neutral.

somewhat unsatisfactory.
very unsatisfactory.

If I were to compare the two programs, I would say

the modified program is far superior to the
traditional one.

the modified program is somewhat better than
the traditional one.

both the modified and the traditional programs
have equal merit.

the traditional program is somewhat better
than the modified one.

the traditional program is far superior to

the modified one.

Please make any comments about your feelings or eXperiences
with these two programs below.

APPENDIX I

Questionnaires

139

APPENDIX I

Questionnaires

GENERAL DIRECTIONS FOR QUESTIONNAIRES

Enclosed are two questionnaires, one for the wife and one for the husband.
It should take about half an hour apiece to fill out the questionnaires.
Specific directions are included in the questionnaires themselves when needed.

It is important that you try to answer each question even though it may
sometimes be difficult to decide on an answer. If you should have difficulty
with a question, answer it as best you can; and 11 you wish, write a comment
explaining your answer.

Please fill out your own questionnaire before talking with your spouse
about‘how he/she would answer. After you have both finished your question-
naires, feel free to discuss your answers with each other if you wish. However,
do ppp_change your original answers on the questionnaire after talking with
your spouse.

Return the completed questionnaires separately in the two envelopes which
are provided.

Thank you

140

APPENDIX I

Questionnaires

ID i l ' oars
pre-husb '

 

HUSBAND'S quesTIoaNAxns

murr*

Host persons have disagreements in their relationships. Please indicate below
the approximate extent of agreement or disagreement between you and your partner
for each item on the following list.

- Almost Occa- Fre- Almost
- Always Always sionally , quently Always Always
.Agree Agree Disagree Disagree Disagree Disagree

1. Handling family finances
2. Matters of recreation
3. Religious matters

4. Demonstration of affec- ‘
tion

5. Friends
6. Sex relations

7. Conventionality (correct
or proper behavior)

8. Philosophy of life

9. Hays of dealing with
parents or in-laws

10. Aims. goals. and things
believed important

ll. Amount of time spent
together -

' 12. Making major decisions
13. Household tasks

14. Leisure time interests
and activities

-15. Career decisions
16. Child raising

an ' hue -
the Host of often Occa- '
time the time than not sionally Rarelz Never

ll. How often do you discuss ’ -
or have you considered
divorce. separation or
terminating your relao
tionship? ‘ ‘

18. How often do you or your
mate leave the house
after a fight?

19. In general, how often do ~
you think that things
between you and your
partner are going well?

Over

* Part I is mainly comprised of the Spanier Dyadic
Adjustment»Scale.

141

ID i
pre-husb

All More ,
the Host of often Occa-
time the time than not sionallv Rarely, Never

20. Do you confide in your
note?

21. Do you ever regret that
you married? , '

22. How often do you and your
partner quarrel? '

23. How often do you and your
mate 'get on each
other's nerves?“

. .

' ‘ Almost Occa-
Everv an Every Day sionally, Rarely Never

24. Do you kiss your mate?

All of Host of Some of Very few None of
them them them of them then

2S. Do you and your mate en-
gage in outside interests
together?

 

- How often would you say the following events occur between you and your mate?

Less than Once or Once or
once a Twice a Twice a Once a More
Honth Month week day often

if
<
0
‘

 

 

25. Have a stimulating exchange
of ideas

27. Laugh together
28. Calmly discuss something
29. Work together on a project

There are some things about which couples sometimes agree and sometimes disagree.
Indicate if either item below caused differences of opinions or were problems in
your relationship during the past few weeks. (Check yes or no)

Yes No
30. .__ Being too tired for sex..

3l. Not showing love.

The dots on the following line represent different degrees of happiness in your

elationship. The middle point, "happy," represents the degree of happiness of

most relationships. Please circle the dot which best describes the degree of

happiness. all things considergd, of your rglationshipa S 6
O

 

Extremely Fairly A Little Happy Very Extremely Perfect ’
yghepay . Qghaapy U_nhappy - Happy Haney

11:2

In I
pro-hush

32. which or the following statements best describes how you feel about the future
o! your relationship?

_I want desperately tor my relationship to succssd. and would go to almost
a; length to son that it does.

_I want very much for my relationship to succeed, and will do all I can
—to see that it does.

_I want very much for my relationship to succeed, and will do n: fair
—shars to see that it does.

_It would bo nice it my relationship succeeded. but I can't do much more
—§hgg I am doing now to help it succeed.

It would be nice i! it succeeded. but! refuse to do gag more than I so
doing now to keep the relationship going.

Hy relat -onship can never succeed. and there is no more that I can do
to keep the relationship going.

PAR! II

1. Check the response below'which best describes what changss'havs occurred in
your total family income within the last six months.

Total income decreased 36, 000 or more.

Total income decreased less than 3e,OOO.

Total income remained the same.

Total incoma increased only by a cost of living raise.

Total incoma increased by more than cost of living but less than 3‘, 000.
Total income increased by more than $4,000.

2. Has your wife's employment situation changed as a result of the pregnancy?
(circle one) Yes No If yes, describe how below.

3. During this pregnancy. how often has your wife seemed to experience physical or
mental discomfort due to the pregnancy? (check best answer)

all of the time
most of the time
more often than not
occasionally

rarely

never

l ‘ I

4. Are there regularly scheduled or usual times in your daily routine when you and
your wife discuss things with each other? (circle one) Yes No

If your answer was yes. when are those times?
If your answer was yes. how often do they occur? (check best answer)

less than once a month
l-Z times per month
l-Z times per week
_ once a day
____more than once a day

ever

11+}

In f
pre-husb

6. What is the average anount of tine.you and your wife spend in discussions each
day? (check best answer)

less than 15 ninutes

between 15 ninutss and 30 minutes
between 30 ninutes and 1 hour
between 1 and 2 hours

‘ note than 2 hours

7. When you are faced with a decision, how often do you consult with your wife?
(check best answer) -

all of the tine sons of the tine
nest of the ties occasionally Never

8. Please list below any recent decisions you have nsde about the toning baby.

PART 111

Please indicate the degree of your agree-ens or disagree-set with each of the
following statenents by circling the best answer according to the key below.

III: &A - Strongly Agree d - disagree
a - agree SD - Strongly Disagree
3 - Neither agree nor disagree
1. sa a a a so Housework is the wonan's job.

2. SA a h d SD A husband should feel obligated to help his wife if he has
the tine.

'3. SA a N id SD housework should be done before the husband cones hone.

A. SA' a N d '50 The husband and wife should share in decisions concerning
expenditures of money.

5. SA a H d SD All in all, ny own parents did a good job raising ne.
6. SA a N d SD All in all. ny wife's parents did a good job raising her.

7. SA a N d so At the present tine ny wife seess generally pleased with
our sexual relationship.

8. SA a N d SD Adjusting to this pregnancyis a difficult experience for ne.

9. SA a N .d 80 Adjusting to this pregnancyis a difficult experience for
' ny wife. - _

1.0..” a a d 50 After conpleting this questionnaire. ny wife and I are
likely to discuss our answers to it.

Continue to next page

144

In I
pro-hush

2A2! IV

Generally at the present tine, how satisfied are you with each of the following?
(check one answer for each iten)

very Somewhat Soaewhat -Very
satisfied satisfied dissatisfied dissatisfied

a. You and your wife's
decisions about work

b. You and your wife's
decisions about parenting

c. You and your wife's
decisions about nosey

d. You and your wife's . -
decisions about leisure
tine activities

.e. You and your wife's.
sexual relationship

f. You and your wife's
conversations

g. The anount of ties you and your
wife spend in consersations

h. Your present job situation

i. Your wife's present job
situation -

1. Your participation in faeily
decision nahing

k. Your wife's participation in
fanily decision raking

’ Paar v

IRSTRUCTIOSS: For the following items, please check the answer which best
conpletes the sentence.

1. As a result of ny.wife's pregnancy, ny wife and I now
feel ouch closer to each other.
feel sonewhat closer to each other.
feel sonewhat about the sane degree of closeness as before the pregnancy.
feel sonewnat less close to each other.
feel such less close to each other.

2. Conparad with before ny wife's pregnancy. ny wife and I now have
easy note discussions than before.
a few note discussions than before.
about the sans nunber of discussions.
slightly fewer discussions than before.
nany fewer discussions than before.

 

Over

145

In I
pta-husb

3. Compared "ifih 0“! 3031138! 5010‘! my wife became pregnant. my wife and I can
now be described as

1____nuch less satisfied with our present situation.
_ slightly less satisfied with our present situation.
____about as satisfied as we were before the pregnancy.
____nore satisfied with our present situation.

much more satisfied with our present situation.

‘e M ‘ :‘3‘11: 0‘ my "1:". r. nc ..
I have assumed many diff:::ntybehaviors and tasks from those I previously

performed in the family. _ . ,

I have assumed some new behaviors and tasks within the family.

I heve kept the same behaviors and tasks-within the family.

I have performed fewer of my usual behaviors and tasks within the family.
I have stopped many routine family tasks and behaviors.

ated with how I felt before.ny wife became pregnant. I now feel

much more unsure of my ability to handle difficulties than I felt before.
somewhat less sure of my ability to handle difficulties than I felt before.
about the same amount of confidence in my ability to handle difficulties.
somewhat more confident of my ability to handle difficulties than I felt
before. - ‘
____euch more confident of my ability to handle difficulties than I felt before.

6. Cfllpetfid 91:5 how I felt b£f°!| my wife became pregnant. I'now feel
much happier. -

somewhat happier. '

about the same amount of happiness.

somewhat less happy.

much less happy.

7. when most decisions occur in our family.
__g_one partner makes the final decision with little or no consulting of
the other.
____one partner makes the final decision after discussion with the other.
____both partners reach the decision together through discussion and comprmnise.
our decisions are not our own but are often forced on us by outside
circumstances.

Ellll

u
s

PAR: VI

1. You probably have given some thought to what you think having a baby in the
. family will be like. How much do you expect the coming baby to change each of
the following in your family? (Check the best blank for each item.)

A A moderate ' Very hot at
great deal amount Somewhat little all

a. Your relationship with
your wife

b. Your life style

c. Your leisure time activities

d. Your sleeping and eating habits
e. Your sexual relationship

f. Your family finances

 

 

Continue to next page

In!
preehusb

2. Following is a partial list of new parents' tasks. Indicate how you think each
of these tasks should be divided in your family. Check the appropriate blank
for each item as you think your family should divide it.

husband .Busband Husband was was
should should do and wife should do should
always do more than should share more than always do
wife equally husband
a. Change baby's -
diapers
b. Launder baby's
clothes

c. Quiet baby when it
tries

d. Arrange for care for
baby when wife
must be away

s. Get up in the night
with baby

f. feed baby
g. Play with baby

b. Other tasks (please
Ivscifr):

 

‘PAII VII'

to: the following questions, make an I on the percentage line in the place
which best represents your answer or opinion. .

1. All things taken into account. what percentage of the time have things been
going well during the past month? (Mark the line below.)

I ._n[ I I ~ I I I I I gI I
1002 so: so: 70: so: so: «or 30: 20: to: or

2. All things taken into account. what percentage of the time have you felt satis-

fied with your marriage relationship during the past month? (Hark the line
below.)

I I I j I I I I I_ I' I
1002 901 802 702 b0: 50: 601 302 202 10! OZ

3. when all family decisions for the past month are taken into account, mark
- the line below to indicate what percentage of those decisions you agree with.

I '1" I I I I_ I I I I I
100: 902 802 702 602 50% 60: 301 201 10: 0:

Over

147

APPENDIX I

Questionnaires

10 f DATE
post l-husb

 

HUSSAND‘S QUESTIOflflAIRE

emu:

Host persons have disagreements in their relationships. Please indicate below
the approximate extent of agreement or disagreement between you and your partner
for each item on the following list.

Almost Occa- Fro- ‘ Almost
Always Always sionally quently Always Always
Agree Aggree Disagree Disagree Disagree Disagree

1. Handling family finances
2. Matters of recreation
3. Religious matters

4. Demonstration of affec- ‘
tion

5. Friends
6. Sex relations

7. Conventionality (correct
' , or proper behavior)

8. Philosophy of life

9. Rays of dealing with
parents or in-laws

lD. Aims, goals. and things
believed important

ll. Amount of time spent
together

.olZ. Making major decisions
l3. Household tasks

. l4. Leisure time interests
and activities

15. Career decisions
_l§. Child raising

 

All More .
the Host of bften Occa-
time the time than not sionallz» ggrely Hever

l7. How often do you discuss

or have you considered

divorce. separation or

. terminating your rela-
tionship? . -

l8. How often do you or your
mate leave the house
after a fight?

19. In general. how often do
. you think that things
between you and your

partner are going well?

Over

* Part I is mainly comprised of the S anier D d'
Adjustment Scale. p ya it

11i8

.ID i
post 1

All ' More _
the Most of often Occa-
time the time than not sionally, Rarely Never

20. Do you confide in your
mate?

Zl. Do you ever regret that
you married?

22. How often do you and your
partner quarrel?

23. How often do you and your .
mate "get on each
other's nerves?”

‘ "" Almost Occa-
Eve Da Ever: Oaz sionallz Rarely Never

24. Do you kiss your mate?

All of Host of Some of Very few None of
them them them of them them
25. Do you and your mate en-
gage in outside interests
together? -'

How often would you say the following events occur between you and your mate?

Less than Once or Once or
once a Twice a Twice a Once a More
flgggg’ Month Month week day often

26. Have a stimulating exchange
of ideas

27. Laugh together
28. Calmly discuss something
29. Work together on a project

There are some things about which couples sometimes agree and sometimes disagree.
Indicate if either item below caused differences of opinions or were problems in
your relationship during the past few week . (Check yes or no)

Yes he
30. Being too tired for sex.

31. Not showing love.

The dots on the following line represent different degrees of happiness in your
elationship. The middle point, ”happy.” represents the degree of happlness 0*
most relationships. Please circle the dot which best describes the degree of

happaness. all things considergd. of your rglationshipa

 

 

 

 

5 6
Extremely Fairly A Little Happy Very Extremely Perfect
Qghappy unhappy_ Enhappy Happy H399!

Continue to next page

149

ID I
poot l-hnob

32.

1.

2.

3.

5.

5.

Hhich at tho following ototononto boot'doocziboo how you fool about tho fututo
o! you: tolotionohip?

_I wont dooporotoly tot oy rolotionohip to ouccood, ond would go to olnoot
—ggz_lggggg.to ooo thot it dooo.

I wont voty ouch for oy tolotionohip to ouccood, ond will do all I too
to too thot it dooo.

I wont voty ouch for oy tolotionohip to ouccood, ond will do 31 to it
ggg§:,to ooo thot it dooo.

_It would bo nico it oy tolotiooohip ouccoodod, but I con' t do ouch ooto
—§hon l on dgigg now to holp it ouccood.

It would bo nico it it ouctoodod. but I tofuoo to do on: noto thou I on
doigg now to hoop tho tolotionohip going.

fly tolotionohip con novor ouccood, ond thoro is no noto thot 1 con do
to hoop tho tolotionohip going.

PAR! 11

Chock tho tooponoo bolow which boot dooctihoo who: thongoo hovo occuttod in
you: totol tonily incnoo within tho loot oio noutho.

Total incono doctooood $5,000 or onto.

Iotol incooo doctooood looo thon $6,000.

Totol incooo tonoinod tho oolo.

rotol incono inctooood only by o toot o! living toioo. '

totol incooo incxooood by noto thoo toot of living but looo thou $6,000.
_Iotol incooo inczooood by onto thon $6, 000.

lovo you oovod oo o tooult at tho now boby? (cirtlo ono) to: lo If yon,
dooctibo how your living ottongooonto hovo choogod (o.g., oowod tron
l-bodrooo.opo:toont ond bought houoo).

PLEASE NOT! NEH 12183808! HUHBER:
During thio ptognoncy, how ottoo did you: wiio oooo to ooporionco phyoicol or

 

. oll at tho tino octooionolly
ooot of tho tino __ ttrIlY
noto ofton thon not novor

how would your wito'o lohot ond dolivory boot bo doocribed?
voty ditticult oooy
difficult ‘ voty oooy

obout tho oooo oo ooot

Arc thoto togulotly ochodulod or uouol tinoo in you: doily toutino whon you
and your wito diocuoo things with ooch otho:2 (circlo ooo) to: No '

It you: onowo: woo yoo. whon oro thooo.tiooo?

11 you: onowot woo yoo, how otton do thoy occur? (chock boot ooowot)
looo thon onco o nonth ooco o doy

l-Z tinoo pot oonth _ooto thon onto o doy
l—Z tinoo pot wook

Ovor

150

ID !
poot l-huob

6. Shot in tho ovorogo anount of tinoyouond yourwito opond indiocuooiono ooch
doy? (chock boot ono'wor) , '

looothoolininutoo ,

bomon 13 oinutoo and 30 oinutoo
botnoon 30 oinutoo and 1 hour
botwoonlondlhouro '
norothonlhouro

7. Hhon you oro tocod with o docioion. how otton do you conoult with your wito?
(chock boot onowor)

ollotthotino ';_ooooo£thotiao .
_ooot o1 tho tino . '_occooionolly Novor

8. Ploooo liot bolow ony rocont docioiono you hovo oodo obout tho now boby.

an 111
Ploooo indicoto tho dogroo o1 your ogroaont or dioogronont with ooch of tho
following ototononto by circling tho boot onowor according to tho koy bolow.

In: so - Strongly Agroo ’d - dioogroo
o - ogroo SD - Strongly Dioogroo
l - noithor ogroo not dioogroo
1. SA o l d 30 louoowork io tho wooon'o job.

2. SA o R d 50 A huobond should fool obligotod to-holp hio wiio i: ho hoo
tho tino.

3. 8A o. N '_d 81) Bouooworh should bo dono bototo tho huobond coooohooo.

6. SA o R d 50 "rho huobond ond wito ohould ohoro in docioiono concorning
upondituroo o1 oonoy.

5.8A o s d 51) Allinoll,nyownporontodidogoodjobroioingno.
6. so .‘ x a so Allinoll.oywi£o'o poronto didogood job roioing hot.

7. SA o N d SD At tho prooont tioo oy wifo oo-no gonorolly plooood with
our ooansol rolotionohip.

8. SA o H d 81) ddjuoting to thio now boby in o difiicult ooporiooco {or no.

9. 8A o I d 81) Adjuoting to thio now boby io o difficult ooporionco for.
any wizo.

10..“ o a d $0 “to: cooploting thio quootionnoiro. oy wito ond I oro
7 likoly to diocuoo our onoworo to it.

Continuo to non: pogo

1151

lb I
poo: l-huob
an IV

Gonorollyotthoproaont tino. hooootiotiodoaroyouwithoochot thotollowingl
(chockonoanowortoroochitu)

_ Yor'y Solowho: Sol-aha: Vory
ootiotiod ootiotiod dioootiotiod dioootiotiod

o. You and your wito'o
dociaiono about uork

b. You ond your wifo'o
docioiono about porootin;

t.'You and your wito'o
docioiono obout oonoy

d. You and your wifo'o

docioiono obout loiouro
:ioo octivitioo

.o. You-‘ond your wilo'o.
ooouol rolotionohip

1. You and your wifo'a

convorootiooa

g.‘!hoooounto£tiooyouoodyour
witoopondinconvorootiooo

h. Your prooon: job oituotion

1. Your wiio'o prooont job
oituation

j..Your participotiou in tonily
docioion noting

h. Your wilo' o puticipotion in
looily docioion noting

rmv

1331313611038: Yo: tho following itooo, ploooo chock tho atom which but
cooplotoo tho oontonco.

l.dootooulto£ thiobirth,nywi£oandlnoo
tool nth clooor to ooch othor.
tool oouowhot clooor to oach othor.
tool aouowhot obout tho “so dogroo of clooocooo oo boron-o tho prepaid-y.
‘5 fool oooouhot looo clooo to ooc'a othor.
foolnuch loco clooo to oochothor.

2. Connorod with hotoro tho birth of our baby, :1 21:. cod 2. now hovo
‘ oony noto diacuooiono than boforo.
o tow aoro diocuooiono than boforo.
. about tho oano nuobor o1 diocuooions.
_ olightly towor diocuooiono than botoro.
oony fowor diocuooiono thon boforo.

152

In I
post l-huob

3. Cooparod with our foolings boforo tho birth of our baby. ny wifo and I can
now bo doscribod as
____nuch loss satisfiod with our prosont situation.
___.slightly loss satisfiod with our prosont situation.
___.about as satisfiad as wo wora boforo tho prognoncy.
ooro satisfiod with our prasont situation.
_ouch noro aatisfiad with our prosont situation.

A. As a rasult of this birth.

____I hovo assunod nony difforont bohoviors and tasks tron thooo I prawiously
porfornod in tho faoily.
I hovo assunod soon now bohowiors and tasks within tho faoily.
_ ____I hows hop: tho saoo bohowiors and tasks within tho faoily.
I hovo porfotnod favor of ny usual bohavioro and tasks within tho fanily.
_I hovo stoppod nony routino faoily tasks and bohawiors.

S. Conoarod with how I fol: boforo tho birth of our baby, I now fool

_ouch ooro unouro of oy ability to handlo difficultios than I fol: boforo.
_sonowha: lass aura of ny ability to bandlo difficultios than I fol: boforo.
about tho saoo aooun: of confidonco in ny ability to hondlo difficultios.
sooowho: ooro confidant of oy ability to hondlo difficultios than I fol:
bofoto.

____ouch ooro confidant of oy ability to handlo difficultias than I fol: bofora.

6. Coooarod with how I fol: boforo tho birth, I now fool
ouch hoopior.

aooowhot hoppior.

about tho saoo anoun: of happinoso.

sooowhat loos happy.

ouch loss happy.

soot docisiono occur in our fanily.
ono partnor aakos tho final docision with littla or no consulting of
tho othor.

mpartnar nokos tho final docision aftor discussion with tho othor.
_bo:h partnors roach tho docision togothor through discussion and conproniso.
:our docisions aro not our own but aro oftan forcod on us by outsida
—circuostoncos.

7

IA]: VI

1. A now baby always cousas sooo changes in tho family. Chock tho blank which
.-boo: doscrihoo how such your now baby has changod oath of tho following.

A A nodarato ' Vary Not a:
grant doal amount Sonowhot littla all

a. Your rolationahip with
your wifo

b. Your lifo stylo

c. Your laisuro tins activitios

d. Your slooping and oating habits
o. Your sandal rolationship

f. Your fanily financoa

g. 0thor (plooao opocify):

llllll
llllll
llllll

 

 

Continua to nor: pogo '

153

ID I .
post l-husb

2. following is a partial list of now paronta' tasks. Placo an ”S” in tho
blank which indicatas how you think oach of thoso tasks should bo dividod
in your family. Plato an "A" in tho blonk which indicatss how this task
actually i_s_ dividod in your family. . You will has two answors for oath itan.

husband Husband Husband Wifo "ifs
should should do and wifo should do should
always do unto than should shora noro than always do
wifo squally husband

a. Chango baby' a
diopors

b. Laundor baby's
clothas

c. Quiot baby whon it
crios

d. Arrango for cars for
baby whon wifo
oust bo away

.o 6.: up ‘3 eh. m:
with baby '

f. toad baby
g. Play with baby

h. ' 0thor tasks (plooao
spocify) :

 

rm VII'

For tho following quostions. oaks an x on tho portontago‘ lino in tho placo
which boot roprosonts your answor or opinion.. ,

1. All things takon into account. what parcantago of tho tins hows things boon
going wall during tho pas: nonth‘! (Hark tho lino bolow.)

L I I I « I I I - J J I ' I
max 90: so: 70: . 60: so: 40: 30: 20: 10: oz

' 2. All things takon into account, what parcantago of tho tins hows you fol: satis-
If’itd with your norriago rolstionship during tho pas: nonth? ,(hark tho lino
o ow.
l I Ifi I f / I It I I /
1001 901 80: 701 60: 502 401 302 201 10: oz

3. "hon all fanily docisions for tho past month aro takon into account, nork
tho lino bolow to indicato who: porcontago of thoao docision: you agroo with.

. I / / - / I / l I
1002 902 802 701 602 502 40% 301 201 1.02 OZ

Ovor

154

In I
post-l

1mm:

8mm.

Cooploto tho following sontoncas as quickly as you too. Don't worry
about tartbook answors; cooploto th- ths way m fool about tho issuoo

involwod.

l.

1.

3.

6.

3.

7.

9.

1‘.

Who: poronts want nos: of thair childron

 

 

Sooowooondon'twaottnbowocbildranbocouso

 

 

Hynothor

 

 

hon wont childran bocauso

 

 

Largo fanilias

 

 

fathor oopocts his child

 

 

 

birth control

 

A childlaso Iarriago

 

 

Conorally, tho rooson for having childron

 

 

I want to boys childron bocauso

 

 

Sooooondon': wan: to howo childron bocauoo

 

 

hoot fanilios

 

 

Hononwantchildranbocauso

 

 

Although having childran is natural

 

 

Continua to nor: pogo.

16.

17.

21.

22.

30.

155

In planning for a child's futuro

 

 

Rho: childron won: ans: of thoir parants

 

 

Ibo only child

 

 

hnthor axpocts hor child

 

 

Ibo roason I want to born a son

 

 

o

"ban a child is ya: unborn, tho paronts

 

 

In considoring oorriago. a poroon

 

 

Childron who aro not plannod

 

 

I would oopoct Iy son to

 

 

I would liko to hawo a daughtar bocauoo

 

 

hy fathor

 

 

Early norriogoo

 

 

Plannod paronthnod

 

 

logarding childron, tho wifo wants hor husband to

 

 

I would oopoc: ny daughtar to

 

 

I hops to hows 0, l, 2, 3, 5+ childran. (Circlo ono)

156

APPENDIX I

Questionnaires

ID I DATE
post g-husb

 

HUSBAND‘S QUESTIONNAIRE

PART I

Must persons have disagreements in their relationShips. Please indicate below
the approximate extent of agreement or disagreement between you and your partner
for each item on the following list.

Almost Octa- Fre- Almost
lweys Always sionally quently Always Always

Am Am Disagree Disagree Disaggg Disagree

>

l. handling fhnily finances
2. Matters of recreation
3. Religious setters

4. Demonstration of affeco
tion

5. Friends -
6. Sex relations

7. Conventionalitxmicomct
or proper behavior)

8. Philosophy of life

9. Hays of dealing with
parents or in-laws

l0. Aims. goals. and things
believed important

ll. Amount of tine spent
together

l2. Making najor decisions
l3. Household tasks

l4. Leisure time interests
and activities

15. Career decisions
16. Child raising

I
III
III
III
HI I I
MI

More _
Host of often Occa-
the time than not gionally Rarely . Never

|§~£§lll

l7. How often do you discuss
or have you considered
divorce. separation or
terminating your rela-
tionship? -

l8. How often do you or your
note leave the house
after a fight?

l9. In general. how often do
you think that things
between you and your
partner are going well?

157

ID! ,
you:

All ‘yore
the Host of often Occa-
time the time than not sionally Rarely Never

20. Do you confide in your
mate?

Zl. Do you ever regret that
you married?

22. Haw often do you and your
partner quarrel?

23. How often do you and your
mate ”get on each
other's nerves?“

Almost Occa-
Evegz Day Eves: Day sionally Rarely» Never _

24. Do you kiss your mate?

All of Host of Some of, Very few-hone of
them them than . of them them

25. Do you and your mate en-
gage in outside interests
together? .. __ __

How often would you say the following events occur between you and your mate?

Less than. Once or Once or
-once a Twice a Twice a Once a More
Never, Month Honth 9 week ..day gften

 

 

 

26. Have a stimulating exchange _
of ideas _ -

Z7. Laugh together
28. Calmly discuss something
29. Work together on a project

There are some things about which couples sometimes agree and sometimes disagree
indicate if either item below caused differences of opinions or were problems in
your relationship during the gag: few necks. (Check yes or no)

Yes No
30. __ _ Being too tired for sex.
31. __ __ Not showing love.

The dots on the following line represent different degrees of happiness in your
clationship. The middle point.-"htppy." represents the degree of happiness of
most relationships. Please circle the dot which best describes the degree of
happiness, all things considergd, of your rglationshipa 5

0

 

Extremely Fairly A Little _ Happy Very Extremely Perfect
911mm game)! when Happy - Happy

158

In!
post Z-husb

32. Which of the following statements best describes how you feel about the
future of your relationship?

I want desperately for my relationship to succeed. and would go to almost
any lgggth to see that it does.
I went very much for my relationship to succeed. and will do all I can
to see that it does.
I went very much for my relationship to succeed. and will do 5: fair
share to see that it does.
It would be nice if my relationship succeeded, but §_ggg___gg_ggg§_gggg
than I am doing now’to help it succeed.

It would be nice if it succeeded. but I refuse to do any more than I

«doing now to keep the relationship going.

fly relationship can never succeed. and there is no more that I can do
to keep the relationship going.

Illll

 

‘ ' ‘ {All 11

1. Check the response below which best describes what changes have occurred in
your total family income within the last year.

tbtal income decreased $6,000 or more.

total income decreased less than 36,000.

total income remained the same.

Total income increased only by a cost of living raise.

Total income increased by more than cost of living but less than $6, 000.
Total income increased by more than $6,000.

2. Have you moved as a result of the baby? (circle one) Yes no If yes,
describe how your living arrangements have changed (e.g.. moved from
lmbedroon apartment and bought house).

PLEASE HOT! NEW TILEPBON! NURSER:

 

3. have you changed your Job situation as a result of the baby? (circle one)
Yes no If yes, describe how.

é. Are there regularly scheduled or usual times in your daily routine when you
and your wife discuss things with each other? (circle one) Yes No If
your answer was yes, when are those tines?

5. What is the average amount of time you and your wife spend in discussions
each day? (check best answer)

Lass than 15 minutes

Between 15 minutes and 30 minutes
Between JO minutes and 1 hour
Between 1 and 2 hours

More than 2 hours

(Continue to next page)

159

to:
post Z-husb

6. When you are faced with a decision, how often do you consult with your wife?

All of the time ‘ . Some of the time Never
Most of the time Occasionally

7. Please list any recent decisions you have made regarding your chiid.

[All 111

Pleaae indicate the degree of your agreement or dieagreeeent with each of the
following atatenente by circling the beat enewer according to the key below.

III: SA - Strongly Agree d - dieagree
a - agree SD - Strongly Dieagree
U - Neither agree not disagree

1. SA a K d SD Housework ie the wouen'a.job.

2. SA a N d SD A hueband should feel obligated to help hie wite it he has
(MU-IO. A

'3..SA a I d SD Housework ahould be done before the huebend tonne hole.

4.34 a x a so TheMebandendwiieehouldahareindeoiaioneconoerning
.eapenditurea ot noney.

5. SA. a N d '80 All in all. ly own perente did a good job raieing ae.
6. SA a N d SD All in all. ay wife'a parents did a good job raining her.

7. SA a N d so At the preaent tine my wife aeene generally pleaaed with
our aexual relationahio.

8. SA a h d SD Adjusting to thin new baby in a difficult experience for ne.

9. SA a h .d SD Adjusting to thin new baby in a diificult experienee for
‘ Iy wile. ‘ .

10. SA a N d SD Alter toupleting thio questionnaire. lay wife and I are
likely to diituea our anewere to it.

I1.SA a N d SD Our friends and relativea think I as doing a good job
raining our child.

12. SA a N d SD Our friends and relativea like our baby.

(Continue to next page)

160

ID!
poet Z-husb

PART IV

Generally at the present tine. how satisfied are you with each of the following?
(check one answer for each itee) ‘

v... , 3...... Sonewhat Vary
aetisfied satisfied dissatisfied dissatisfied

a. You and your wife's
decisions about work

b. You and your wife's
decisions about parenting

c. You and your wife's
decisions about honey

d. 'You and your wife's
decisions about leisure
tine activities

a. You and.your wife's

_ sexual relationship

f. You and your wife's
conversations . . .

g. The anount of tine you and

. your wife spend in

conversations

h. Your present job
situation

1. Your wife’s present
job situation

1. Your participation in
family decision making

k. Your wife's participation in
family decision making

1. Your wife's ability to be
a good parent

n. Your own ability to be
a good parent

4

 

PAR! V

INSTRUCTIONS: For the following items, please check the answer which best
‘ coepletns the sentence. .

1. As a result of our child, my wife and I now

feel nuch closer to each other.

feel somewhat closer to each other.

feel sonewhat about the same degree of closeness as before the pregnancy.
feel somewhat less close to each other.

feel ouch less close to each other.

2. Compared with before our baby arrived. my wife and I now have
nany more discussions than before.

a few more discussions than before.

‘about the sane number of discussions.

slightly fewer discussions than before.

many fewer discussions than before.

ID

161

I

post Z-husb

3.

A.

5.

6.

7.

f.
g.

Compared with our feelings before the birth of our baby, my wife and I can
now be described as
____much less satisfied with our present situation.
slightly less satisfied with our present situation.
___.about as satisfied as we were before the pregnancy.
_mors satisfied with our present situation.
:much more satisfied with our present situation.

As a result of this birth,

*1 have assumed many different behaviors and tasks froe those I previously
*performed in the family.

I have assumed sole new behaviors and tasks within the family.

I have kept the ease behaviors and tasks within the fanily.

I have performed fewer of my usual behaviors and tasks within the fanily.
I have stopped many routine family tasks and behaviors.

Compared with how I felt before the birth of our baby. I now feel

much sore unsure of my ability to handle difficulties than I felt before.
somewhat less sure of ay ability to handle difficulties than I felt before.
about the same amount of confidence in my ability to handle difficulties.
somewhat more confident ofw ability to handle difficulties than I felt
before.

_auch more confident of my ability to handle difficulties than I felt before.

Compared with how I felt before the birth. I now feel
much happier.

somewhat happier.

about the same amount of happiness.

somewhat less happy.

much less happy.

the other.

one partner makes the final decision after discussion with the other. _
_both partners reach the decision together through discussion and compromise.
:our decisions are not our own but are often forced on us by outside
—circumstances. .

PAR! VI

A baby always causes some changes in the family. Check.the blank which
best describes how much your baby has changed each of the following.

A A moderate . Very' Hot at
great deal amount Somewhat little all

'Your relationship with

your wife
Your life style
Your leisure time activities
Your sleeping and eating habits
Your sexual relationship
Your family finances
Other (please specify):

 

 

 

Continue to next page

162

ID 0
post l-husb

2. following is a partial list of new parents' tasks. Place an "S" in the
blank which indicates how you thinkzeach of these tasks should be divided
in your family. Place an "A" in the blank which indicates how this task
actually ig_divided in your‘family. ,You will have two answers for each item.

Husband ' "Husband Husband nu. nu.
should should do and wife should do should
always do more than should share more than always do
wife equally ‘husband
a. Change baby’s
diapers
b. Launder baby's
clothes

c. Quiet.baby when it
an».

d. Arrange for care for
baby when wife
must be away

s. Get up in the night
with baby

1. feed baby
g. Play with baby

b. Other tasks (please
specify):

 

2A2: VII

Yor the following questions, make an x on the percentage line in the place
which best represents your answer or opinion.

l. All things taken.into account. what percentage of the time have things been
going well during the past month? (Mark the line below.)

I - I I I I I ' / I I I
«100: ~ 90: so: 70: 602 502 «or 30: 20: 102 oz

2. All things taken into account, what percentage of the time have you felt satis-

{1:4 with your marriage relationship during the past month? (hark the line
ow. "

g I I I I I - I / ' I /' I
100: 90: 80: 70: so: 502 act 30: 20: . 101 oz

3. when all family decisions for the past month are taken into account, mark
the line below to indicate what percentage of those decisions you agree with.

I " I I' I I I j I I I I
1001 so: so: 70:: . 602 50?. «oz 30: 20: 101 oz

Over

163

ID!
post Z-husb
PAR! VIII
A. What method of feeding did you choose for your child? (Please check one and

answer any questions which follow the answer you checked.)

breast only

How long was baby breastfed?

Bottle only

Combination of breast and bottle
How long was breastfeeding used?
How did you combine breast and bottle?

3. Of all the times you may want a babysitter. how easy is it for you to
get one? (Circle a number.)
1 2 3 6 S
Sitter Sitter Available Sitter Sitter never
always available usually available about half usually not available
the time available
When you do get a babysitter, how confident do you feel about your sitters'
ability to cars for your child? (Circle a number.)
1 ‘ 2 3 5 5
Extremely ' neutral Extremely un-
confident in comfortable
aitter's ability with aitter’s
ability
C. Following are four reasons that people may wish to have children. First, rank
these items from I to 6. placing a 1 next to the reason that is most important
to you personally, 2 next to the second must important reason, etc. Next rank
these items as you think most people in this country would rank them.
Your personal ranking How you think

others would
rank them

A. An affection and liking for children; a
concern for children; a desire to take care of
‘or nurture a child.

3. A feeling that it is part of the purpose or
destiny of people, a desire to continue the
human race.

 

C. A desire to create someone in his own image;
the child's ability to follow in his/her
parents' footsteps or to reflect well on
his parents.

D. A child's ability to provide comfort or support
for a parent, such as companionship,
affection. cement for a marriage or help
around the house.

ID!

164

post 2

PAII II

From birth. different babies have different ways of reacting to experiences.
This section asks you to describe your baby' a style of reacting along several
dimensions. Circle the number on the scale which best describes your baby.
(There are no right or wrong answers: rather this is an attempt to describe the

l.

3.

temperament with which your child was born.)

Activity level: Does your baby move around a lot. twist, squirm or kick
while you dress him/her or does s/he lie quietly awake for long periods?

Very active very quiet

l _2 3 _ 4 ,' . ' 5' '
Regularity: Is your baby predictable with respect to eating. sleeping and
bowel movements or is s/he unscheduled and erratic? .
Very ~ very unscheduled
Predictable

1 2 3 b 3

’Adaptability to change in routine: low easily does your .baby adapt to

changes in schedule or to new situations? Does it take many experiences with
a new situation for your baby to adapt to it? Do you find yourself adapting
your schedule to the baby or does your baby readily adjust to,a schedule
which is convenient to you?

Adapts very easily Experiences great die-
to new situations comfort with new situs
and schedules ' ' ations and schedules

1 . 2‘ ,3 6 S -

Reaction to new experiences: How does your baby usually'react the first time
s/he encounters new people. foods. situations, etc.? Does s/he act pleased
and curious or tend to act somewhat frightened and shy away? (Bots: It is

'devulopmentally normal for a child to begin showing a fear of strange people
. sometime between 6 S 12 months. If your baby has reached this stage, dis-

regard his/her reactions to strange people when answering this question.)

Very pleased S . Very easily frightened
curious about a new in strange & new
situation ' situationa'

l 2 3 6 5

Level of sensitivity to sensations: Does your baby startle easily at loud
noises? Become annoyed by bright lights, rough clothes, hot or cold tempera-
tures? Does pain (a bump or scratch) bring a howl of discomfort or barely

a whimper?

Very sensitive Pays very little
to sensations attention to sensations
l 2 3 6 5

(Continue to next page)

165

ID!
post 2

6. Positive or negative mood: Is your beby generally pleased and contented or
frequently fussy and dissatisfied even after a nap or feeding? Does
slhe'cry a lot upon awakening?

Almost always .Almost always dis-
contented satisfied 8 unhappy
l 2 3 A 5

7. Intensity of response: when your baby expresses feelings. bow intensely
does a/he do it? Does s/ha cry loudly or fairly quietly in comparison to
other babies? when happy, does s/he squeal with excitement or simply-
smile? How much energy does s/he seem.to have for eating, fussing and
generally moving about?

leacta very leects very mildly
intensely
l 2 3 b S

8. Distractibility: How easy is it to draw your child's attention away from
an activity? When crying, can s/bo be easily distracted with.a toy or
change of position? when eating..is s/ha easily distracted by-other

activities?
Very easily Persists in face of
distracted. most distractions

. l 2 3 A 5

9. Persistence and attention span: How long will your baby stick with an
activity. even if difficult or interrupted? For example. the persistent
child keeps trying to reach a toy,out of reach; the nonpersistont one
tries only once or twice. ,A persistent child may keep fightins ¢8P0=1r
ences s/he dislikes. like having his/her face washed while the nonpersis-
tent child accepts without protest. A persistent child may return again
and again to a forbidden activity, while the nonpersistsnt child may stop
almost immediately. '

Extremely usually accepts
persistent without protest
l 2 3 6 3 '

APPENDIX J

Interviewer Training

II.

166
APPENDIX J

Interviewer Training

Introduction of interview outline to be used

OLD?)

C)

PHD

Discussion of each subject area

Memorization of subject areas and subtopics
Discussion of how to introduce self at beginning of
interview

Keeping a log of hours

istening skills

Paraphrasing
1. Definition of paraphrase
2. Demonstration of paraphrase
3. Practice of paraphrase (interviewers use each
other to practice skill)
Empathy
1. Definition of empathy
2. Demonstration of empathy
3. Practice of empathy and paraphrasing together
Asking questions
1. Open-ended questions
a. Definition of open—ended questions
b. Purpose (to expand on topic)
c. Creation of questions relevant to interview
outline
d. Practice
(1) Each other (role plays)
(2) Actual parent interview
2. Pursuit questions
a. Definition of pursuit questions
b. Purpose (to track down more specific inform-
ation
0. Creation of pursuit-type questions relevant
to questionnaire
(1) Introduction of closed questions-—
specifically the ones included as part
of the interview
(2) Pursuit questions aimed at answering
the closed questions
d. Practice
(1) l-2 actual parent interviews listened
to and critiqued by trainer and other
interviewer
(2) l-2 parent interviews to be completed
in free time at home

Transitions
1. What makes a good transition
2. What kinds of natural transitions may occur in

this particular subject matter
3. What to do when transition isn't there (genera-
tion of ways to smoothly introduce each topic)

167

n. Continued practice
I. Begin recording answers
a. For interviews done as practice at home, go
over forms in class
b. For interviews done in class, both inter-
viewers fill out the interview form to check
for reliability
c. Practice continues to criterion reliablity
F. Dealing with interviewee's questions

(Total training time estimated at 15-20 classroom hours.)

APPENDIX K

Outline of Telephone Interviews

168

APPENDIX K

Outline of Telephone Interviews

Prebirth interview

 

I.

II.

III.

IV.

VI.

VII.
VIII.

Introduction

A. Identification of interviewer

B. Establishment of convenient interview time

C. Investigation of privacy and degree of comfort of
interviewee

Reactions to pregnancy

A. Discovery of pregnancy
B. Interviewee's reaction
C. Spouse's reaction

D. Pregnancy planning

Changes in life due to pregnancy

A. How is being pregnant different from before
pregnancy

B. What have been changes with pregnancy

C. How long taken to adjust to changes

Support structure

A. Who is contacted for problems or concerns

B. How often contacted

G. How comfortable does interviewee feel contacting
resource

Expectations of parenthood and coming baby
A. What changes are anticipated

B. What rewards are expected

C. What difficulties are anticipated

Communication with spouse
A. Topics currently discussed

.3. Differences between current topics and pre-pregnancy

topics
Other reactions or feelings

Interviewer's assessment

Degree of comfort for interviewee

Degree of honesty of interviewee

Inconsistencies

Additional reactions to interviewee or interview
process

bow»

169

Postbirth interview--1 month

 

I.

II.

III.

IV.

VI.

Introduction

A. Identification of interviewer

B. Establishment of convenient interview time

C. Investigation of privacy and degree of comfort of
interviewee

Labor and delivery

A. Description of the labor and delivery

B. Description of reaction at first sight of baby
1. Interviewee's reaction
2. Spouse's reaction

C. Efficacy of classes in preparing for labor and
delivery

Baby's name

A. When chosen

.B. Why chosen

C. Who was primarily responsible for choice

The baby at home
A. Feelings and reactions to having baby at home
1. How is it as eXpected
2. How is it different from eXpected
B. Changes in family routine and roles
1. New activities or chores
2. Changes in old routines
3. Most difficult changes
C. Return of family routine to a predictable pattern

Marital relationship
A. Effect of new baby on marital relationship
1. Changes
2. Positive aSpects
3. Negative aspects
B. Effect of new baby on communication
1. How conversations are different from before
birth ,
2. How satisfied interviewee is with conversations
and frequency

Support sturcture

A. Who is contacted for problems or concerns

B. How often contacted

C. How comfortable does interviewee feel contacting
resource

D Has there been contact with other prenatal classmates

170

VII. Xpectant parent classes feedback
What stands out
. What was most helpful
. What would interviewee leave out
. What additional reactions
VIII. terviewer' 8 assessment
Degree of comfort for interviewee
Degree of honesty of interviewee
Inconsistencies
Additional reactions to interviewee or interview
precess

E
A.
B
C
D
In
A.
B.
C.
D.

Postbirth interview--1 year

I. Introduction
A. Identification of interviewer
B. Establishment of convenient interview time
C. Investigation of privacy and degree of comfort of
interviewee

II. Description of child
A. Personality of child
B. Characteristics which parent might like to change
C. Special problems in growth or health
D. Hopes for child

III. Decision to have more children
A. Does couple plan additional children
B. What factors influence decision
C. Who would be primarily responsible for decision

IV. Changes in life due to baby

A. Changes in lifestyle and relationships to other
people

Use of leisure

. Attitudes toward job

Relationships with friends

Relationships with relatives

Spontaneity

Personal goals

B. Age of child when household routine settled into a
predictable and comfortable pattern

C. Readjustment of marital relationship

mmthr-A

V. Relationship with spouse
A. Ways in which baby has affected relationship
B. Effects on sexual relationship
C. View of spouse in parental role

VI.

VII.

VIII.
IX.

171

Attitude toward self as a parent

A. View of self in parental role

B. Effects of parenting on self-concept

C. Strengths and weaknesses as a parent

D. Relationship between parenting role and life goals

Parenthood

A. How is parenthood as expected

B. How is parenthood different from eXpected
C. What are rewards and costs

Advice or thoughts for parents—to-be
Reactions to participation in survey

Interviewer's assessment

. Degree of comfort for interviewee

. Degree of honesty of interviewee

Inconsistencies

Additional reactions to interviewee and interview
process

UOtUID

APPENDIX L
Interscale Correlations for Original
Communication, Decision-making and Marital Adjustment

Subscales Before Creating Combined CDMA Scale

172

APPENDIX L
Interscale Correlations for Original
Communication, Decision-making and Marital Adjustment

Subscales Before Creating Combined CDMA Scale

Pre-birth observation (N = 66)

 

 

 

MA DM
Communication (COM) .93* .79*
Marital Adjustment (MA)‘ .73*
Decision-making (DM)
1-month observation (N = 93)
MA DM
COM .61* .69*
MA , .56*
l-year observation (N = 95)
MA DM
COM .66* .60*
MA .72*

* significant at p _<_ .001

APPENDIX M

Inter Scale Correlations at Each Time of Observation

173

APPENDIX M

Inter Scale Correlations at Each Time of Observation

Pre-birth observation (N = 66)

CRADJ SEXADJ
CDMA — .35 .47
CRADJ* - .38

l-month observation (N = 93)

CRADJ SEXADJ DISCR
CDMA — .08 .44 .37
CRADJ* .09 - .19
SEXADJ .OO

DISCR*

l-year observation (N = 95)

CRADJ SEXADJ DISCR ATTBA
CDMA - .35 .43 .13 .20
CRADJ* - .33 - .10 - .39
SEXADJ .05 .33
DISCR* ' ' .17

* The reader is reminded that for these scales, low values
are a positive score while high values are poor.

KEY: CDMA - Communication/Decision-making/Marital Adjustment
CRADJ - Crisis Adjustment
SEXADJ - Sexual Adjustment
DISCR - Discrepancy Between Should and Actual in
Division of Tasks .
ATTBA - Attitude Toward Baby

APPENDIX N

Item Content for Scales

174

APPENDIX N

Item Content for Scales

Communication/Decision-makinEZMarital Adjustment (CDMA) Scale'

ITEM CONTENT (Questionnaire location of items is designated

10

11

12

13

in parentheses. See Appendix I, p. 139 for
actual questionnaires.)

Presence or absence of regularly scheduled or usual
times in daily routine when husband and wife discuss
things with each other (II 4)

Average amount of time couple spends in discussions
each day (II 5)

Likelihood of consulting with spouse when faced with
a decision (II 6)

Belief that the husband and wife should share in
decisions concerning eXpenditures of money (III 4)

Degree of satisfaction with own and spouse's decisions
about work (IV a)

Degree of satisfaction with own and spouse's decisions
about parenting (IV b)

Degree of satisfaction with own and spouse's decisions
about money (IV c)

Degree of satisfaction with conversations with spouse
(IV f)

Degree of satisfaction with the amount of time Spent
in conversations with Spouse (IV g)

Degree of satisfaction with participation in family
decision-making (IV j)

Degree of satisfaction with spouse's participation in
family decision-making (IV k)

Degree of consulting between spouses when making
family decisions (V 7)

Percentage of time respondent has felt satisfied with
the marriage relationship during the past month (VII 2)

175

14 Percentage of all family decisions during the past
month with which respondent agrees (VII 3)

15 Total score for the Spanier Dyadic Adjustment Scale (I)

176

APPENDIX N

Item Content for Scales

Crisis Adjustment (CRADJ) Scale

ITEM CONTENT (Questionnaire location is designated in
parentheses. See Appendix I, p. 139 for
copies of questionnaires.)

\) O‘xU‘t (rm

Degree to which adjusting to pregnancy/birth has been
a difficult eXperience for the respondent (III 8)

Degree to which adjusting to pregnancy/birth has been
a difficult eXperience for the spouse (III 9)

Degree of change in relationship with spouse (VI 1 a)

Degree
Degree
Degree

Degree

of
of
of
of

change
change
change

change

in life style (VI 1 b)
in leisure time activities (VI 1 c)
in sexual relationship (VI 1 e)

in family finances (VI 1 f)

177

APPENDIX N
Item Content for Scales

Sexual Adjustment (SEXADJ) Scale

 

ITEM CONTENT (Questionnaire location for each item is
designated in parentheses. See Appendix I,
p. 139, for copies of questionnaires.)

1 Degree of couple's agreement about sex relations (I 6)

2 Degree to which spouse seems generally pleased with'
present sexual relationship (III 7)

3 Respondent's satisfaction with couple's sexual
relationship (IV e)

A Subscale score for Affective EXpression from the
Spanier Dyadic Adjustment Scale (I)

178

APPENDIX N
Item Content for Scales

Discrepancy_Between Actual and Expected
Division of Tasks (DISCR) Scale

 

For each item, the difference was calculated between
the respondent's view of who should do as opposed to who
actually does the following tasks.

ITEM CONTENT (Questionnaire location is designated in
parentheses. See 1-month or 1-year question-
naires in Appendix I, p. 139.)
1 Change baby's diapers (VI 2 a)
2 Quiet baby when it cries (VI 2 c)

3 Arrange for care for baby when wife must be away
(VI 2 d)

A Get up in night with baby (VI 2 e)
5 Feed baby (VI 2 f)
6 Play with baby (VI 2 g)

179

APPENDIX N
Item Content for Scales

Attitude Toward Baby (ATTBA) Scale

ITEM CONTENT (Questionnaire location for item is designated

10

11

12

in parentheses. See l-year questionnaire in
Appendix I, p. 139. Items 6-15 are from the
1-year interview.)

Parental rating of baby's activity level (X 1)
Parental rating of baby's regularity (X 2)

Parzntal rating of baby's reaction to new eXperiences
(X)

Parental rating of baby's level of sensitivity to
sensation (X 5)

Parental rating of baby's positive or negative mood

(X 6)
Whether the couple has decided to have another child

Number of costs of parenthood listed in response to an
open—ended question

Three-point rating of how rewarding parenthood has
been for the respondent

Three-point rating of how costly parenthood has been
for the respondent

Three-point rating of the degree to which a subject
answered with fatalistic responses when asked open-
ended questions about rewards and costs of parenthood

Three-point rating of the degree to which a subject
answered with instrumental responses when asked
open-ended questions about rewards and cost of
parenthood

Three-point rating of the degree to which a subject
answered with physical responses when asked open-ended
questions about rewards and costs of parenthood

13

1A

15

180

Three-point rating of the degree to which a subject
answered with economic responses when asked open-ended
questions about rewards and costs of parenthood

Three—point rating of whether parenthood has been
easier than the parent expected.

Three-point rating of whether parenthood has been
harder than the parent eXpected.

APPENDIX O

Scale Items' Reliabilities and Correlations
with Own and Other Scales

181

APPENDIX 0

Scale Items' Reliabilities and Correlations
with Own and Other Scales

Communication/Decision-making/Marital Adjustment (CDMA) Scale

 

Pre-birth observation (N = 66)
ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ RELIABILITY
1 .35* -.10 -.16 .12
2 .27* .11 -.02 .08
3 .55** -.39* .41** .30
4 .29* -.10 .04 .08
5 .63** -.21 .38** .40
6 .44** —.18 .16 .19
7 .61** —.31* .34* .37
8 .56** -.22 .24 .31
9 .49** -.28* .23 .24
10 .72** -.20 .28* .52
11 .71** -.O9 .23 .51
12 .50** -.13 .16 .25
13 .57** -.17 .32* -32
14 .74** -.22 .25* .54
15 .74** -.33 .70** .55
* p é .05

** p 9. .001

a Item content can be found in Appendix N, p.

171+.

1—month observation

 

ITEMa

O \O (I)\) O\U\ C'Kl) N

H H H H H H
Kn PK») N H

*-
*4!-
a

182

ITEM CORRELATION WITH EACH SCALE

p £2.05
5:.001
Item content

(N = 93)
CMDA CRADJ SEXADJ
.12 .09 .09
.32* .09 .01
.25* .01 33*
.25* .27* 02
.60** .05 .39**
.55** .24* .31*
.59** .06 .09
.61** .22* .10
.71** .10 .13
.61** .03 .22
.66** .02 .28*
.90** .09 .19
.62** .19 .43**
.70** .00 .26*
.70** .01 .57**

DISCR
.02
.23*

.21*
.00
.20
.21*
.15
.27*
.20
.35*
.33*
.27*
.22*

.30*

ITEM
RELIABILITY

.02
.10
.06
.05
.36
.30
.35
.38
.50
.37
.AA
.16
.39
.50
.A9

can be found in Appendix N, p. 174.

183

1-year observation (N = 95)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR ATTBA RELIABILITY
1 .09 .12 .05 -.14 —.07 .01
2 .32* -.12 .05 .19 -.09 .11
3 .30* .12 .05 .06 -.27* .09
4 .54** -.18 .14 .12 .02 .29
5 .52** -.19 .19 -.04 .15 .27
6 .65** -.19 .28* .10 .19 .42
7 .64** -.30* .34** -.O7 .29* .41
8 .68** -.24* .34** .04 .17 .46
9 .67** -.23* .27* .08 .14 .45
10 .70** -.23* .18 -.01 .20 .49
11 .66** —.O7 .20 .06 .15 .44
12 .30*- -.13 .10 .44** .05 .09
13 .37** -.26* .62** .15 .34* .14
14 .24* -.19 -.09 -.11 -.04 .06
15 .73** -.49** .45** .10 .27* .53
* p 5E.05

** p s. .001
a Item content can be found in Appendix N, p. 174.

184

APPENDIX 0

Scale Items' Reliabilities and Correlations
with Own and Other Scales

Crisis Adjgstment (CRADJ)_Scale

Pre-birth observation (N = 66)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ RELIABILITY
1 -.21 .39* -.24 .15
2 -.28* .50** -.17 .25
3 -.34* .57** —.27* .32
4 -.01 .78** -.22 .61
5 -.02 .62** —.22 .39
6 -.44** .65** -.38* .43
7 -.16 .74** -.14 .55

l-month observation (N = 93)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR RELIABILITY

1 -.16 .54** -.21* -.05 .29
2 -.17 .63** -.13 -.21* .40
3 -.14 .54** -.05 -.29* .30
4 .08 .64** .01 .04 .41
5 .11 .56** —.06 .06 .32
6 .07 .62** -.06 -.11 .39
7 ~.11 .46** .15 —.18 .21

* p 5.05

** p s .001

a Item content can be found in Appendix N, p. 176.

185

ljyear observation (N = 95)

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR ATTBA RELIABILITY

1 -.12 .51** -.18 —.14 —.41** .27
2 -.25* .52** -.23* -.22* -.46** .27
3 -.25* .47** -.12 .01 -.05 .22
4 —.07 .75** -.27* -.05 -.06 .56
5 -.15 .68** -.28* -.01 -.24* .46
6 -.26* .48** -.18 .05 -.23* .23
7 -.22* .30* .05 .00 .01 .09
* 2 5.05

** 5:. .001

a Item content can be found in Appendix N, p. 176.

APPENDIX 0

Scale Items' Reliabilities and Correlations

with Own and Other Scales

Sexual Adjustment (SEXADJ) Scale

Pre-birth observation (N = 66)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ RELIABILITY
1 .27* -.28* .86** .73
2 .46** -.26* .66** .44
3 .29* -.35* .74** .55
4 .44** —.29* .84** .70

1-month observation (N = 93)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR RELIABILITY
1 .21* .07 .78** -.1O .60
2 .27* -.O5 .55** .12 .31
3 .40** -.20 .63** .03 .40
4 .29* -.05 .69** -.04 .48
* p éi.O5
** p :é.OOl
a Item content can be found in Appendix N, p. 177.

187

1-year observation (N = 95)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR ATTBA RELIABILITY
1 .29* -.19 .81** —.08 .18 .65
2 .26* -.28* .79** .08 .29* .62
3 .40** -.29* .75** .10 .36** .57
4 .43** -.27* .84** .06 .22* .71
* p 5.05

** p é.- .001
a Item content can be found in Appendix N, p. 177.

188

APPENDIX 0

Scale Items' Reliabilities and Correlations
with Own and Other Scales

Discrepgncy in Task Division (DISCR) Scale

1-month observation (N = 93)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR RELIABILITY
1 .33* -.23 -.04 .77** .58
2 .24 -.18 -.04 .59** .35
3 .15 -.10 .36* ' .17 .03
4 .14 .03 -.21 .63** .40
5 .04 .00 -.13 .59** .35
6 .28* -.13 .07 .50** .25

1-year observation (N = 95)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR ATTBA RELIABILITY
1 -.01 .00 -.19 .56** -.O2 .31
2 .05 -.13 .10 .73** .16 .54
3 .11 .03 .13 .46** .21* .22
4 -.10 -.02 -.O7 .68** .15 .47
5 .04 -.09 .07 .70** .10 .49
6 .36** -.12 .14 .28* -.03 .08
* p 5;.05
** p 5 .001

a Item content can be found in Appendix N, p. 178.

189

APPENDIX 0

Scale Items' Reliabilities and Correlations
with Own and Other Scales

Attitude Toward Bapy (ATTBA) Scale

1-year Observation (N = 95)

 

ITEMa ITEM CORRELATION WITH EACH SCALE ITEM
CDMA CRADJ SEXADJ DISCR ATTBA RELIABILITY
1 -.16 .09 .05 —.16 .17 .03
2 .01 -.13 -.08 —.19 .30* .09
3 .19 .12 -.09 .01 .24* .06
4 -.07 -.17 .07 .22* .12 .02
5 .08 .10 .06 .09 .17 .03
6 .08 —.29* .34** .35** .60** .35
7 .01 —.35** .29* .19 .39** .15
8 .08 -.19 .19 .05 .45** .20
9 .25* -.29* .30* -.09 .63** .40
10 .20 -.02 .20 .07 .28* .08
11 .11 .09 .17 -.02 .22* .05
12 .01 —.15 .18 —.06 .40** .10
13 .03 .04 -.08 -.02 .27* .07
14 .05 -.35* —.13 .19 .31* .10
15 .18 -.48** .22 .19 .56** .32
* 2 5;.05

** p {1.001
a Item content can be found in Appendix N, p. 179.

 

APPENDIX P
Summary of Alpha Coefficients for each Scale

at each Observation

190

APPENDIX P
Summary Of Alpha Coefficients for each Scale

at each Observation

Pre-birth 1-month l-year Average
CDMA .86 .84 .83 .84
CRADJ .80 .77 .73 .77
DISCRa .71 .74 .73
ATTBAa’b .66 .66
SEXADJ .86 .76 .87 .83

a Scale not administered pre-birth

b Scale not administered at 1—month

APPENDIX Q
Correlations Between Husbands' and Wives' Scale Scores

at each Time of Observation

191

APPENDIX Q
Correlations Between Husbands' and Wives' Scale Scores

at each Time of Observation

Prebirth Observation (N = 33 couples)

 

CDMA CRADJ SEXADJ
CDMA .69**
DRADJ .53**
SEXADJ .61**

1-month observation (N = 38 couples)

 

CDMA CRADJ SEXADJ DISCR
CDMA .48**
CRADJ .22
SEXADJ .45**
DISCR .27*

1-year observation (N = 39 couples)

 

HUSBANDS’ SCALES

CDMA CRADJ SEXADJ DISCR ATTBA
CDMA .49**
CRADJ .28*
SEXADJ .54**
DISCR .31*
ATTBA .36*

* p 22.05
** p .4;- .001

 

APPENDIX R

Regression Analysis Summary Tables

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193

APPENDIX R
Regression Analysis Summary Tables

Wives' l-month Changg Score

VARIABLE CONTENT (Questionnaire location is provided in
parentheses. See Appendix I, p.139.for
questionnaires.)

1 Wife's indication that she (as opposed to her
husband) should be more responsible for arranging
care for the baby when she must be away (VI 2 d)

2 Composite score for couple including wife's
indication of percentage of time things have been
going well, both parents' indications Of the per-
centage of time each has felt satisfied with the
marriage relationship recently, and each parent's
indication of the percentage Of recent family
decisions with which S/he has agreed (VII)*

3 Husband's indication of how likely he is to
consult with his wife when making a decision (II 6)

4 Husband's combined score on two items indicating
that Since the pregnancy he has felt happier and
closer to his wife (V 1 & 6)**

5 Wife's level Of education (Background Information
Form, Appendix C, p. 127)

6 Composite score for both husband and wife
indicating the degree to which each eXpected the
coming baby to change activities in their lives
such as their relationship with each other, life
style, sleeping and eating patterns, their sexual
relationship and family finances (VI)***

7 Wife's indication Of how likely She is to consult
with her husband when making a decision (II 6)

8 Husband's indication Of the degree to which he
eXpectS the coming baby to change his leisure time
(VI 0)

* Inter—item correlations range from .681 to
.917. All are significant at p éi.001.
** Items correlate .683 which is significant at
p s .001.
*** Inter-item correlations range from .321 to .783.
All but one are signigicant at p 5&.05.

194

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195

APPENDIX R
Regression Analysis Summary Tables

Wives' l-year Change Score

CONTENT (Questionnaire location of items is pro-
vided in parentheses. See Appendix I,
p. 139, for questionnaires.)

Wife's indication of how much change she expects
the coming baby to cause in her relationship with
her husband and their sexual relationship (VI a &
e)*

Composite score for couple including wife's indi-
cation of percentage of time things have been
going well, both parents' indications of the
percentage of time each has felt satisfied with the
marriage relationship recently, and each parent's
indication of the percentage of recent family
decisions with which s/he has agreed (VII)**

Husband's indication of the average amount of time
he Spends in conversations with his wife each day

(II 5)

Whether husband's employment has changed as a
result of the pregnancy (II 2)

Husband's indication of how likely he is to consult
with her husband when making a decision (II 6)

Wife's indication of how likely She is to consult
with her husband when making a decision (II 6)

Husband's indication of the degree to which he
eXpects the coming baby to change his sexual
relationship with his wife (VI e)

Husband's indication Of how pleased he thinks his
wife is with their present sexual relationship
(III 7)

* Items correlate .683 which is Significant at
2 as .001.

** Inter-item correlations range from .681 to .917.
All are significant at p 42.001.

196

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197

APPENDIX R

Regression Analysis Summary Tables

Husbands' 1-month Change Score

VARIABLE CONTENT (Questionnaire location is provided in
parentheses. See Appendix I, p. 139.
for questionnaires.)

1 Husband's indication of the average amount of time
he Spends in conversations with his wife each
day (II 5) '

2 Combined score for husband's indication of the

degree of satisfaction he feels in his own and his
wife's participation in decision-making and of the
extent to which family decisions are made as a
joint process (IV j & k, V 7)

3 Composite score for couple including wife's
indication of percentage of time things have been
going well, both parents' indications of the
percentage of time each has felt satisfied with the
marriage relationship recently, and each parent's
indication of the percentage of recent family
decisions with which S/he has agreed (VII)**

4 Husband's indication of how well he thinks his
wife's parents did raising her (III 6)

5 Husband's indication of the degree to which he
eXpects the coming baby to change his Sleeping
and eating patterns (VI d)

6 Wife's indication of how likely She is to consult
with her husband when making a decision (II 6)

7 Husband's indication of whether or not a regular
time is set aside for communication with his
wife (II 4)

8 Wife's indication of how satisfied she feels with

family decisions regarding parenting (IV b)

9 Husband's indication of the degree to which he as
opposed to his wife should be responsible for
feeding the baby (VI 2 f)

10

198

Wife's indication of how satisfied she is with
her husband's employment situation (IV i)

Husband's indication of how satisfied he is with
his own employment situation (IV h)

Husband's indication of how his wife's employment
situation has changed as a result of the pregnancy
"'1'

(11 2)

* Inter-item correlations range from .500 to
.774. All are significant at p s .01.

** Inter-item correlations range from .681 to
.917. All are Significant at p 52.001.

199

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200

APPENDIX R

Regression Analysis Summary Tables

Husbands' 1-year Change Score

VARIABLE CONTENT (Questionnaire location is provided in
parentheses. See Appendix I, p. 139,
for questionnaires.)

1 Composite score for both husband and wife
indicating the extent to which each felt satis-
fied with his/her own and the Spouse's partici-
pation in family decision-making (IV j & k)*

2 Composite score for couple including wife's
indication of percentage of time things have been
going well, both parents' indications of the
percentage of time each has felt satisfied with the
marriage relationship recently, and each parent's
indication of the percentage of recent family
decisions with which S/he has agreed (VII)**

3 Wife's level of satisfaction with her own employ-
ment situation (IV h)

4 Husband's indication of the extent to which he
expects the coming baby to change his relationship
with his wife (VI a)

5 Husband's indication of how pleased he thinks his
wife is with their present sexual relationship
(III 7)

6 Wife's combined score indicating how likely she is

to consult with her husband when making a decision
and how satisfied She has been with family
decisions regarding work and parenting (II 6,

IV a & b)***

* Inter-item correlations range from .662 to
.832. All are significant at 2 £- .05.
** Inter-item correlations range from .681 to
.917. All are significant at p éi.001.
*** Inter-item correlations range from .337 to
.462. All but one are significant at
p £2.05.