Pre- and Perinatal Parenting Education for the 21st Century: Biopsychosocial factors that impact thriving of the mother, father, and baby.

  • Christine L McKee

Student thesis: Doctoral Thesis


There has been a long history of provision of pre- and perinatal (PPN) education to mothers.Whilst more recently programs have included fathers, the literature suggested current offerings may not reflect paternal needs as they transition to parenthood in the 21st century.Due to inconsistencies in both research methodologies and subsequent study findings,understanding what constituted best practice for both mothers and fathers remained unclear.This dissertation examined factors perceived to be important considerations when designing,developing, and delivering PPN parenting programs. Exploratory self-report questionnaires and Delphi methodology across four studies were utilised. The purpose of this research was to expand on the existing literature as well as offer recommendations for future PPN parenting programs. More specifically, the current research aimed to provide recommendations regarding content and logistical factors that may lead to positive influences on the emotional, mental, physical, and relational wellbeing and thriving of mothers, fathers,and babies during a pregnancy and beyond.

In Studies 1 and 2, 54 existing mothers and seven fathers (N=61) who had previously attended PPN parenting programs completed an online questionnaire that examined programcontent strengths, gaps, and limitations. An outcome based on Braun and Clarke’s (2006)thematic analysis process, was that two important topic areas were revealed to be important when assessing PPN parenting programs. They were support during pregnancy and mindfulness in the context of the power of a parents’ influence on a prenate. These were discussed separately in Studies 1 and 2.

Consistent with the literature, results from Study 1 revealed that PPN parenting programs focussed on generic practical skills, and fathers reported feeling under-supported during the time of their partner’s pregnancy. Fear, negative emotions, and lack of support were the most commonly reported causes of stress for expecting parents during the time of pregnancy. Whilst some research advocated that existing programs mitigated these concerns,the current research did not concur. A wide range of topics were identified as being essential content in PPN parenting programs. Based on these, questions and items were formulated for consensus rating in parent and birth professional Delphi methodology studies (Studies 3 and 4).

Study 2’s findings were consistent with the literature on PPN psychology,mindfulness, and neuroscience, purporting that parent thoughts, emotions, beliefs, moods, as well as quality of partner relationship during the pregnancy, may influence a prenate. Thestudy highlighted the need to understand what mindfulness-based knowledge, skills, and tools expecting parents could be educated on to enable healthy pregnancy, birth, couple relationship, and transition to parenthood. This was explored in Studies 3 and 4.

Studies 3 and 4 constituted Delphi methodology expert consensus studies, where parent (Study 3, N=23 after three rounds) and birth professional (Study 4, N=20 after three rounds) panels completed online questionnaires. Each round examined nine literature-derived factors deemed to be important when considering designing, developing, and delivering effective PPN parenting programs. Collectively, the expert panellists generated 209 recommendations for inclusion in future PPN parenting programs across the nine factors measured. Results revealed recommendations that were unique to each expert panel. Many were also consistent with existing literature, as well as across the two Delphi groups. Most notable were items relating to content, barriers to fathers’ attendance, and groups of parents who may benefit from attending PPN parenting programs. Consistent with the literature,clarity was not achieved for most appropriate timing and length of programs. Due to the volume and diversity of recommendations, seven suggestions for practical and effective execution of design, development, and delivery of future PPN parenting programs were identified.

The findings from across the four studies added to the literature in PPN psychology by highlighting what PPN parenting education for the 21st century may need to include to be considered effective for mothers, fathers, and babies to thrive. More than 90 content suggestions spanning the times of pregnancy, labour and birth, and post birth were offered.Examples included focus on emerging fields that discuss consciousness of a prenate,epigenetics, conscious parenting, mindfulness, and neuroscience; ensure sessions focus on being experiential, interactive and that utilise a multimedia environment; have core and optional modules, along with at-home practice time; facilitators to be from diverse birth professional backgrounds, and to be judgement free. Developing a range of PPN parenting programs, as well as measuring effectiveness through pre and post-test randomised clinical trials utilising large sample sizes and control groups, was recommended. Outcomes may result in sustainable prenatal care, positive parenting post birth, decreased maternal stress,anxiety and depression, needs-based inclusion of expecting fathers, and a positive transition for couples into parenthood.
Date of Award16 Jun 2018
Original languageEnglish
SupervisorA M Pidgeon (Supervisor) & Peta Stapleton (Supervisor)

Cite this