The challenging transition from couple to family

The act of starting a family is usually associated with a sense of meaning and happiness. But it is easy to forget that the transition from couple to family is also a critical life event. The mental health of the parents is decisive for the child’s development both before and after birth. It is therefore important to seek help if problems such as depressive symptoms occur. The life of the mother and father and their relationship to each other undergo a fundamental change after the birth of a child. The need to be available for their own child around the clock can severely limit their independence, thus imposing a considerable physical and mental burden. These facts are often not discussed beforehand – the emphasis tends to be on joyful anticipation of the birth – and this can increase people’s reluctance to seek help at an early stage.

The parents’ well-being has a significant impact on the health and development of the child. However, roughly thirty per cent of women1 have mild, moderate or severe symptoms of depression after giving birth, develop anxiety or suffer from stress – and it is not uncommon for fathers to be affected by these symptoms too. It often costs new parents a great deal of effort to seek help in these situations, because the pressure from society is enormous. Barbara Blatter Hofmann, a MAS-qualified midwife and nursing expert in the Department of Paediatric and Adolescent Medicine at Cantonal Hospital Winterthur, notes: “It impresses me time and again to see how women simply go on functioning despite having postpartum depression or anxiety. However, the infant notices that its mother is not well. If the mother or father has an untreated psychiatric condition, this can endanger the child’s development and increase the risk of behavioural disorders. That’s why this type of symptom must be addressed as soon as possible.” If a mother-to-be is suffering from a trauma, depression or severe stress, it can trigger a premature birth or affect the development of the fetal brain. This, in turn, can lead to long-term complications in the child – for example in its cognition or speech – which is why it’s important for pregnant women to seek help promptly if they have mental health problems.

It is equally essential for women who develop depression or anxiety before or during pregnancy to have a good social environment and professional support.

Children don’t just change their parents’ lives; they also affect the relationship between the couple. As responsibilities towards the new baby increase, satisfaction and affection between the parents often decrease at the same time. The causes range from time constraints through lack of support, lack of sleep and declining sexual activity. It is therefore important for couples to find time for themselves during this period and talk about their expectations and wishes.

The degree to which the birth of a child affects a couple’s relationship also depends on the division of roles. The framework conditions for parents have improved somewhat in recent years owing, for example, to the introduction of a two-week period of parental leave for fathers. Compared with other countries, though, Switzerland is still lagging behind in terms of childcare and, according to UNICEF, is at the bottom of the international ranking, alongside the USA, Cyprus, Slovakia and Australia. If both parents are working full-time before the child is born, it is usually the woman who subsequently reduces her hours or takes a break from work, while the father tends to continue working as before. This often re-establishes a traditional division of roles in the household, which can generate dissatisfaction, despite fathers nowadays tending to play a more active role within the family than was usual ten years ago.

The transition from couple to family is a challenging phase of development for everyone concerned. It is therefore important for professionals to draw young parents’ attention to the help available – for example, the support provided by midwives, and counselling services for families, mothers and fathers. Ultimately, satisfied parents, a stable relationship, good parenting skills and a positive climate within the family all have a positive effect on the child’s mental health.