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

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

SHEARING IRRADIATED URANIUM PLATES

Natural U plates that were irradiated to 600 and 1500 Mwd/t were cut under water by a guillotine-iype shear. Irradiation reduced the force required for shearing to 50% of that required for unirradiated U. Measurements were made of radioactivity released to treated and untreated water in which the cut sections were stored. (auth

The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis

Objective: This review aimed to identify the impact of childbirth-related post-traumatic stress disorder (PTSD) or symptoms (PTSS) on a couple’s relationship. Background: Childbirth can be psychologically traumatic, and can lead to PTSD. There is emerging evidence that experiencing a traumatic birth can affect the quality of the couple’s relationship. This is an important issue as poor quality relationships can impact on the well-being of partners, their parenting, and the welfare of the infant. Methods: A systematic search was conducted of Amed, CENTRAL, Cinahl, Embase, Maternity and Infant Care, Medline, MITCognet, POPLINE, PsycARTICLES, PsycBITE, PsycINFO, Pubmed, and Science Direct. Additionally, grey literature, citation, and reference searches were conducted. Papers were eligible for inclusion if they reported qualitative data about parents who had experienced childbirth and measures of PTSD or PTSS and the relationship were taken. Analysis was conducted using meta-ethnography. Results: Seven studies were included in the meta-synthesis. Results showed that childbirth-related PTSD or PTSS can have a perceived impact on the couple’s relationship and five themes were identified: negative emotions; lack of understanding and support; loss of intimacy; strain on the relationship; and strengthened relationships. A model of proposed interaction between these themes is presented. Conclusions: The impact of childbirth-related PTSD or PTSS on the couple’s relationships is complex. As the quality of the couple relationship is important to family wellbeing, it is important that health care professionals are aware of the impact of experiencing psychologically traumatic childbirth as impetus for prevention and support

The impact of birth trauma on the couple relationship and related support requirements; a framework analysis of parents' perspectives

BACKGROUND: Ongoing distress following a traumatic birth experience, commonly known as birth trauma, can lead to post-traumatic stress symptoms. Experiencing birth trauma can affect personal well-being and impact the couple relationship. OBJECTIVE: The present study aimed to explore the lived experience of the impact of birth trauma on the couple relationship and related support requirements. METHODS: A purposive sample of men and women in the UK who had experienced birth as traumatic were recruited and interviewed remotely in 2021. Data were analysed using framework analysis in NVivo 12. RESULTS: The sample (N=18) contained 9 women who were first time parents and 9 men; 5 of which were first time parents and 4 who had two children. Twelve themes are reported related to the impact of birth trauma on the couple relationship. Findings suggest the impact of birth trauma on the couple relationship can be negative and distressing, or for some lead to a strengthened relationship. Fourteen themes are reported related to associated birth trauma support. Negative aspects of support were reported in themes: unavailability of help from friends and family; unhelpful birth debriefing services; no personal awareness of birth trauma; absence of trauma validation from health care professionals; lack of awareness of the emotional needs of men; and barriers to accessing psychological services. Potential improvements to support included: supporting parents to understand the traumatic events; birth trauma informed antenatal preparation; improving access to specialist psychological services; and compassionate parent centred maternity services. CONCLUSIONS: The impact of birth trauma on the couple relationship appears complex with both positive and negative affects reported. Current support for the impact of birth trauma on the couple relationship has perceived inadequacies for which improvements are proposed

Recognising and acting on perinatal mental health

Practitioners have a key role in promoting good mental health and in understanding when mothers and fathers may need extra support for mental health problems

Health care practitioners' views of the support women, partners, and the couple relationship require for birth trauma: current practice and potential improvements

Aim: To examine health care practitioners’ views of the support women, partners, and the couple relationship require when affected by birth trauma, barriers to gaining such support, and potential improvements. Background: Ongoing distress following psychologically traumatic childbirth, also known as birth trauma, can affect women, partners, and the couple relationship. Birth trauma can lead to post traumatic stress symptoms (PTSS) or disorder (PTSD). Whilst there is a clear system of care for a PTSD diagnosis, support for the more prevalent experience of birth trauma is not well-defined. Method: An online survey of health care practitioners’ views of the support parents require for birth trauma, barriers to accessing support, and potential improvements. Practitioners were recruited in 2018 and the sample for the results presented in the article ranged from 95 to 110. Results: Practitioners reported differing needs of support for women, partners, and the couple as a unit. There was correlation between practitioners reporting having the skills and knowledge to support couples and feeling confident in giving support. The support most commonly offered by practitioners to reduce the impact on the couple relationship was listening to the couple. However practitioners perceived the most effective support was referral to a debriefing service. Practitioners observed several barriers to both providing support and parents accessing support, and improvements to birth trauma support were suggested. Conclusions: Practitioners indicate that some women, partners, and the couple as a unit require support with birth trauma and that barriers exist to accessing effective support. The support that is currently provided often conflicts with practitioners’ perception of what is most effective. Practitioners indicate a need to improve the identification of parents who need support with birth trauma, and more suitable services to support them

Studies of Control, Power Shaping, and Burnout Behavior for Aetr

Parametric studies were carried out to optimize the performance and obtain an understanding of the nuclear characteristics of the Advanced Engneering Test Reactor (AE TR) design concept. Two-dimensional two-group diffusion theory calculations were performed for the purpose of evaluating the worth of the droppable safety reflector. Removal of the D/sub 2/O from the 4-in. thick safety reflector region from the level of the top of the active core to the level of the bottom of the active core with a fully poisoned shim reflectcr region resulted in a decrease in the multiplication factor from 0.9911 to 0.7515. Removal of the D/ sub 2/O from the 4-in. thick safety reflector region with a clean D/sub 2/O shim reflector resulted in a decrease in the multiplication factor from 1.18 to about 1.04. This indicated that the safety reflector wonth decreases as the boron poison is removed from the shim reflector during the core life. An iterative procedure using one-dimensional three-group dlifusion theory calculations was performed to determine a graded fuel distribution which produces a flat radial power density. The calculations were terminated when the maximum-toaverage power density was reduced to 1.018. Burnup calculations, using the CANDLE one- dimensional, four-group diffusion theory depletion code, were performed for flat and graded fuel cores, each containing 12 kg U/sup 235/ initially. The radial variations in the fuel distributions and the power density distributions during the fuel cycle were determined at several times. The effectiveness of a burnable core poison to supplement the soluble-poison shim control in the reflector was investignted. Using a Bi/sup 10/poisoning of 0.075 reduced the initial multiplication factor by 5.9%. By adjusting the fuel loading and optimizing the burnable poison, it appeared that the 19-day fuel cycle is feasible. (M.C.G.

Women's experiences and views of routine assessment for anxiety in pregnancy and after birth: A qualitative study

Background: Anxiety in pregnancy and postnatally is highly prevalent but under‐recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal. Methods: A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi‐structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes. Results: Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) Raising awareness; (2) Improving support; (3) Surveillance and stigma; (4) Gatekeeping; (5) Personalized care and (6) Trust. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative ‘tick box’ exercise that depersonalizes care and does not provide a space to discuss mental health problems. Conclusion: Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care

Evaluation of perinatal anxiety assessment measures: a cognitive interview study

Background: Anxiety in pregnancy and postpartum is highly prevalent but under-recognised. To identify perinatal anxiety, assessment tools must be acceptable, relevant, and easy to use for women in the perinatal period. Methods: To determine the acceptability and ease of use of anxiety measures to pregnant or postpartum women (n = 41) we examined five versions of four measures: the Generalised Anxiety Disorder scale (GAD) 2-item and 7-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS). Cognitive interviews were used to examine ease of comprehension, judgement, retrieval and responding. Results: All measures were acceptable. Some items were deemed less relevant to the perinatal period e.g., difficulties sleeping. Ease of comprehension, judgement, retrieval and responding varied, with all measures having strengths and weaknesses. The SAAS and CORE-10 had the lowest mean number of problematic components. The GAD had the highest mean number of problematic components​. Non-binary response options were preferred. Preferences for time frames (e.g. one week, one month) varied. Qualitative data provides in-depth information on responses to each measure. Conclusions: Findings can be used to inform clinical guidelines and research on acceptable anxiety assessment in pregnancy and after birth