Thesis (M.S.)--Boston University

Attitudes of primiparous women toward childbirth were studied longitudinally as they varied with the intervention of childbirth education classes before delivery; and as they varied with the experience of labor and deli very and having a baby in the home after delivery. An anxiety scale was used measuring anxiety toward labor, delivery, the parenthood role, and stress on the marriage relationship. Measurement on the anxiety scale was taken prior to childbirth education when primiparous mothers ranged from 4 months to 7-l/2 months gestation. Measurement II on the anxiety scale was taken after childbirth education, one month prior to delivery. Measurement III on the anxiety scale was taken one month following delivery . The sample consisted of primiparous women selected from two Childbirth Education Classes at the Logan L. D. S. Hospital, Logan, Utah, in September and October of 1974. The following numbers of women responded on each of the three questionnaires: Measurement I - 77 Measurement II - 69 Measurement III - 66 Total Matched sample including all three measurements - 56. H was found that anxiety toward delivery increased significantly alter childbirth education and as time for delivery drew nearer, while anxiety toward labor decreased slightly but not significantly. One month following delivery, however, anxiety decreased toward both labor and delivery, as was expected, but anxiety toward delivery dec rea ed to a lower level than did anxiety toward labor. H appears that these primiparous women experience more anxiety toward delivery prior to the experience, but after experiencing labor and delivct·y, some feel more anxious about labor than about delivery. No differctlCC was found between any of the three measures on anxiety toward the role of parent. The participation of husbands in labor and delivery was viewed by over !JO percent of these primiparous mothers as a positive factor, on all th rcc measurements. Earlier in pregnancy, prwr to childbirth education on Measurement 1, a strong positive correlation was found between physical symptoms of pregnancy and overall an.xiety level. However, this relationship seemed to disappear after childbirth education, one month prior to delivery on Measurement II. An analysis of variance showed significant variation in the anxiety or stress of the childbearing cycle on the marriage relationship with the highest stress being just prior to delivery.

Master of Science / School of Family Studies and Human Services / Melinda S. Markham / Childbirth has an effect on an individual and family. In Western culture, the presence of fathers is expected at labor and birth. The role fathers play during pregnancy, labor and birth, and postpartum is ambiguous. Paternal and infant attachment are developed during this transition to parenthood. There are many choices and unexpected outcomes but through childbirth education, individuals and families can be empowered to have a satisfying experience, ultimately setting the family up for success. Military individuals and families have unique and often challenging obstacles when it comes to participation in childbirth. Utilizing education developed to address concerns military individuals and families might face can lead to an empowering and satisfying experience, and help family bonds during a deployment. A module was created to bridge the gap in childbirth education, specifically for military families facing deployment. The module was developed to supplement existing childbirth education curriculum and is divided into three subsections: pregnancy, labor and birth, and postpartum.

In an attempt to strengthen marriages during the transition to parenthood, the Marriage Moments program was developed from Blaine Fowers' virtues based model of marital quality. Marriage Moments is a non-intrusive, mostly self-guided approach to marriage education, which is easily incorporated into childbirth education classes. The Marriage Moments curriculum stresses building marriage on a strong foundation of friendship and partnership. In this model, marital friendship is strengthened through a shared vision of life and important life goals; partnership is nurtured by the virtues of generosity, fairness and loyalty. This program was tested on 155 married couples that were expecting their first child. Couples were randomly assigned to one control or two treatment groups. The control group participated in a childbirth education class, but did not receive the Marriage Moments program. The instructor-encouraged treatment group viewed the Marriage Moments video in their childbirth education classes and were encouraged to do workbook activities by their class instructor; the self-guided treatment group couples were given the video and workbook to use at home. The Marriage Moments video is comprised of five, eight-minute segments introducing the marital virtues of friendship, generosity, fairness and loyalty. The workbook provides couples with additional information about the transition to parenthood and the possible applications of the virtues principles, including individual and couple activities. All couples were assessed using a battery of self- and spouse-report measures immediately before and after their child-birth classes and then at three and nine months after the birth of their babies. This longitudinal study examined the effect of the Marriage Moments program on marital virtues, marital quality, and intentionality. Relationship outcome measures included in this study were the Marital Virtues Profile, Revised-Dyadic Adjustment Scale, RELATE Satisfaction subscale and Transition Adjustment Scale. Treatment group couples reported high involvement in and enjoyment of the program. When asked to rate the program, couples evaluated the program as 'important' and 'worthwhile.' However, despite positive program evaluation, statistical tests revealed no consistent difference between the control and treatment groups over four times. Subgroup analysis also failed to reveal group differences when controlling for education, number of years married, and early marital distress. Suggestions for future study include contrasts of skills and virtues based curriculums, as well as high and low dosage interventions. In addition, this program should be studied in both clinical and educational settings.

Strengthening marriages is important to the well-being of individuals, families and communities. The transition to parenthood brings with it particular risks and opportunities for marriage relationships, yet no interventions have been successful in accessing a large number of couples during this critical time prepare and strengthen them for the challenges of becoming parents. The healthcare system has an established education infrastructure (childbirth education) that interacts with a significant number of couples during the transition to parenthood and has become increasingly open to incorporating relationship strengthening efforts into existing programs. The Marriage Moments program was designed to access couples through this system. This new approach to marriage education employs a program design unique in three ways: the context of childbirth education, a low-intensity content based on a model of marital virtues, and a simple, self-administered format of materials that gives the program great flexibility and transportability that can be implemented in a variety of existing systems. Initial formative program evaluation data show that the program is well received by participating couples. Marriage Moments is currently being pilot tested to evaluate its effectiveness in strengthening marriage through the transition, but it is expected the program will be disseminated widely and reach numerous couples as they transition to parenthood.