Towards Parenthood

The Towards Parenthood program includes nine chapters: eight antenatal chapters and one postnatal chapter. Each chapter contains information and activities designed to encourage reflection, conversation and communication between partners.

Parents can begin with either Chapter 1 (Towards Motherhood) or Chapter 2 (Towards Fatherhood), depending on which feels most relevant. While these chapters reflect different perspectives, parents are encouraged to read both. Subsequent chapters are relevant to all parents and are designed to be worked through together.

Chapter list:

• Preface
• Acknowledgements
• About the Authors
• Chapter 1: Towards Motherhood
• Chapter 2: Towards Fatherhood
• Chapter 3: We’re expecting. Preparing for parenthood
• Chapter 4: Caring for yourself is caring for your baby
• Chapter 5: From lovers to parents. Managing relationship changes
• Chapter 6: Keeping some balance in your life
• Chapter 7: Healthy thinking, healthy self
• Chapter 8: Caring for your newborn baby
• Chapter 9: Welcome to ‘The Club’
• Appendices
• References

What parents say

Parents who have completed Towards Parenthood report improved communication, increased confidence, and greater awareness of their emotional wellbeing during the transition to parenthood.

‘Exploring the expectations, worries and fears of motherhood in the first chapter allowed me to think about some issues.’

‘Reading the first two chapters opened up discussions with my husband.’

‘The problem-solving skills were really useful.’

‘Taking part in the program allowed for reflection on the transition to parenthood and the responsibilities involved.’

‘I found the chapter “From lovers to parents” enhanced communication between me and my partner.’

‘The support services list is a useful resource.’

‘The most helpful aspects of the guidebook for me were the distraction and self-talk techniques.’

‘Understanding the relationship between thoughts, feelings and behaviours using the model was very useful.’

‘Identifying contributors to low mood was something I had not considered.’

‘Recognising passive, aggressive, assertive and indirect communication styles helped me review the way I communicate with others.’

‘The discussion of self-esteem was useful in trying to be a role model to my own children.’

Evidence base

Towards Parenthood has been evaluated as an antenatal intervention to support adjustment to parenthood and reduce symptoms of depression, anxiety and parenting stress.

Towards parenthood: An antenatal intervention to reduce depression, anxiety and parenting difficulties

This paper describes the effectiveness of an antenatal intervention which targeted risk factors for poor postnatal adjustment, with the dual aim of reducing both postnatal symptoms of depression/anxiety and parenting difficulties.

Background There have been few antenatal interventions aimed at preparing women for the transition to parenthood and previous attempts to intervene antenatally to prevent postnatal depression and anxiety have had limited impact.

Methods We evaluated the effectiveness of an antenatal intervention which targeted risk factors for poor postnatal adjustment, with the dual aim of reducing both postnatal symptoms of depression/anxiety and parenting difficulties (a nine-unit self-guided workbook with weekly telephone support). Based on an initial feasibility study (n = 200) which confirmed a low level of help-seeking among distressed women during pregnancy, an additional community networking component was developed aimed at increasing social support and access to health professionals to facilitate treatment of current antenatal depression/anxiety, if present. In the evaluation of a second version of the intervention, pregnant women (n = 143) were randomly allocated to receive either the intervention or routine care.

Results Following the antenatal intervention there were significantly fewer cases scoring above threshold for mild-to-severe depression/anxiety symptoms postnatally compared to routine care, along with a trend towards reduced parenting stress. The community networking component appeared helpful and women with higher baseline depression scores showed higher levels of help-seeking in both intervention and routine care groups.

Limitations It was not possible to evaluate the efficacy of individual program components separately.

Conclusions The findings provide support for the effectiveness of the Towards Parenthood intervention both as a preparation for parenthood program and in reducing symptoms of postnatal depression/anxiety.

Milgrom, J., Schembri, C., Ericksen, J., Ross, J., & Gemmill, A. W. (2011). Towards parenthood: an antenatal intervention to reduce depression, anxiety and parenting difficulties. Journal of Affective Disorders, 130: 385-394 doi:10.1016/j.jad.2010.10.045

Towards Parenthood has been evaluated as an intervention to prepare couples for the transition to parenthood. Towards Parenthood is able to provide helpful information to make a significant difference in the adjustment to parenthood for women. In a randomised controlled trial, women who received Towards Parenthood antenatally together with phone coach calls were:

• less anxious
• less stressed
• less depressive symptoms
• experienced less parenting stress during the transition to parenthood than those who did not have TP.

The workbook has now been published by ACER and was launched on 23 June 2009 by Professor Rob Moodie, Professor of Global Health, Nossal Institute for Global Health, University of Melbourne & Chair of the National Preventative Health Task Force. It is currently in its first reprint.

The program has experienced international interest, is translated into Italian and is currently being translated and modified for use in the Netherlands. It is also being used in the United Kingdom.

Download the inaugural media release for the Towards Parenthood Workbook here.

Prof Jeannette Milgrom Director of the Parent-Infant Research Institute Jeannette Milgrom is Professor of Psychology, Psychological Sciences, University of Melbourne and Director of Clinical and Health Psychology at Austin Health in Melbourne, Australia. Jeannette pioneered ‘The Infant Clinic’ and in 2001 established the Parent-Infant Research Institute (PIRI) focusing on high-risk infants, ante and postnatal depression, and developing psychological treatments. She has had international recognition for her work with mothers and babies, and her book on treating postnatal depression has been translated into Italian and condensed in French. Her work with postnatal depression has included training of health professionals and delivering public health initiatives. She has an ongoing active research interest through PIRI and is the principal chief investigator on a number of grants including several National Health and Medical Research Council (NHMRC) grants. Her work has been recognized with a Medal of the Order of Australia.

Ms Jennie Ericksen Clinical Psychologist Jennie Ericksen is a Clinical Psychologist who worked as the Coordinator of the Infant Clinic of the Parent-Infant Research Institute at Austin Health since its inception. She has specialising in working with parents and children during pregnancy and early parenthood in a variety of settings. Her interests include parental mental health, adjustment and the parent child relationship. She has a strong interest in supporting parents making the transition to parenthood and in building capacity in other health professionals to undertake this work. She has contributed to writing and evaluating a number of PIRI interventions and has managed and worked on a number of the Parent-Infant Research Institute research studies while leading a multidisciplinary team of parent-infant specialists. She has published a number of articles and contributed to improving awareness in the media of the needs of mothers, fathers and infants.

Dr Bronwyn Leigh Clinical and Health Psychologist Bronwyn Leigh is a clinical and health psychologist who worked at the Infant Clinic and Parent Infant Research Institute for 5 years. Bronwyn’s areas of interest include; adjustment to parenthood, premature birth, perinatal mood disturbance, perinatal loss, the parent infant relationship, infant mental health and maintaining intimacy between couples in the transition to parenthood. She has published in academic journals, presented at conferences and provided media interviews. Bronwyn is experienced in the revision of clinical supervision, training and consultancy. She is currently in private practice working with parents and infants.

Ms Yolanda Romeo Clinical Psychologist Yolanda Romeo is a clinical psychologist who worked with infants, children and their families at the Parent-Infant Research Institute at Austin Health for 5 years. She has two Masters Degrees in clinical psychology and child clinical psychology from the University of Melbourne, and has also undertaken further studies in the Graduate Diploma in Parent-Infant Mental Health, also at University of Melbourne. Yolanda has over nine years of experience working in the departments of child and adolescent psychiatry at a number of major hospitals in Melbourne including Austin Health and Monash Medical Centre and is currently in private practice. Her interests include parent-child attachment and relationship problems, the impact of family of origin and trauma issues and postnatal depression.

Ms Elizabeth Loughlin Dance Therapist Elizabeth Loughlin is a professional dance therapist who has worked with mothers and infants in dance in the community, studio and clinical setting for many years. At the Infant Clinic, Parent Infant Research Institute at Austin Health, she offers dance and movement with music as a therapeutic intervention for mothers with postnatal depression and their infants. The aim is to build on the mother’s intuitive processes that may have been dampened by postnatal depression and to encourage expressive communication between infant and mother. Elizabeth has published in the area and also teaches about this work at the International Dance Therapy Institute of Australia and creative arts therapies in the University of Melbourne School of Social Work.

Ms Bella Saunders Clinical Psychologist Bella Saunders is a clinical and developmental psychologist who worked at the Infant Clinic, Parent Infant Research Institue at Austin Health for 3 years during the major development of the Toward Parenthood program. She has a strong and continuing interest in working with women with postnatal depression. She has extensive experience working in the areas of child and family issues, across private, government and hospital sectors. She specialises in parenting issues and assessing children’s (0-8 years of age) social, emotional and behavioural needs and is currently teaching health professionals.

Ms Rachael McCarthy (1969-2005) Clinical Psychologist Rachael McCarthy was a clinical psychologist who worked at the Infant Clinic and Parent-Infant Research Institute for 10 years. Rachael possessed a passionate interest and rare sensitivity in working with mothers, babies and families. Her contribution to this book and to PIRI will not be forgotten and continues to resonate in the lives of all who she worked with.

Ms Bev Aisbett Illustrator Bev Aisbett is the author and illustrator of a number of self-help books for depression, anxiety and panic.