Maryse Guedes

Characteristics of primiparous women of advanced age and their partners: a homogenous or heterogenous group?

BACKGROUND Recent studies have reported that primiparous women of advanced maternal age (AMA) appear to constitute a heterogeneous group, emphasizing the need to revise stereotyped views. The aims of this study were the following: 1) to describe the sociodemographic and marital characteristics of Portuguese couples who experienced first childbirth at advanced maternal age (the AMA group) compared with their younger counterparts (the comparison group); 2) to compare the reproductive characteristics of both groups and identify distinct reproductive trajectories within the AMA group; and 3) to distinguish among different subgroups of couples within the AMA group, depending on distinct patterns of sociodemographic, marital, and reproductive characteristics. METHODS The sample consisted of 250 couples. Both partners completed sociodemographic, marital, and reproductive health forms during pregnancy. RESULTS Despite being more highly educated, having a higher socioeconomic status, and having been employed longer, the AMA group displayed diverse conjugal configurations and reproductive trajectories over time. Within the AMA group, two subgroups were distinguished: couples who experienced infertility problems and couples who did not. CONCLUSIONS Couples who experience first childbirth at AMA constitute a heterogeneous group, which includes distinct subgroups with different psychosocial needs during the transition to parenthood. To revise stereotyped views of these couples, protective social policies should be improved, and health professionals should assume nonjudgmental attitudes and promote informed reproductive decisions. Psychoeducative programs concerning the transition to parenthood should take into account the distinct subgroups of couples who experience first childbirth at AMA.

Perceptions of Influencing Factors and Satisfaction With the Timing of First Childbirth Among Women of Advanced Age and Their Partners

The transition to first-time parenthood at advanced maternal age has become a rising challenge for families in the 21st century. The present study aimed to examine the perceptions of influencing factors and the satisfaction with child-timing among older first-time mothers and their partners (older parents) compared with younger first-time mothers and their partners (younger parents) and to explore the relationships between these variables, depending on age group. A total of 105 older parents and 93 younger parents were recruited in a Portuguese urban referral maternity and completed self-report scales during pregnancy. Both age groups perceived that a shared desire to have children and a suitable partnership were the most influential factors. However, older parents were less satisfied with the timing of first childbirth than younger parents. Aside from some perceptions of influencing factors, advanced maternal age was the most consistent predictor of lower satisfaction with child-timing.

Childbearing motivational patterns of primiparous women of advanced age and their partners

Objective: This study aimed to: (1) describe the positive and negative childbearing motivations of primiparous women of advanced maternal age and their partners (AMA group) compared with their younger counterparts (comparison group) during pregnancy; (2) identify distinct childbearing motivational patterns in the AMA group; and (3) to explore their correlates. Background: First childbirth at advanced maternal age is a growing social concern, but few studies have explored couples’ childbearing motivational patterns, challenging the stereotypes that presuppose that this reproductive trend reflects ambivalent motivations. Methods: Forty-six couples in the AMA group and 44 couples in the comparison group responded to the Childbearing Motivations Scale during the third trimester of pregnancy. Results: The AMA group differed from the comparison group in positive but not negative childbearing motivations. Two childbearing motivational patterns were identified in the AMA group. The ‘realistic childbearing motivational pattern’ was characterised by highly positive motivations that coexisted with moderate negative motivations. The ‘disengaged childbearing motivational pattern’ was characterised by moderate positive motivations that coexisted with low negative motivations. These two patterns had comparable frequencies for women and men. Women who were less satisfied with their professional life and experienced prior adverse pregnancy outcomes and men who reported a higher deviation from child-timing expectations were more likely to report a ‘realistic childbearing motivational pattern’. Conclusion: Healthcare providers should avoid stereotyped views and develop couple-focused interventions across the reproductive lifespan and during antenatal care to promote satisfactory decisions and to prepare couples for the positive aspects and demands of childrearing.

Psychosocial adjustment of couples to first-time parenthood at advanced maternal age: an exploratory longitudinal study

Objective: This study aimed to describe the psychosocial adjustment of primiparous women of advanced age and their partners (AMA group) compared to their younger counterparts (comparison group) from the third trimester of pregnancy to six months postpartum and to explore the psychosocial adjustment of the AMA group, depending on infertility history. Background: First-time parenthood at advanced maternal age (AMA) is a growing reproductive trend; however, few longitudinal studies have explored the psychosocial adjustment of couples from pregnancy to the first postpartum months, considering the distinct trajectories that precede this reproductive behaviour. Methods: Fifty-eight couples in the AMA group (≥35 years at the time of delivery) and 41 couples in the comparison group (20–34 years) were consecutively recruited in a Portuguese urban referral hospital. Both partners responded to the Brief Symptom Inventory-18, the EUROHIS-QoL-8 and the Dyadic Adjustment Scale – Revised during the third trimester of pregnancy (T1), at one month (T2) and six months postpartum (T3). Couples also completed visual analogue scales to assess parenting difficulty, competence and gratification at T2 and T3. Results: The psychosocial adjustment of the AMA group and the comparison group over time was more similar than different. Within the AMA group, perceived parenting difficulty decreased over time for previously infertile couples but remained stable for previously fertile couples. Conclusion: Healthcare providers should avoid stereotypical views and normalise the psychosocial adjustment over the transition to first-time parenthood at AMA. Antenatal psychoeducational interventions should promote realistic expectations about the demands of early parenting, especially among previously infertile couples.

Variáveis sociodemográficas e socioculturais e ajustamento psicológico à decisão e experiência de interrupção voluntária da gravidez

Researchers and clinicians have emphasized the relationship between some socio-demographical and socio-cultural variables and the adjustment to the experience of induced abortion. With the recent legalization of voluntary termination of pregnancy in Portugal, this study aimed to investigate the relationship between some socio-demographical and socio-cultural variables and the psychological adjustment at the decisional period and after induced abortion. The sample was collected at the Maternity Doctor Daniel de Matos of the University of Coimbra Hospitals, consisting of 53 women, who seek for the Reproductive Counselling Consultation, between December 2007 and March 2008. This prospective study had two assessment moments (before the termination; two to four weeks after the termination), with self-report instruments. Single and separated/divorced women and with strong religious affiliation who opted for induced abortion tended to show poorer psychological adjustment. The implications of these results for research and clinical practice are discussed.