Dr Karin Hammarberg's Research

The following two articles are sourced from www.unimelb.edu.au (Melbourne University) and www.apo.org.au (Australian Policy Online) respectively.  Just click the hyperlinks for the original transcripts.  You can also read Dr Hammarbergs abstract, or view the full text of 'Women's experience of birth and early mothering following assisted conception' (PDF file) by clicking thesis.

The University of Melbourne

More support needed for IVF mums, says University of Melbourne study

Media Release, Monday 5 March 2007

Women who conceive using assisted reproductive technology, such as IVF, are more likely to feel anxious and lack confidence in caring for their babies than those who conceive without treatment, according to a University of Melbourne study.

In the largest Australian study of mothering after assisted conception, research fellow Dr Karin Hammarberg, from the Key Centre for Women’s Health in Society, tracked more than 150 women over the first 18 months of motherhood.

Their experiences of early parenting were compared with data taken from the general population and other surveys of new mothers.

The study found that compared to other women, those who conceived using assisted reproductive technologies were:
• Three times more likely to be admitted to early parenting centres;
• Less likely to be breastfeeding their babies at three months;
• Less confident about their mothering skills;
• More anxious about caring for a new baby;
• Twice as likely to have a caesarean; and
• More likely to be disappointed with their birth experience.

Dr Hammarberg says there is a correlation between the amount of difficulty a woman has in conceiving and her confidence levels on leaving hospital.

“Women who take longer to conceive, go through more treatment cycles and have miscarriages have lower levels of confidence when they go home with their new babies,’’ she says.

Dr Hammarberg’s research also found that women who received assisted reproductive technology were also on average five years older when they gave birth, more likely to be first time mothers and nine times more likely to have twins.

Dr Hammarberg says women who conceive using fertility treatment have very high expectations of life with a new baby.

“These expectations can leave them unprepared for the extraordinary demands involved in caring for a newborn,’’ she says.

“A degree of distrust in their ability to care for their baby may also explain their higher use of residential parenting services such as sleep schools.

“However, because it has been so difficult for them to fall pregnant, they are immensely grateful for their children and do not feel entitled to complain about the problems and anxieties of new motherhood.’’

Dr Hammarberg’s says her study provides important information for health professionals working with new mothers.

“My study clearly shows that many women who receive fertility treatment need extra support once they become mothers – and this is a great opportunity to intervene early and support them before problems arise,’’ she says.

Dr Hammarberg’s study suggests strategies to better prepare women for parenthood. These include:

• Reassuring women that it is normal to feel ambivalent about motherhood;
• Providing women with information about their increased likelihood of caesarean to lessen disappointment after birth;
• Boosting women’s belief in their ability to care for their baby;
• Intensive support to help women with breastfeeding problems;
• Practical advice on feeding and settling babies after leaving hospital; and
• Including fathers in pre-natal education so they understand how important it is to provide practical and emotional support to their partners.

“Being a new mother can be extremely exhausting and isolating, especially if your baby is unsettled and cries a lot,’’ Dr Hammarberg says.

“Women need to know that, regardless of how they have conceived their baby, that needing help is universal and normal.’’
 

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 Australian Policy Online

 INFERTILITY
The emotional cost doesn’t stop when a baby is born

Key Centre for Women's Health in Society, University of Melbourne

Posted: 28-03-2007

A new study proposes strategies for health care professionals to ease the transition to motherhood for women who give birth after fertility treatment, writes Karin Hammarberg

AMONG the women who give birth in Australia each year, the proportion aged 35 and over has increased from 12.7 per cent in 1994 to 19.5 per cent – or nearly one in five – in 2004. Many couples who try to start a family when they are in their late 30s and 40s discover that they are unable to conceive and resort to assisted reproductive technology (ART). The birth rate after fertility treatment in Australia is increasing; in 2004, over 7000 children were born as a result of ART, accounting for 2.7 per cent of all Australian births that year. But the evidence suggests that ART creates a unique set of challenges for women.

Delayed childbearing is due to a range of factors. Women are leaving the parental home and forming permanent relationships at an older age. Marriages are more likely to break down and cohabiting couples have a high rate of separations. More women are pursuing a career and are increasingly financially independent. And, of course, contraception is more reliable. Recent research also suggests that some women miss their opportunity to have children due to their partner’s reluctance to commit to parenthood.

As a nurse with 20 years experience of working with couples with fertility problems, I became acutely aware that this pathway to parenthood is not without its personal and physical consequences. To better understand the needs of the growing group of women who become mothers after assisted conception, the Key Centre for Women’s Health in Society at the University of Melbourne conducted a prospective longitudinal study of the experiences of childbirth and early parenting after assisted conception.

This study is the largest and most comprehensive Australian investigation of mothering after assisted conception, with over 150 women completing three questionnaires after the birth of their child. My colleagues and I compared this data with the general population and with data from other studies of childbearing women.

 The ART group was more socioeconomically advantaged than other women of comparable age. On average, they were five years older when they gave birth, and more likely to be first-time mothers (70 per cent versus 42 per cent), have twins (18 per cent versus 1.6 per cent) and experience a caesarean section delivery (51 per cent versus 25 per cent). When asked about their experience of the birth, they were more likely than other women to feel disappointed, particularly if they had a caesarean section birth. Furthermore, they were more likely to report feeling anxious about caring for the new baby when they left hospital.

The study found that women who conceive with ART experience more early-parenting difficulties than comparison groups, including a lower sense of maternal confidence, a three times higher rate of admission to residential early parenting services in the first eighteen months, lower rates of breastfeeding at three months, and more anxiety about being separated from the baby.

Becoming a mother is a significant event in any woman’s life. This study shows that when the path to motherhood has been complicated by infertility and ART it may be more emotionally complex. We believe that infertility, the need for technology to conceive and an operative birth may have a cumulative effect in eroding a woman’s confidence in herself and her own body. On top of that, these women are often immensely grateful that the treatment worked and have a very low sense of entitlement to complain about the problems and anxieties they are facing when adjusting to motherhood.

The findings of this study allow us to think of ways to meet the needs women who give birth after ART. Some suggested strategies include the following:

• Make it very clear during pregnancy that there is a high chance that the birth will be by caesarean section to lessen disappointment if that happens.

• Reinforce to women that it is normal to feel ambivalent about the baby and being a mother, even if the baby was very wanted and conception was difficult.

• Increase awareness that being a new mother, especially if the baby is unsettled and cries a lot, can be extremely exhausting and isolating.

• Provide clear, concise and consistent advice about feeding and settling babies.

• Reassure women about their ability to care adequately for their baby.

These strategies could be used by health care professionals to ease the transition to motherhood for the growing group of women who give birth after ART.

Karin Hammarberg is a research fellow in the Key Centre for Women’s Health in Society, University of Melbourne.

Key Centre for Women's Health in Society, University of Melbourne


 

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