Mental training during pregnancy. Feelings and experiences during pregnancy and birth and parental stress 1 year after birth – A pilot study Ingegerd Hildingsson a,b,⇑ a Mid Sweden University, Department of Health Science, Sundsvall, Sweden b Karolinska Institute, Department of Women’s and Children’s Health, Stockholm, Sweden article info Article history: Received 17 May 2011 Revised 21 November 2011 Accepted 22 November 2011 Keywords: Parental stress Mental training Parenthood Birth experience Follow-up study abstract Background: Parental stress has been recognized as a problem despite governmental support of parent education programs aiming to prepare parents for parenthood. Aim: to compare parents who underwent a mental training program during pregnancy with a control group to measure feelings and experiences during pregnancy and birth and perceived parental stress. Methods: A comparative pilot study of 46 self-selected parents who underwent a mental training pro- gram during pregnancy, and 1408 parents living in the same catchment area (control group). Data was collected in mid-pregnancy, 2 months and 1 year after birth. The main outcome was parental stress. Results: Parents in the mental training group were more often expecting their first baby and had a higher level of education compared to parents in the control group. Parents participating in the mental training program had less positive feelings about expecting a baby (OR 14.0; 6.7–29.3), the upcoming birth (OR 2.0; 1.1–3.8) and the newborn baby (OR 3.1; 1.6–6.2). Parents who attended the mental training program attended an antenatal parent education to a higher degree (OR 2.0; 1.6–2.4) and were more likely to stay in contact with other participants in the antenatal education (OR 4.1; 1.9–8.6). Mothers in the mental training program used psycho prophylaxis to a higher extent (OR 3.0; 1.2–7.1) There was no difference in the birth experience or the perceived parental stress. Conclusion: Participating in a mental training program for birth and parenthood was not associated with the birth experience or the assessment of parental stress 1 year after birth. Ó 2011 Elsevier B.V. All rights reserved. Background Becoming a parent is a major life event usually associated with happiness and joy, but for some parents, parenthood can be demanding and stressful [1]. Factors related to perceived difficul- ties or stress in parenthood include financial problems, a low level of education, a lack of partner support and the occurrence of inti- mate violence [2,3]. The adjustment to parenthood has been de- scribed as a vulnerable period in which the marital relationship is exposed to dramatic changes [4]. Parental stress was developed by Abidin in 1995 [5] and could be caused by a disparity between the perceived demands of par- enting and the resources available to meet those demands [5]. In- creased parental stress is a risk factor for dysfunctional parenting [6] and behavior problems in the child [7]. In a recent survey of the staff in child health clinics, a majority reported that contemporary new parents perceive parental stress to a high degree and that they, despite regular visits to the clinic, often seek additional help for themselves or their infant [8]. It was also reported that parents often regarded their parental expec- tations as going unmet and that they did not feel as happy as they thought they would be. Independent of biomedical risk, maternal prenatal stress was significantly associated with infant birth weight, gestational age at birth, miscarriage and pre-eclampsia; it is also known that stress also increases the risk of the child for developing diseases later in life [9]. Attempts at reducing parental stress during or after pregnancy have been introduced, such as antenatal education programs, indi- vidual or in group sessions [10]. A Cochrane review of educational programs after birth showed unclear benefits [11]. Several initia- tives have been introduced in Sweden to prepare new parents for parenthood. These initiatives are incorporated into the parent edu- cation classes in antenatal and child healthcare offered for free to all parents in Sweden [12]. However, only first-time parents are offered antenatal education programs in most public antenatal clinics and mainly highly educated parents attend these types of programs [15]. The official purpose of parental support in antenatal and child health clinics is to provide knowledge and information, strengthen parents in their parenting role, and provide contact with other par- ents [13]. Government investigations have evaluated the effects of parental education and have found that participation is lower among parents of foreign origin [14], a finding also confirmed by a 1877-5756/$ - see front matter Ó 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.srhc.2011.11.003 ⇑ Address: Mid Sweden University, Department of Health Science, Holmgatan 10, SE-87150 Sundsvall, Sweden. Tel.: +46 70 5941982; fax: +46 60 148519. E-mail address: ingegerd.hildingsson@miun.se Sexual & Reproductive Healthcare 3 (2012) 31–36 Contents lists available at SciVerse ScienceDirect Sexual & Reproductive Healthcare journal homepage: www.srhcjournal.org