Supporting couple relationships for better infant mental health

Its Infant Mental Health Awareness Week (#IMHAW17) and I'm delighted that one of the key areas of the campaign this year is supporting couple relationships from pregnancy and across the early years.

A great number of changes (physical, psychological, financial and practical) take place during the process of planning parenthood and becoming a parent, which can increase relationship stress and conflict. Research tells us that such relationship changes can have a worrying impact on a number of areas of family life:

Parental physical and mental health

Couples experiencing relationship difficulties are at increased risk of higher levels of stress, anxiety and depression. They are also at an more likely to experience of a range of physical health problems such as cardiovascular disease, diabetes, and obesity. It is well established that stressful life events in pregnancy, such as relationship difficulties, can have a negative impact on pre-term birth, whether women have a caesarean or instrumental delivery, as well as the birth weight of the baby. 

Parenting and coparenting quality

Relationship difficulties have been found to impact how sensitively you parent, and how co-operatively you are able to parent with your partner. 

Infant development

Many children whose parents experience relationship difficulties in pregnancy and after birth go on to have a normal development. However, a number of recent studies indicate that they are at increased risk of adverse outcomes, such as child anxiety, depression, aggression, hostility, anti-social behaviour,criminality, poor performance in school and impaired physical development, such as increased risk of obesity.

Family breakdown

We know from Department of Work and Pensions data that around one fifth of children under one do not live with both their biological parents. Low-income families are most affected, with over 50% of low-income families with children under five breaking down.

How we are making a difference to couples

To be able to prevent these devastating outcomes, more relationship support is desperately needed for expectant parents. However, it is currently almost completely absent in obstetric, fertility, maternity, mental health or early years services. To help fill this global gap in provision weare developing and piloting two couple-focused programmes.

The Linking Loss Group

Miscarriage is the most common adverse outcome of pregnancy, but for many women and their partners it is associated with high levels of depression, anxiety, grief and trauma, and higher risk of perinatal mental health difficulties in subsequent pregnancies.

The Linking Loss Group is a psychological group for couples who have experienced early pregnancy loss  or who are having long-term difficulties conceiving. It is an integrative group intervention underpinned by psychoeducation, peer support, mindfulness and couple communication techniques. 

The group is facilitated by one peer supporter (someone with lived experience of perinatal loss) together with a professional group worker and they discuss themes such as anger, grief, shame, social support, and relationship intimacy.

Becoming a Family

Becoming a Family is a couple-focused group programme developed at Berkley University by Professors Carolyn and Phil Cowyn to support couples across the transition to parenthood. It is delivered by two facilitators who are mental health or early years professionals with specific training in the intervention model. 

The group starts in pregnancy and couples bring their babies along once they have been born. This provides a ‘living laboratory’ for parent-infant work and partners can discuss issues and solve problems while their babies provide on-going distractions, both positive and negative.

Other topics discussed include: the need to consider intergenerational patterns and attachment relationships; understanding and accepting couple differences; and interruption of escalating negative emotional exchanges.

Together with Tavistock Relationships and a number of other academic institutions, we are now leading a piece of work to bring it over to the UK to support couples in the perinatal period. We are also hoping to complete the first ever randomised controlled trial of a couple-focused perinatal programme in the UK, and increase the evidence-base for this kind of programme. Watch this space.

More information

For further details on the Mental Health Foundation’s work to support the couple relationship please contact Dr Camilla Rosan on [email protected].