Elsevier

Midwifery

Volume 27, Issue 6, December 2011, Pages 802-810
Midwifery

Maternal parental self-efficacy in the postpartum period

https://doi.org/10.1016/j.midw.2010.07.008Get rights and content

Abstract

Objective

to present an integrated literature review on maternal parental self-efficacy (MPSE) in the postpartum period.

Data sources

a literature search of CINAHL with full text and MEDLINE and PsycINFO from their start dates to February 2010.

Study selection

inclusion criteria were English written research articles which reported the measurement of MPSE in the postpartum period.

Data extraction

articles were reviewed based on purpose, theoretical framework, data collection method, sample, main findings and nursing implications for maternal parenting. In addition, data related to the instruments that were used to measure MPSE were included.

Data synthesis

data revealed is a statistically significant increase in MPSE over time from baseline; a positive relationship between MPSE and number of children, social support, maternal parenting satisfaction and marital satisfaction; and a negative relationship between MPSE and maternal stress, anxiety and postpartum depression. A variety of instruments to measure MPSE were used but the majority were based on Bandura’s framework.

Conclusions

findings from this review may assist women’s health researchers and clinical nurses/midwives in assessing and developing appropriate interventions for increasing risk awareness, enhancing MPSE and subsequent satisfaction with parenting and emotional well-being. Further research is necessary underpinned by theoretical frameworks using domain-specific instruments to identify predictors of MPSE.

Introduction

Parenting in the early postpartum period is a time of maternal learning and adaptation. Mothers must learn new behaviours to care effectively for infants and to achieve satisfaction with parenting (Mendes, 2007). The postpartum period is defined as ‘the time from birth until the woman’s body returns to an essentially pre-pregnant state’ (Ladewig et al., 1998, p. 173), and this period usually lasts for six to eight weeks. This period usually refers to the mother’s physical health, and progress through this stage may be hindered by her physical recovery from childbirth. Physical recovery may take longer for some mothers, particularly if they have experienced complications during pregnancy, childbirth or both. However, Mercer, 2004, Mercer, 2006 suggests that length of time is also determined by maternal, infant and environmental variables, particularly for first-time mothers or mothers experiencing a new phenomenon such as a small preterm infant or an infant with special needs. It is possible that first-time mothers ‘become mothers’ by the end of this period or, alternatively, it may take considerably longer (Mercer, 1986). One influential maternal characteristic of becoming a mother is maternal confidence (Leahy-Warren, 2005). Confidence has been described in terms of self-efficacy, which Bandura (1997) defines as a person’s beliefs in their ability to perform a particular behaviour successfully. New mothers’ self-efficacy in infant care skills is important in facilitating adaptation to motherhood and experiences of motherhood (Barclay et al., 1997). Maternal parental self-efficacy (MPSE) has been identified as a major determinant of competent parenting behaviours (Jones and Prinz, 2005) and is closely linked to child development (Coleman and Karraker, 2000). Constructing MPSE is considered to be a crucial step in mothering development (Bandura, 1997). This paper provides a discussion on theoretical foundations of the concept self-efficacy focusing on the work of Bandura (1997). This is followed by a critical review of research which reports measurement of MPSE in the postpartum period. Implications for clinical practice and recommendations for future research are also addressed.

Section snippets

Theoretical foundations

Self-efficacy was first described by Bandura as one of the major components of social cognitive theory and a theory in its own right (Bandura, 1977a, Bandura, 1977b). Bandura’s (1997) work concentrates on perceived self-efficacy, which he describes as a belief in one’s capabilities to organise and execute the course of action required to attain a goal or perform a certain task. He reasoned that individuals may believe that their own behaviour could result in a certain desired outcome but might

Methods

A systematic search of the literature was conducted using CINAHL with full text and MEDLINE and PsycINFO from their start dates to February 2010. Various combinations of the keywords: Bandura, self-efficacy, maternal, parent, post/natal/partum were used for the search. The databases were limited to the English language. The first search conducted in CINAHL with full text and MEDLINE yielded 43 research articles. The second search of PsycINFO yielded 68 research articles. Details of the study

Review

This review begins with an overview of the designs, samples and instruments used in the eight studies. This is followed by a synthesis of the main results under the headings of maternal attributes and infant characteristics. Finally, a brief discussion of the findings is presented with clinical implications and future direction for research concerning MPSE in the postpartum period. The eight articles included in this review are summarised in Table 1.

Maternal attributes

According to Bandura’s (1997) theory of perceived self-efficacy, direct experience with a task or similar tasks is the most potent source of efficacy expectations. Froman and Owen (1990) examined MPSE in 186 new mothers and the nurses caring for them in the postnatal wards prior to discharge in the early postpartum period. Results indicated that infant care behaviours commonly performed (such as holding the infant) had the highest mean scores, whereas those that are much less routinely

Discussion

From the studies reviewed herein, MPSE is important for mothers’ satisfaction with parenting, and is inversely associated with postpartum depression, stress and anxiety (Cutrona and Troutman, 1986, Reece, 1992, Reece and Harkless, 1998, Hudson et al., 2001, Porter and Hui-Chin, 2003, Haslam et al., 2006, Salonen et al., 2009). Multipara were found to have higher levels of MPSE than primiparas, and levels of MPSE increased over time for both primiparas and multiparas (Froman and Owen, 1990,

Conclusion

Generalisability of the findings from this review is fraught with difficulty due to the low-risk, demographically restricted nature and size of the samples utilised and time frames of data collection within the studies. Furthermore, while half of the studies utilised exclusive first-time mother samples, the remainder included both experienced and inexperienced mothers, but small numbers inhibited universal applicability further. Nevertheless, the majority of the studies in this review

Recommendations for further research

Further research using a longitudinal design and a domain-specific measure to early parenting with new mothers, particularly first-time mothers, is necessary to identify at-risk groups and at-risk mothers. Research which also includes maternal and infant attributes with large diverse samples is necessary to identify correlate variables.

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