Melbourne School of Population and Global Health - Research Publications

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Author: Fisher, Jane × Start date: 2005 × End date: 2005 ×

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    Assisted conception is a risk factor for postnatal mood disturbance and early parenting difficulties
    Fisher, Jane R. W. ; HAMMARBERG, KARIN ; Baker, H. W. Gordon (Elsevier, 2005)
    Objective: To investigate whether assisted conception is associated with an increased risk of admission to a residential early parenting program for treatment of maternal mood disorder or infant feeding or sleeping disorders in the postpartum year. Design: Systematic audit of consecutive medical records. Setting: Masada Private Hospital Mother Baby Unit (MPHMBU), Melbourne, Australia Patients: Medical records of all mother-infant dyads admitted to MPHMBU between July 2000 and August 2002. Main outcome measures: Modes of conception and delivery of index infant, maternal and infant age on admission, multiplicity of birth, infant birthweight and Edinburgh Postnatal Depression Scale scores. Results: A total of 745 records were audited and mode of conception was recorded in 526 (70.6%) of records. Overall 6% (45 / 745) of the admitted infants had been conceived through ART compared to 1.52% in the general population (RR 4.0, 95% CI 3.0 - 5.4). Mothers who had conceived with ART were older and more likely to have had caesarean and multiple births than those who conceived spontaneously. Conclusions: Assisted conception appears to be associated with a significantly increased rate of early parenting difficulties. Women who experience assisted conception may require additional support after their babies are born.
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    Early parenting difficulties: implications for health services policy
    Fisher, Jane ; ROWE, HEATHER ; Tattam, Amanda ( 2005)
    Australia’s residential early parenting centres are unique internationally and provide a highly valued service to parents and their very young children. Clinical practice in these services has been based on extensive experience, but now needs to be derived from an evidence base. In response to this need, Tweddle Child and Family Health Service (TCFHS) in Melbourne - a public access early parenting service - commissioned a review of literature relating to its practice and a prospective longitudinal survey of a consecutive group of mothers admitted with infants aged up to one year. This article summarises the main findings of both the literature review and the survey. Australia’s public access residential early parenting centres are a unique national resource and were established initially for the care of abandoned, relinquished or mistreated young children. Over time their purpose and function has altered to reflect social change associated with reduction in relinquishment of children for adoption, and policies that have sought to minimise removal of children from parental care. Now they focus on assisting parents to improve caretaking capacity. There are no equivalent services in any other country in the world. In general, services for parents experiencing difficulty caring for their infants in industrialised countries are based in primary health care of outreach home visiting services. Consumer satisfaction surveys indicate that parents value early parenting services highly, but as yet there is a limited evidence base to their clinical practice.