Changes in alcohol use and relationship satisfaction in Norwegian couples during pregnancy

Background: Numerous studies have documented a profound reduction in alcohol use among pregnant women, whereas research on expectant fathers has been scarce. The aim of this study was to measure changes in alcohol consumption from before pregnancy to 17 weeks in gestation for mothers and fathers, differentiating between parents with and without any previous children, and to measure how level and change in alcohol consumption into early pregnancy was associated with relationship satisfaction. Methods: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. This cohort now includes 108 000 children, 90 700 mothers and 71 500 fathers recruited from 1999 to 2008. The present study comprises 82 362 couples. Alcohol consumption was assessed using a questionnaire including items about usual drinking frequency, quantities, and number of occasions with heavy episodic drinking (HED). Relationship satisfaction was measured by five items scored on a Likert agreement scale. Results: The findings indicate that both mothers and fathers reduce their drinking significantly during pregnancy. Reduction was apparent for all three measures of alcohol consumption. First-time fathers reduced their alcohol consumption more than experienced fathers, from initially higher levels. The gap between the fathers and their pregnant partner was greater for first-time parents compared to parents with previous children. Drinking pre-pregnancy and relationship satisfaction during pregnancy were weakly related within each partner, whereas no association across partners was observed. Conclusions: Both expectant mothers and fathers changed their alcohol consumption patterns when expecting a child. Almost all mothers stopped drinking, whereas fathers reduced their drinking to a considerable degree. Relationship satisfaction was only slightly related to their drinking patterns. The findings may have important policy implications, mainly with regard to developing alcohol preventive strategies.publishedVersio

Alkoholbruk, partilfredshet og samlivsstatus. Før, inn i, og etter svangerskapet – korrelater eller konsekvenser?

Women in Norway usually reduce or stop using alcohol when they realize that they are pregnant. However, information about their postpartum drinking pattern is scarce, and we also know little about how expecting fathers drink. Moreover, information of any effects of alcohol consumption before and during pregnancy on relationship quality and stability after the child is born is also scarce. This thesis explored the extent to which expecting parents changed their alcohol consumption levels when the woman becomes pregnant. Furthermore, we assessed the development of mother’s alcohol consumption postpartum, and associations between drinking and relationship satisfaction and dissolution. Method: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study (MoBa), which is a prospective population based cohort study conducted by the Norwegian Institute of Public Health. Participants were recruited between1999-2008, and the cohort presently includes 114 500 children, 95 200 mothers and 75 200 fathers. The sample size and demographical characteristics varied depending on the particular research question in focus. Paper I examined mothers’ and fathers’ alcohol consumption levels before and into the pregnancy, at respectively 17th and 19th week of gestation, respectively. It also examined to what degree changes in alcohol consumption affected both partners’ relationship satisfaction. The analysis was conducted within an APIM framework. The reference recall period before pregnancy was 3 months for mothers and 6 months for fathers. The paper included a total number of 82 363 couples. Paper II examined how mothers resume their pre-pregnancy drinking level after the child is born and how the consumption develops towards the child’s first three years. The mothers’ alcohol consumption levels before pregnancy was used as a predictor and her civil status and number of children were used as moderators. The mothers were divided into three different groups; married (n=34 516), cohabitants (n=40 824) and single (n=1 797). Postpartum alcohol consumption was measured at four different times (0-3 months; 4-6 months; 18 months: and 36 months after birth). Paper III examined the extent to which pre-pregnancy alcohol consumption affects postpartum relationship satisfaction and risk for divorce three years after the birth. Relationship satisfaction was used as a mediator in order to explain any relationship between pre-pregnancy alcohol use and relationship dissolution. The sample included married and cohabiting mothers divided into three alcohol consumption groups: low-risk (n=67 155/89.2%); medium- risk (n=6 609/8.8%); and high-risk (n=1 467/1.9%). The study used data collected at 17th week of gestation, and 4-6; 18; and 36 months postpartum. Results: The results of paper I revealed that both expecting mothers and fathers reduced their alcohol consumption when the women got pregnant. First-time parents had the highest initial level of alcohol use and they also reduced their consumption more than experienced parents The fathers’ reduction was not related to the mothers’ reduction. The results from paper II indicated that 44.6% of the mothers had started to drink alcohol already when the child was three months old. The resumption pattern showed a steady increase towards 18 months, where 90% of the mothers were drinking. Their postpartum alcohol use was most strongly predicted by their pre-pregnancy alcohol use. Married and cohabitating parents had higher frequency of drinking compared to single mothers. However, single mothers reported more alcohol units when drinking. The results from paper III indicated that the high-risk consumption group had 55% higher odds of being divorced three years after the birth, although alcohol consumption itself was not causing relationship deterioration. Rather high consumers tend to have several characteristics associated with higher risks for marital dissolution; being younger, having unplanned pregnancies, not being married, and having shorter relationship duration. The relationship between pre-pregnancy alcohol use and divorce was mediated by relationship satisfaction. Conclusions: In Norway both men and women seem to reduce their alcohol consumption when they expect a child. The rather strong reduction of the fathers’ alcohol use was a surprise and may indicate an early identification with the role as a father, and could reflect the high level of gender equity in Norway. Alcohol consumption in pregnancy and postpartum also seem to be a function of marital status and number of children. Information about the importance of marital status and number of children on mothers’ alcohol consumption levels could be useful when tailoring preventing interventions towards parents with small children. Moreover, high levels of alcohol consumption were associated with lower levels of relationship satisfaction during the first years of the child, and a higher risk for relationship dissolution. However, family structures seem to predict mothers’ alcohol consumption more strongly than fathers’ and mothers’ alcohol consumption predict relationship satisfaction and dissolution when parenting young children

Changes in alcohol use and relationship satisfaction in Norwegian couples during pregnancy

Background: Numerous studies have documented a profound reduction in alcohol use among pregnant women, whereas research on expectant fathers has been scarce. The aim of this study was to measure changes in alcohol consumption from before pregnancy to 17 weeks in gestation for mothers and fathers, differentiating between parents with and without any previous children, and to measure how level and change in alcohol consumption into early pregnancy was associated with relationship satisfaction. Methods: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. This cohort now includes 108 000 children, 90 700 mothers and 71 500 fathers recruited from 1999 to 2008. The present study comprises 82 362 couples. Alcohol consumption was assessed using a questionnaire including items about usual drinking frequency, quantities, and number of occasions with heavy episodic drinking (HED). Relationship satisfaction was measured by five items scored on a Likert agreement scale. Results: The findings indicate that both mothers and fathers reduce their drinking significantly during pregnancy. Reduction was apparent for all three measures of alcohol consumption. First-time fathers reduced their alcohol consumption more than experienced fathers, from initially higher levels. The gap between the fathers and their pregnant partner was greater for first-time parents compared to parents with previous children. Drinking pre-pregnancy and relationship satisfaction during pregnancy were weakly related within each partner, whereas no association across partners was observed. Conclusions: Both expectant mothers and fathers changed their alcohol consumption patterns when expecting a child. Almost all mothers stopped drinking, whereas fathers reduced their drinking to a considerable degree. Relationship satisfaction was only slightly related to their drinking patterns. The findings may have important policy implications, mainly with regard to developing alcohol preventive strategies

Effect of Prepregnancy Alcohol Consumption on Postpartum Relationship Satisfaction and Divorce among Norwegian Mothers

This study assessed the effect of prepregnancy level of alcohol use among mothers on relationship breakups with young children at 36 months after birth and the extent to which relationship satisfaction (RS) throughout the postpartum period could mediate any association between alcohol use and divorce. The data were part of the Norwegian Mother and Child Cohort Study, and analyses of the present article were based on a total of 69,117 mothers divided into low-, medium-, and high-risk consumption groups. All the three groups experienced a decrease in RS, but the largest effect was observed for the high-risk group. Mothers in this group had 55% higher odds for divorce as compared to the low-risk group. The findings supported a conceptual model whereby the effects of alcohol use on divorce were mediated through lowered RS

Sounds of silence. The “special grief” of drug-death bereaved parents: a qualitative study

Background: Drug-death bereavement is an understudied topic. We explore what bereaved parents experience after losing their child to drug use. The aim of the paper is to provide knowledge about what drug-death bereaved parents go through and study the kinds of help and support they receive. Method: Reflexive thematic analysis is used to analyze 14 semi-structured in-depth interviews with Norwegian parents. Results: We generated four main themes: (I) ‘constant preparedness’ describes the burdensome overload that the parents experienced before death; (II) ‘stigmatization’ represents public and self-induced stigma; (III) ‘emotional overload’ refers to the parents’ complex and ambivalent emotions, such as anger, guilt and shock after the loss; and (IV) ‘complex relations’ describes the parents’ relations with public services and their personal social networks. Discussion: We discuss how overload, before and after the loss experience, causes a special grief. How this overload, silence from helpers, self-stigma and complicated interactions with social networks contribute to the grief of these parents is also discussed. Potential implications for policy and practice are subsequently outlined

How do Professionals in Municipal Health and Welfare Relate to Bereaved Persons During the Acute Phase of a Drug-Related Death? A Qualitative Study

This study aims to broaden our knowledge of how professionals in municipal health and welfare relate to bereaved persons during the acute phase of a drug-related death. A reflexive thematic analysis was applied to six focus group interviews with 27 first responding personnel in Norway. The article describes the complexity and simultaneousness of the professional response. Three main themes were identified: (a) establishing contact, (b) diverse, supportive assistance, and (c) a complex helping context. The analysis showed that experiences from previous encounters and the deceased’s illicit drug use affected many of the professionals’ assessments, and implied an evaluation of the bereaved as not in need of emergency services or psychosocial follow-up. Professionals should be trained to understand drug-related death as a sudden and unnatural death, and to initiate immediate psychosocial crisis intervention. There is a need for further research on the perspective of professionals in the health and welfare services on the drivers and barriers to support (bereaved persons) during the acute phase