A systematic review and meta-synthesis of the impact of becoming parents on the couple relationship

Highlights

• The transition to parenthood can impact upon a couple's relationship.

• Some parents report feeling unprepared for the impact on their relationship.

• Six themes of relationship impact are presented including Strain and Strength.

• Relationship strain can be short-term and strength can transpire in the long-term.

• The presented themes contain examples of positive and negative effects.

Abstract

Background

the transition to parenthood (TTP) is associated with changes to a couple's relationship. Quantitative evidence shows the TTP is associated with reduced satisfaction and quality of a couples’ relationships. Qualitative research provides information on the lived experience of couples in the TTP so can provide a more in-depth understanding of the impact. This review therefore aimed to synthesise qualitative research of the perceived impact of the TTP on a couple's relationship in contemporary Western society.

Design

a systematic search was conducted of nine databases and grey literature. Key author, citation and reference searches were also undertaken. Papers were included if they presented qualitative data of romantic partner relationships during the TTP with parents aged 18 or over. Studies were restricted to those conducted from 1996 in Western societies. Analysis was conducted using meta-ethnography.

Findings

searches identified 5256 papers. After applying inclusion criteria 12 papers were included in the meta-synthesis. Six main themes were identified: (1) Adjustment Phase (a period of change in the relationship), (2) Focus on the Baby (with a sub-theme of feeling unprepared for the relationship impact), (3) Communication (shifts in communication patterns and importance), (4) Intimacy (changes to sexual relations, romance and closeness), (5) Strain on the Relationship (short-term or prolonged), and (6) Strengthened Relationships (deepening of connection and new affinity). Except for the themes of Strain on the Relationship and Strengthened Relationships, the findings showed the TTP had positive and negative impacts on couples’ relationships.

Key conclusions and implications for practice

the review highlights a range of TTP relationship issues that couples experience and may require help with. Health care professionals working with parents in the TTP may be able to provide support through antenatal education that includes preparation for relationship changes, and provision of postnatal support to identify and overcome problems.

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.