Review ArticleA systematic review and meta-synthesis of the impact of becoming parents on the couple relationship
Introduction
Understanding the transition to parenthood (TTP), the effects of pregnancy and early parenting, on a couple's relationship is essential as good quality relationships are important for personal well-being (Proulx et al., 2007). For individuals, the quality of relationships has been shown to be associated with positive personal outcomes (Reynolds et al., 2014), increased achievement (Marjoribanks, 2016a), and improved physical (Robles et al., 2014) and emotional health (Figueiredo et al., 2008).
From the perspective of the child, the quality of their parent's relationship is important as it can influence parenting and the parent-child attachment (DCSF, 2010). Low quality relationships and high rates of conflict between parents are associated with an insecure infant-parent attachment (Finger et al., 2009, Wong et al., 2009) which can affect a child's psychological well-being (Sroufe, 2005). Economic analysis estimates the cost to UK society of family breakdown to be £48 billion per annum (The Relationships Foundation, 2016) and for the child, parental relationship breakdown is associated with poverty, ill health, lower educational attainment, and behavioural problems (Coleman, 2010).
The TTP creates changes in a couple's relationships and has been shown to have a significant impact on marital functioning (Doss et al., 2009), resulting in strain (Nelson et al., 2014), reduced marital quality (Ahlborg et al., 2009) and decline in relationship satisfaction (Mortensen et al., 2012). However, it is argued that research has largely focused on the costs of parenting with the benefits being largely ignored (Nomaguchi and Milkie, 2003). There is growing research suggesting parenthood is associated with greater marital stability (Roy et al., 2014), with first-time parents generally being more satisfied with their relationship than childless couples (Guttmann and Lazar, 2004).
The TTP seems to magnify existing difficulties in a couple's relationships (Belsky and Rovine, 1990, Doss et al., 2009) however, this experience can differ by gender and the impact can be transient in nature (Cowan and Cowan, 2000). The strength of the relationship prior to becoming parents (Lawrence et al., 2008), marital status (Howard and Brooks-Gunn, 2009), and if the pregnancy was planned (Schwerdtfeger et al., 2013) can influence the impact of the TTP on the couple's relationship.
Relationship disharmony in the TTP may be due to several factors. For example, tension has been associated with the shift in roles (Twenge et al., 2003), perceived fairness of labour division (Chong and Mickelson, 2016), and increased opportunities for conflict (Roy et al., 2014). Patterns of parenting develop after birth and co-parenting alliance (Van Egeren, 2004), parenting self-efficacy and parenting stress have been associated with relationship satisfaction (Kwan et al., 2015).
The strength of partner relationships can affect the psychological adjustment of parents (Figueiredo et al., 2008) and be a predictor of postnatal depressed mood (Matthey et al., 2000). There is emerging evidence that experiencing psychologically traumatic childbirth can affect the couple relationship (Delicate et al., 2018), that there is concordance of mental health problems between partners (Roberts et al., 2006) and that those with mental health problems more commonly report poor partner relationship (Parfitt and Ayers, 2014).
Conflict concerning finances is a common theme seen in all types of partner relationship research and becoming parents bring its own financial pressures (Marjoribanks, 2016b). As well as increased expenditure relating to caring for the baby, parents often have loss of income due to changes in employment to enable parental leave. The length of maternity and paternity leave (Feldman et al., 2004), the women's return to work (Spiteri and Xuereb, 2012) or ceasing work to be a full-time parent (Keizer et al., 2010) are also associated with a negative impact on a couple's relationship.
Pregnancy and childbirth can also effect a couple's physical relationship (Yeniel and Petri, 2014) with sexual relationship concerns appearing widespread (Schlagintweit et al., 2016) and for some long-term (Hansson and Ahlborg, 2012). Changes in sexual relationships have been shown to be affected by altered body image (Olsson et al., 2005), mismatch of desire, and less time due to parenting (Houlston et al., 2013).
The social and cultural context within which relationships and families develop has altered in the last two decades due to changing attitudes to relationships (Duncan and Phillips, 2008), increasing personal self-sufficiency, and the fragmentation of community, family and friend networks (Gabb et al., 2013). Whilst the structure and practices of family life continue to change, the importance of good quality relationships is still paramount (Marjoribanks, 2016b). Therefore, it is important to comprehend the impact of the TTP on relationships in contemporary society to develop appropriate information and support services.
There is an extensive body of quantitative research on the TTP and relationship changes. Much of this research focuses on changes in factors such as relationship satisfaction (Mortensen et al., 2012, Shapiro et al., 2000), relationship quality (Shapiro et al., 2000; Doss et al., 2009; Kluwer, 2007), and patterns of interaction within couples (Belsky and Rovine, 1990, Cox et al., 1999). In contrast, qualitative research provides an understanding of the lived experience of the TTP (Al-Busaidi, 2008). Much of the qualitative research focuses on particular aspects of the relationship during the TTP such as intimacy (Olsson, 2005), gender (Sevón, 2012) and fatherhood (Deave and Johnson, 2008). This qualitative literature provides a rich account of couples’ experiences during the TTP and therefore helps develop a more in-depth understanding of this complex phenomenon (Walsh and Downe, 2005).
The presented review therefore aimed to synthesise the available body of qualitative work on the impact of the TTP on a couple's lived experience of their relationship in contemporary, Western society. The results of the synthesis can help inform midwives and allied professionals of the current relationship issues parents may require preparation and support with.
Section snippets
Inclusion criteria
Paper were included if they presented qualitative data of romantic partner relationship changes experienced by parents aged eighteen or over. Inclusion was restricted to studies conducted from 1996 in a western society. The lead author conducted literature selection against the inclusion criteria with final agreement by all authors.
Search strategy
Nine databases were searched in October 2016 (Amed, Cinahl. Maternity and Infant Care, Medline, POPLINE, PsycARTICLES, PsycINFO, Pubmed, Science Direct). Search
Results
Twelve studies met inclusion criteria and an overview of these studies is given in Table 1. Sample sizes varied from five couples (Ahlborg and Strandmark, 2001) to 128 men in a mixed methods study (Williamson et al., 2008). Six studies were based on men: four in Sweden (Fägerskiöld, 2008, MacAdam et al., 2011, Olsson et al., 2010, Premberg et al., 2008), one in the UK (Deave and Johnson, 2008) and one in Australia (Williamson et al., 2008). Three studies had women as participants: one in
Discussion
This review synthesised the qualitative evidence of the impact of the TTP on couples’ lived experience of their relationships in contemporary Western societies. From 12 included papers, the review identified six themes of: Adjustment Phase, Focus on the Baby, Communication, Intimacy, Strain on the Relationship and Strengthened Relationships, which is largely consistent with previous literature. The review illustrates both positive and negative effects of the TTP on relationships within the
Limitations and strengths
The review adds to the body of evidence by systematically reviewing and analysing the lived experience of couples’ TTP in contemporary Western society. This combined with the comprehensive search strategy means the review offers a good indication of the current situation for parents in Western societies. The review findings are novel in documenting a range of impacts the TTP has on couples’ lived experiences of their relationship, with a balance of negative and positive experiences.
However, the
Conclusion and recommendations
This review and meta-synthesis suggests that the TTP has a notable impact on a couple's relationship. Six themes were identified of: Adjustment Phase, Focus on the Baby, Communication, Intimacy, Strain on the Relationship, and Strengthened Relationships. Within the first four themes, there were examples of both positive and negative effects of the TTP on relationships.
The quality of couple relationships are important for the wellbeing of partners and their children and this review highlights
Ethical approval
Not applicable.
Funding sources
Amy Delicate is a PhD student matched-funded by City, University of London and NCT (48001HY).
Clinical trial registry and registration number
Not applicable.
Conflict of interest
None.
References (79)
- et al.
First-time parents' prenatal needs for early parenthood preparation-A systematic review and meta-synthesis of qualitative literature
Midwifery
(2016) - et al.
Parental leave and work adaptation at the transition to parenthood: individual, marital, and social correlates
Journal of Applied Developmental Psychology
(2004) - et al.
Quality of the intimate and sexual relationship in first-time parents–A longitudinal study
Sexual and Reproductive Healthcare
(2012) - et al.
Paternal and maternal depressed mood during the transition to parenthood
Journal of Affective Disorders
(2000) Transition to motherhood
Journal of Obstetric, Gynaecologic, and Neonatal Nursing
(2003)- et al.
A new baby in the bedroom: frequency and severity of postpartum sexual concerns and their associations with relationship satisfaction in new parent couples
The Journal of Sexual Medicine
(2016) - et al.
An Australian perspective of fatherhood and sexuality
Midwifery
(2008) - et al.
Perception of marital quality by parents with small children: a follow-up study when the firstborn is 4 years old
Journal of Family Nursing
(2009) - et al.
The baby was the focus of attention–first‐time parents' experiences of their intimate relationship
Scandinavian Journal of Caring Sciences
(2001) Qualitative research and its uses in health care
Sultan Qaboos University Medical Journal
(2008)
The impact of the birth of the first child on a couple's relationship
Evidence-Based Midwifery
Patterns of marital change across the transition to parenthood: pregnancy to three years postpartum
Journal of Marriage and the Family
Evaluating meta ethnography: systematic analysis and synthesis of qualitative research
Health Technology Assessment
Fathers' experiences of their transition to fatherhood: a metasynthesis
Journal of Reproductive and Infant Psychology
Perceived fairness and relationship satisfaction during the transition to parenthood: the mediating role of spousal support
Journal of Family Issues
Understanding couple relationship breakdown
New Digest
When Partners Become Parents: the Big Life Change for Couples
Marital perceptions and interactions across the transition to parenthood
Journal of Marriage and the Family
Support For All: the Families and Relationships Green Paper
The transition to parenthood: what does it mean for fathers?
Journal of Advanced Nursing
Transition to parenthood: the needs of parents in pregnancy and early parenthood
BMC Pregnancy and Childbirth
The impact of childbirth-related post-traumatic stress on a couple’s relationship: a systematic review and meta-synthesis
Journal of Reproductive and Infant Psychology
The effect of the transition to parenthood on relationship quality: an 8-year prospective study
Journal of Personality and Social Psychology
New families? Tradition and change in partnering and relationships
A change in life as experienced by first‐time fathers
Scandinavian Journal of Caring Sciences
Negotiating intimacy, equality and sexuality in the transition to parenthood
Sociological Research Online
Partner relationships during the transition to parenthood
Journal of Reproductive and Infant Psychology
Parent relationship quality and infant–mother attachment
Attachment and Human Development
When Couples Become Parents: the Creation of Gender in the Transition to Parenthood
Enduring love? Couple Relationships in the 21st Century
Survey Findings Report
Criteria for marital satisfaction: does having a child make a difference?
Journal of Reproductive and Infant Psychology
Relationship supportiveness during the transition to parenting among married and unmarried parents
Parenting: Science and Practice
The transition to parenthood and well-being: the impact of partner status and work hour transitions
Journal of Family Psychology
Conflict frequency and relationship quality across the transition to parenthood
Journal of Marriage and Family
Does motherhood get easier the second-time around? Examining parenting stress and marital quality among mothers having their first or second child
Parenting: Science and Practice
The moderating roles of parenting self-efficacy and co-parenting alliance on marital satisfaction among Chinese fathers and mothers
Journal of Child and Family Studies
Marital satisfaction across the transition to parenthood
Journal of Family Psychology
Cited by (53)
The effect of ear acupressure on sexual functioning among lactating women: A randomized sham controlled trial
2023, European Journal of Integrative MedicineWomen's quality of life and mental health in the first year after birth: Associated factors and effects of antenatal preventive measures among mothers in the ELFE cohort
2023, Journal of Affective DisordersCitation Excerpt :Fathers may be more responsive to changes shortly after birth, and early professional interventions in this regard may be associated with later positive outcomes. Identifying and managing couple difficulties, preparing couples for the gradual and complex nature of the transition to parenthood, and providing support through antenatal and postnatal education appear to be important during this perinatal period (Delicate et al., 2018). With regard to smoking, our results are in line with those of Bai et al. (2018) in his pathway analysis of QOL during the post-partum period.
The structure and correlates of the 20-item Maternal-Fetal Attachment Scale in a population-based sample of Hungarian expectant women
2022, MidwiferyCitation Excerpt :Higher integrity and collaboration in the parenting couple contribute not just to higher emotional involvement in the prenatal period, but to lower levels of parenting stress (Mazzeschi et al., 2015) and maternal depressive symptoms in the postpartum period (Smorti et al., 2019), which could promote the formation of parent-to-infant relation. The transition to parenthood is a critical time in couples’ life (Delicate et al., 2018), but a window of opportunity as well to recruit them to couple relationship intervention aiming at improving the quality of antenatal attachment and couple relationship. Systematic reviews (Pinquart and Teubert, 2010; Park et al., 2020) and effectiveness trials (Petch et al., 2012; Koh et al., 2021) on couple-focused interventions found small to moderate effects on couple communication, paternal and maternal mental health and improvement in prenatal attachment.
Closeness with a partner and parental bond with a child during the transition to parenthood
2022, MidwiferyCitation Excerpt :Young mothers might be more emotionally focused on the baby than on the intimate spousal relationship. This might be a source of strain on the relationship, but at the same time, the parental role might strengthen the relationship between partners by adding a sense of completeness (Delicate et al., 2018). The authors might conclude that particularly for women in our study, perceived emotional closeness with a partner might support their typical large engagement in caregiving during the first year of a child's life without a detrimental impact on the relationship or on the bond with their child.