Becoming a Parent.

The Emotional Journey Through Pregnancy and Childbirth.

Jackie Ganley.

Preface.

The beginning of our journey.

My own journey into pregnancy and childbirth began many years before I had children myself. As a newly qualified clinical psychologist, in my first job, I saw many women who were distressed and struggling with their life and so often their problems were to do with the struggle of being a parent.

As one father said to me,'Why doesn't someone write a rule book and just make it easier for all of us?' Well, I soon realised that there was no rule book but many common themes did emerge: the juggling of responsibilities, the loneliness of women cut off from their former life, the sense of losing your ident.i.ty and balancing your adult needs against the usually more immediate needs of your baby.

One woman whose story I have never forgotten was Sylvia, who was referred for help with depression. Sylvia was in her late sixties and said her life had been dominated by periods of depression and now she felt her final years were slipping away from her. Sylvia said she had always been depressed but when she thought about it, the depression had begun following the birth of her second child. Sylvia said she had rarely allowed herself to think back over that time since she felt embarra.s.sed and ashamed about what had happened. She could remember little of the detail of her labour except that an emergency Caesarean had been necessary. Sylvia remembered feeling distraught and terrified after she had come round from the anaesthetic and she said it seemed like an eter-nity before she was allowed to see her son. Her husband was at home looking after their daughter and was only allowed to see them during visiting hours. Sylvia said that she had developed an 'illness' while in The beginning of our journey hospital which had caused her to sweat and shake for no reason. This illness had made her avoid the midwives, as she was terribly embarra.s.sed.

During the night Sylvia couldn't sleep and would lie awake wondering if her baby was safe in the nursery and if she was going to survive until the morning.Thus, Sylvia said the midwives clearly thought she was 'odd'and had moved her into a side room away from all the other mothers. Sylvia says she remembers the doctors talking about her on ward rounds but no one ever explained what was happening and so she became convinced she had a serious illness and began to worry that she would die and leave two children without a mother. Sylvia was surprised when a smiling doctor discharged her without warning. On returning home Sylvia felt she had had a lucky escape and although she was relieved, as the weeks went on she just couldn't seem to find the energy that she used to have and the care of the children seemed an enormous burden. Sylvia had moved to their home on marrying her husband and although she knew many local mothers to 'say h.e.l.lo to', she hadn't really made any friends in her new surroundings. She wondered why she wasn't like other mothers who seemed to take everything in their stride.

Sylvia was genuinely surprised to discover that her feelings were not unusual for women who had experienced a complicated delivery. She was particularly amazed to discover that her symptoms were anxiety symptoms: she had heard of post-natal depression but didn't realise that very many types of emotional reaction are common to having a baby. Sylvia had experienced little support and care from the professionals around her and, like many women of her generation, she was somewhat isolated from other new parents. It seemed heart-breaking that 40 years after having her baby, Sylvia was still trying to understand exactly what had happened to her.

We can learn a great deal from Sylvia's experience about the sort of care and support that women need when they have a baby. It is important to understand what is happening to you and your baby throughout your pregnancy and childbirth. Medical professionals involved in your care should explain exactly what is happening and why, and parents should be encouraged to ask questions and make their own decisions. New parents today are perhaps more aware of the psychological struggles that surround becoming a parent but often during a period of such rapid adjustment it is difficult to take in what is happening. At times, most parents will feel like Sylvia that there is something wrong with them and that the rest of the world appears to know what they are doing!

There are many books on the market that take us through the process of becoming pregnant and giving birth and this information is an important xiv part of our journey. However, this book will not go into detail about the physical process of pregnancy but will concentrate on the emotional transition that takes place. Psychologists often talk about 'life events' as the significant building blocks that form our lives.These can be both positive and negative: getting married, moving house, changing career, bereavement, illness, and so forth. The more of these events you experience at one time, the more likely it is that you will feel pressurised, stressed or depressed. Becoming a parent is probably the biggest transition that many of us will make. So many things change: there are new roles to learn, new responsibilities to take on and parts of the old self to be given up. This is true for both mothers-to-be and fathers-to-be. Women also have to cope with the physical realities of pregnancy: a changing body shape, morning sickness and sometimes serious health complications such as raised blood pressure. Labour and birth also pose new challenges and experiences. As was the case for Sylvia, often the physical consequences of labour can lead to physical and emotional trauma.

Our journey, however, begins with deciding to have a baby.There may be no right way to decide but it is certainly an issue that many people spend many hours pondering. You may already be pregnant when you read this book but the decision to become pregnant is often revisited once pregnant: why did we do it? Why don't I feel so certain now? Chapter 2 looks at conception. The area of conception and problems with conception probably merits an entire book and here the issues of the pain and disappointment of fertility problems are only touched upon.

The main section of the book, Chapters 3 and 4, is about pregnancy.

Pregnancy is usually thought of in terms of three trimesters and the development of the baby in this time. This book will look at the 'psychological stages' of pregnancy. How might you feel in those early weeks? What sorts of worries do newly pregnant women have? How do they cope with morning sickness or cut down their alcohol intake?

The middle of pregnancy can be a somewhat different time emotionally. Most women have accepted the pregnancy and are getting used to their new ident.i.ty of 'pregnant woman'. The focus therefore shifts away from the internal to the external: How can I prepare for this baby? How will my life change? As pregnancy draws to a close, some of the fears of early pregnancy may return. Predominantly these tend to be fears about labour and giving birth. As the pregnancy comes to an end, it is time to disengage from former responsibilities and reinvest in the new future.

However, every pregnancy is different and for some the experience of pregnancy can be overwhelmed by other problems and concerns.

Depression is just as common in pregnancy as it is post-natally. A great deal of attention is given to supporting mothers so that they do not get depressed following the birth of their baby but more attention should in fact be given to identifying problems in pregnancy and supporting women who are depressed or struggling. After all, there is much more time in pregnancy than there will be after the baby is born: time to think, to talk and to begin to make changes. It is all too easy to get wrapped up in the practical plans for the baby.

Chapter 5 on birth looks at some of the practical decisions to be made in pregnancy such as, shall I have a hospital or home birth? Labour is then considered: what does it feel like and how can I manage the pain? What are birth partners supposed to do? There is also discussion in this chapter and Chapter 3 of loss during pregnancy and birth.

Many books on pregnancy trail off after the discussion of giving birth and this may be because most books are read in pregnancy and it may just be too difficult to think so far ahead or imagine what the challenges will be when your baby is here. It is, however, better to approach this time from a position of some preparation and therefore there are two further chapters: the first few days (Chapter 6) and the first six weeks (Chapter 7). The chapters are divided this way since these two time periods seem to be significant. In the first few days new parents are faced with enormous physical and psychological challenges. A new mother has to recover from the experience of labour while at the same time being thrown immediately into the task of parenting. If you were climbing a mountain, you would rest before working your way back down but recovery from labour has to fit in around your new baby. Chapter 6 also discusses the feelings and reactions of the first few days which may be very different to how you might feel after six weeks. In those early days you might experience the baby blues and struggle to do very much at all. However, in the first six weeks mother and baby start to get to know each other and remarkably by six weeks most new parents feel like they have been through a lifetime with their baby and usually feel that they have 'become parents'. At the very least they will have recognised the basic needs of new babies: feeding and sleeping dispersed with moments of crying and being held. Things may still be very chaotic and difficult at the end of the first six weeks but usually the direction seems a little clearer.

For some women, however, the chaos is all that they see. By six weeks a significant number of women are depressed and feel that they are not coping. Chapter 8, therefore, offers some suggestions on how to deal with anxiety and depression, while the final chapter, Chapter 9, looks forward to the future.

Each chapter includes a 'who can help' section to direct you towards appropriate support. There are also discussion points. These are not a definitive guide, just some suggestions to help encourage discussion between parents-to-be. For new parents 'communication, communication, communication' is probably the key to survival. Try to discuss your thoughts, feelings and dilemmas with whoever is around to listen: partner, parent, friend or fellow new parent. Use the various professionals around you to get information and support too. Remember the things that they are interested in may not be your concerns. Most importantly, try to listen to and learn from your interactions with your baby and remember he is unique and will not behave in the same way as other people's babies do.

Throughout the book I have tried to use the stories of families that I have worked with to highlight the struggles that we all face in becoming parents. To protect the ident.i.ties of those concerned I have changed the names and details of people's stories. I have also taken the decision to refer to babies as 'he'and 'him' throughout. I'm sorry if this offends but as I am the mother of two sons, it was always 'he' in our household and this seemed easier for me. I have also written this book to be read by both mothers-to-be and fathers-to-be and I hope this doesn't alienate the single parent reader. Often new fathers find it far more difficult to become involved in what is happening and it would be ideal if both parents-to-be were to read this book. Support does not necessarily need to come from a father but new parents do far better when they have the concerned support of others. Hopefully, this book can provide you with a little bit of concerned support.

Acknowledgements

A number of people have made it possible for me to write this book but my greatest debt is to James, Jake and George who have disappeared to the park on rainy afternoons and allowed me some time to write. They have been a great source of inspiration in my life and I owe them a great deal in very many ways. Thanks also to my friends and their children who have been with me in my own transition to parenthood and helped to make it such a great journey.

I would like to thank everyone at Wiley for helping this book to come together and also Dr Jane Ogden for her initial suggestion that I should write it.

There are many people who have influenced my professional development over the years and I would like to take this opportunity to thank them. Most of all, I could not have written this book without the numerous people who have shared their own life stories with me over the years. I am very grateful for all I have learned from working with you.

1.

Deciding on parenthood.

What are we letting ourselves in for ?

The mess, the chaos, the disruption, the expense, the loss of personal s.p.a.ce! So why do we do it! Having children is for many people the single most important experience/event of their lives. For many prospective parents it is an irreplaceable part of how they want their lives to be. It may bring great joy and personal fulfilment or it may bring challenges, conflict and sadness at times. For some, the prospect of children is daunting and certainly not an inevitable choice: to have children will be a decision they consciously make after much exploration of their feelings and motives. For others, pregnancy is a situation they collide with ^ an unexpected event possibly in a less than ideal situation. For increasing numbers of people today children will arrive with a new relationship itself where the partner is a single parent.

More and more people today are seeing child-rearing as a choice and not a biological inevitability. For those living in the wealthy nations of the world, parenting has become a lifestyle choice. Having children has enormous financial, emotional and social implications. Whatever the position of prospective parents, whether married for years, a single person, teenagers, or a couple with fertility problems, all will find themselves financially worse off, emotionally challenged and having to give up (if only temporarily) many of the social pleasures that make life manageable. Clearly, deciding to have children is not a particularly rational decision and if we really sat down and calculated the financial burden, the heartache and the sleepless nights, then most people would probably decide against reproduction. So why does it continue to be a choice that the majority will make?

2.Calling this chapter 'Deciding on parenthood' might be misleading: it is here because it is a subject that many people spend hours thinking about.

This chapter's aim is not to give the impression that there is a right way to decide or a list of questions that you can go through and come up with the right answer:'yes, it's for me'or'no, I'm better suited to my career'. At its most basic, deciding whether or not to have children is about weighing up the balance between our adult needs and our perception of the needs and demands of any potential children. However, it is almost impossible to predict the 'costs' of children for any particular individual. One might begin to reckon up the specific financial burden but it is very difficult to predict the emotional costs, especially as these are specific to each individual. Even after the initial decision to become pregnant, the decision-making continues.

Having had a first child, it is still a big decision for many parents about whether and when to have number two. . . or three . . . or four.

One might argue that it is perhaps a reflection of a more 'responsible'

society that people are sitting down and thinking about whether they would make good parents. There are few people left who still believe that 'G.o.d decides' whether a baby is born but there is an alternative view that we have become incredibly omnipotent and unrealistic about how much control we actually have over life and making new life. This chapter will take a look at some of the factors that are involved in making this decision.

What does it mean to be a family ?

Most of us probably don't stop to think about what a family is.The family that we grew up in probably influences our picture of a typical family.

Large numbers of us grew up in a situation where there was a mother and a father who were married, with two or three children and our mother stayed at home in the early years of our life. The family has obviously changed over recent years. Separation and divorce are far more common and now having a baby, as a single parent, is no longer seen as a shameful mistake.The single parent household is now said to be the largest growing new household type. The politicians of the Right like to argue that the 'traditional family' has broken down and that its values have been lost too. It is interesting to wonder what the traditional family actually is, or was, and whether there has ever been a static family structure that was such a defining force in our society.

A look at our social history will show that the family has always been evolving and changing, especially in the past hundred years. In the What does it mean to be a family?

3.mid-twentieth century sociologists talked about the rise of the nuclear family and the demise of the traditional extended family. Now we are told that the nuclear family is breaking down as we have the rise of the single parent household. How long the extended family existed is unclear, since life was such that extended families could not have been common 500 years ago.

It seems likely that family structures have changed as societies have evolved and our needs for survival have changed. Taking just the history of British society and the number of wars that were fought in the last millennium, it is likely that single parent families were very much the norm. One has only to look at the history of the past century with two world wars to see that for extended periods of time fathers were absent from the home, many never to return and that women had to leave their children in the care of others while they worked in factories or on the land.Working mothers were not created in the 1990s.

So what does the family look like today? If diversity is a good thing, then the family is probably doing very well! In this country most babies today are still born to couples but the long-term prospects for those couples is poor in terms of divorce and separation.The break-up of the couple before the child becomes an adult (even where the separation is sensitively handled and the couple continue reasonable relations) does have consequences for the child.These children are more likely to have emotional or behavioural difficulties but this is not inevitable and there are many influences on a child's development. These issues have to be balanced against the costs to the parent of remaining in the relationship, especially where one partner may be experiencing stress or violence.

Just when we might think the nuclear family unit is doomed, however, there are new types of nuclear families coming to take its place. Many more gay and lesbian couples are now openly becoming nuclear family units through a.s.sisted conception or adoption and fostering. Many couples who previously would not have had children are doing so through fertility treatment. The largest new group is said to be the single parent household. However, statistics can be misleading and it is probably only a small number of these families that remain static throughout the life of the child. The 'reconst.i.tuted family', where one family is formed from other family units, is becoming much more common.

From a broader social perspective many Western societies are predicting that their populations are shrinking dramatically as not enough children are being born to replace the population. This is a complex issue since populations do not necessarily expand in expected ways. Often the more prosperous a society becomes, the fewer children 4 people will have. Other societies struggle to contain a growing population.

So the family today comes in many shapes and sizes probably just as it has always done.

Betty and Peter's story Betty came to see me after a year of feeling depressed: at times it was so severe she could hardly speak. Her husband Peter said he couldn't understand it since they had looked forward to retirement and they certainly had enough money to manage. Betty had retired from her job as a cleaner some years ago and had looked forward to a retirement spent with her grandchildren. Betty was the oldest of 11 children and had helped to raise her brothers and sisters following the death of her mother. Betty said she loved children but had only had two because things were different in the years after the war and they couldn't afford any more. Her son had emigrated to Australia with his family and her daughter was married to a soldier and they were currently living in Germany. Betty said she felt 'completely useless', had nothing to do with her time and that her house was empty unless the family were visiting. She said she would never expect her children not to lead their own lives but she felt 'life was empty without your family around you'.

What does it mean to be a mother ? Changes for women Social roles such as 'mother' or 'shopkeeper' or 'friend' are governed by certain rules or expectations.The role of 'mother' has changed drastically in the past hundred years and has probably always been changing in terms of the needs of the wider society at a particular time. For example, during the wars of the past century women were expected to maintain the supply of food and products, especially munitions, that would keep society functioning in time of war. Often they also had to accept long separations from their children who were evacuated for safety. Much has been written about how in the 1950s post-war propaganda (including psychological research) was used to draw women back into the home as full-time parents so that the men returning from war would have jobs. Ideas persisted that children could be 'damaged' by the absence of their mother. However, society has currently swung again towards accepting women in the What does it mean to be a mother? Changes for women 5 workplace and there is censure for those who stay at home and claim benefits to bring up their children. It may be that in our current society supporting children financially is seen as more important than supporting them emotionally.

The role of 'mother' is therefore ever changing and this uncertainty for society about what exactly a mother is can make it more difficult for the individual woman to a.s.sume the role. This may add to or generate a sense of insecurity in late pregnancy. What exactly does it mean to become a mother? Is a mother someone who works outside of the home? Do mothers go clubbing? Do they instinctively know how to care for a newborn baby? In effect, women construct for themselves the role of 'mother', being influenced both by the wider society and their own needs, preferences and responses to their baby. Your early interactions with the baby will shape your perception of yourself as a mother: if your baby is born of very low birth weight your experience will be very different to a mother who gives birth to a 9 lb baby.Your view of yourself as a mother is not static: it will change as you have good times and bad times and as your child displays different needs and demands.

John and Rosemary's story Rosemary came for help with depression the roots of which seemed to stem from dealing with her three-year-old son. Alex seemed a very active and healthy boy but he ate hardly anything throughout the day, which caused his parents an enormous amount of anxiety. John and Rosemary had married early in their twenties and had hoped to have children but the years had rolled on with nothing happening.

They had approached their doctor but initial tests revealed no reasons for their not conceiving and they decided to 'wait and see'. After 13 years they were finally rewarded with a healthy baby boy. Rosemary admitted that they had found the adaptation to parenthood enormously difficult. Their lives had become very ordered and predictable over their married life and now they had sleepless nights, tantrums and constant mess around the house. Rosemary felt guilty about feeling angry with Alex at times and realised that she let him 'get away with everything' for an easy life. Rosemary gradually began setting some limits for Alex and was amazed to find that life for everyone in the family improved.

6.How did having children become a choice?

It is unlikely that our grandparents ever stopped to consider whether they wanted to have children. For our grandmothers, making sure that children occurred within wedlock, i.e. some sort of contract to support them and their offspring, was their main concern. So what has turned child-rearing into a choice? The development of the contraceptive pill in the mid-twentieth century has perhaps done more than any other factor to create the idea of parenting as a choice. With the arrival of the pill came the arrival of the belief that we could decide when we wanted children, how many we wanted and whether we wanted them at all. So society no longer believed that it was G.o.d's decision or that it was a biological inevitability. However, there are other changing social factors that have contributed to people seeing having children as a choice. In recent years the role of women in the workplace has been changing rapidly. Women have always worked, despite what some would have us believe, but increasingly women are seeing their career as lifelong, something that children must be a.s.similated into, rather than just 'something to do until you get married'. As the dimensions of the workforce continue to change, in many areas women now find themselves the only reliable earner. As service and part-time jobs increase for women in areas of high unemployment, many men, skilled in a particular trade, find themselves unemployable.

The possibility of children is financially challenging, as there will be no 'reliable' wage.

At the other end of the financial spectrum many couples today are deciding that their lives are complete without children: the high social and personal costs outweigh the 'biological'desire to reproduce. Couples, and women in particular, can feel that their lives are full enough and that having a child is all about what they will have to give up rather than feeling there is a great void to fill. Prosperity paradoxically makes us more aware of the costs of children.

But despite contraception and education and various life options, how many of us really choose to have a baby? How many of us really decide? Are not a large number of children conceived by 'accident' whereby there has been a significant enough psychological shift for the couple, such that the scales have shifted more in the direction of 'yes' to children than 'no'?

However, some pregnancies do arrive very much by accident and then the decision-making begins.

The tasks of parenting 7.Kara's story Kara came to see me for help with an eating disorder. She tended to diet and then binge on alcohol and food. She would use laxatives and vomit when she sobered up. In the course of our sessions Kara became pregnant. (She had been using the contraceptive pill, which is clearly not recommended as a contraceptive for women with such eating problems.) The father was her flatmate and they had had a 'fling'

during a drinking binge. From what looked like a disastrous situation Kara was able to decide that she needed to take control of her life and sort out her problems in a different way. The pregnancy helped her to get some control over her eating problems. She struggled greatly but accepted the idea of eating regular meals and the binging decreased very quickly. Her flatmate helped her to cut down on her drinking but he was not keen on becoming a father. Kara suddenly decided to return home to her parents in Argentina and I did not see her again.

The tasks of parenting What do children need?

So if we are deciding to have children as a positive choice, then what is it we are deciding to take on? What will our new responsibilities be and how will these impinge on our adult life? Just as much as adult life is continually evolving so is childhood. It is clear that the nature of parenting has changed radically in the past hundred years and probably greatly in the past generation. Parenting is no longer primarily about finding food and shelter. The emphasis of bringing up children today is much more child-centred. The time that we spend with our children is no longer just incidental or about supervision, it is expected now to be about 'playing' and 'teaching' and 'talking to'. It is potentially much more 'difficult' to be a parent as the tasks have increased and become more psychologically complex. Although many of our grandparents struggled against great poverty and adversity just to keep their children alive, it is hard to compare parenting today and say that it is easier. It is clearly different. Our children are growing up in a very complex social world and helping them to negotiate their way in it is difficult, particularly when we may still be struggling to find our own direction. There are lots of expectations of children 8 in our society and consequently they need a great deal of support and specific guidance.

Children today start formal education and are subject to testing much earlier than in the past. A generation ago nursery 'education' was about playing for a couple of hours separate from mum. Now there are early learning goals to be 'achieved'. School children also have greater access to ideas and information via television and the Internet.They are also subject to advertising specifically targeted at them.

So parents today are expected to play, to educate, to support and to guide in a way that they probably did not experience with their own parents. They must also set boundaries or rules for their children without smacking (by the time this book is published the government may be debating legislation on making corporal punishment illegal). It is not surprising really when we look at the pressures on families that children are increasingly suffering from 'mental health problems' and being diagnosed as having an attention deficit/hyperactivity disorder 'ADHD'.

Lucy and Johnny's story Lucy came for help with her six-year-old son Johnny who was difficult to manage, especially at bedtime. Lucy was a single parent and was working full-time in order to make sure that Johnny did not suffer financially from the absence of a supportive father. She had secured for Johnny a place at a very good private school and he was doing extremely well for his age. Johnny, however, was refusing to go to bed at night and would keep coming back down stairs and would be tired and argumentative in the mornings. When we considered Johnny's routine, however, it was clear that from 7 in the morning when he left home for school, right through until 6.30 when he arrived home, he was the model of good behaviour. Clearly he was actually doing extremely well, it was just that Lucy only saw bad behaviour which spoilt their time together. It was hard for Lucy to accept that Johnny was doing well because she felt that she had to be perfect or people would criticise her since she was a single parent. However, she decided to put him to bed half-an-hour later than she would have liked and to spend that time playing 'rough-and-tumble' games with Johnny. Bedtimes improved immediately.

The tasks of parenting 9.Should I go back to work and how will it affect my child?

Most women today are working when they contemplate having a baby or find themselves pregnant unexpectedly. The issues about whether to return to work or how your working life might be different when you have a child are uppermost in the minds of most women when contemplating having a family. When the prospect of having children is some way off, then it is perhaps not clear how your life will change: it is only through the experience of being pregnant and becoming a parent that one can really know how their feelings and responsibilities will change.

The balancing act of work and children changes over the course of the child's or children's life too, as their needs differ and your situation evolves.

Consequently it is impossible to have all the decisions made beforehand.

We will return to these issues in later chapters but as well as what is right for you as an individual, women are also interested to know about the research evidence regarding women, work and the possible consequences for their children.

There is currently great debate on whether a mother returning to work during a child's early years is detrimental to the child's health and development. It would be difficult to give a simple answer to this, so instead a few points will be highlighted here to give a flavour of the debate. There is evidence to show that some children do less well emotionally if their mothers work before they are a year old, if they work full-time or long hours and if the quality of the childcare is poor (see Belsky, 2001) . These factors are said to affect infant^parent attachment and this is more often true for boys. There may also be more aggressive and non-compliant behaviour during the pre-school years from these children. However, many have argued that the quality of care is the fundamental factor.

Mothering or maternal sensitivity is the best predictor of children's social and emotional development, whether mothers are working or not. With regard to child-care, responsive carers who are warm and interactive and provide opportunities for learning are the key to good outcomes.

The actual amount of time that a working mother today spends interacting with and playing with her child compared to her own stay-at-home grandmother may not be hugely different. After all, the latter would have spent a great deal of time hand-washing nappies, walking to the shops and probably looking after a larger number of children. We should not forget too the changing role of fathers and the role that they might play when a mother returns to work. Probably most fathers are more involved with their children today than they were a generation ago and the concept of leisure time, i.e. doing things together socially as a 10 family, was probably something that happened rarely for our grandparents. All these different factors regarding the availability of support for the parents will affect how a family adapts to a mother returning to work.

When looking at this research, one has to consider the methodological difficulties inherent in such work. For example, when comparing the children of women who have chosen to return to work and the children of women who have not, we are not comparing two similar groups. This does not take into account why women have returned to work or have chosen to stay at home. It may be that some of the differences between the children are part of the reason that the decision to return to work or not was made: your relationship with your baby and the temperament of the child may affect whether you feel returning to work is right for you.

The generalities of research mask the individual stories behind women's decisions about work. For many mothers who are struggling at home with their baby the break from the home may have helped improve the relationship between mother and child. Staying at home in itself will not necessarily make everything all right in your relationship with your child: it depends what you do there. For example, if you are depressed, find it difficult to provide much stimulation for the baby and have little contact with other families, then your toddler may enjoy and benefit from a few hours a week at a nursery.

It would be interesting to research how women make the decision to return to work.Why do some women decide to return and others to stay at home? Is it purely economics or is it to do with the relationship with the baby?; is it to do with beliefs held before the baby arrived and how did these beliefs develop? Having returned to work, why does the situation work for some mothers and not for others? Which factors are better predictors of the parents being happy with the decision and which factors contribute to the situation not working out and having to be changed?

One recent study highlighted that women who in pregnancy expressed more commitment to work and less anxiety about non-family child-care were more likely to have securely attached infants.These types of question might be of more use to mothers than research that tries to dictate whether it is 'right' or 'wrong' to return to work.

How many years will the children depend on me?

The picture that we hold in our heads of 'a family' is defined by the beliefs of the society we live in. In our society today we have to hold the contradiction of the idea that children are 'growing up too quickly' or being 'robbed of their childhood' versus the reality that children are clearly The needs of parents 11.becoming dependent on their parents for much longer.This may be due to the complexities of the task of parenting and of the society that we are preparing children to be independent in. It may just be about economics.

More young people are at university and financially dependent for a much longer period of time, particularly in light of trends to get more young people into higher education. Spiralling housing costs keep many more teenagers living at home for much longer periods. These factors interact with cultural practices of particular groups within society, which may determine the situations in which the offspring may or may not live separately. It will be interesting to see how the effects of rising housing costs over recent years affect a generation of young people who are unable to afford to leave home until they are well established in a career.

Many observers argue that we have become too over-protective of our children and that we should 'take more risks' in order to help their development.

The needs of parents Are children in my life plan?

So with all these issues to think about in terms of a child, where does that leave the parent? Are you a parent first or an individual first? What aspects of our adult life are important to us and are these compatible with having children? Just as we now grow up not to see children as an inevitability, we are also likely to have a model in our mind of our'adult life'. Most of us have expectations that form in adolescence about our education, our employment, our relationships and social life, and so on. Today we are faced by enormous choice. Our relative wealth in the West means that many young people are consumers, and products and lifestyles are intensively marketed at this group. The 'dual-income^no-kids' situation is seen as the financial ideal in terms of access to the best that money can buy: entertainment, designer goods, holidays and housing ^ all most available to this group. They have both the money and the time to partic.i.p.ate. So does becoming a parent mean giving up all of this?

Research shows that some things clearly do change after having a baby.

Satisfaction with your relationship tends to decline. This seems to be the case whether your relationship was good or bad to start with. Obviously a good relationship doesn't turn into a terrible one. More likely, issues that have always existed but perhaps been managed before become more significant when you have had sleepless nights and have to care for a very 12 needy and demanding little person. Clearly, too, for most couples today there are work and financial implications involved in child-rearing. Children over time cost an awful lot of money and most families will probably see their earnings decrease since even if you return to the same job you will have child-care costs. Whatever you might think about a baby not changing your life, it does.Work, if you do return, is different if you have a baby to consider.Your social life will change and how you view yourself too.

Should I go back to work and how will it affect me?

If we have at some point definitive research to show that the children of working mothers do less well emotionally, we have to balance this information against research evidence over the past 30 years that shows women who stay at home to care for their children are more vulnerable to depression. In fact, working women suffer less depression than unemployed women who, in turn, fare better than homemakers. This again brings us back to the importance of individual factors: how you feel about returning to work or staying at home, what contribution your partner can make, how flexible your employment situation is and who is available to help you.

The transition to parenthood is not, however, as negative as some of these factors might suggest. The majority of people make the transition and manage to position themselves somewhere along the continuum between totally child-centred and totally individual-centred. It obviously takes different lengths of time and involves different struggles for different people.

Claire and David's story Claire and David had their first child when they were both in their late thirties. They had both worked in management positions in the same department store for a number of years. They had thought about having children for a number of years and eventually Claire became pregnant following a 'second honeymoon' holiday. Claire found the transition to being at home very difficult and could barely get dressed before the evening in the early weeks. She had a lot of support from her Health Visitor but otherwise rarely saw anyone else during the day and she knew no other mums with babies or young children. Claire became The needs of parents 13.increasingly resentful of David who would come home talking about events in their office and 'what everybody was getting up to'. She felt that their lives were now so totally different that there was no point in talking to him because he couldn't understand. David was aware things weren't right but didn't know what to do. Problems came to a head one night when David came home from work to find that Claire had had a 'clear out'and sent his record collection to a charity shop.

In time, Claire and David did come to enjoy their new situation.

Claire started to develop a new life for herself. She began to attend a mother-and-baby group and made some good friends in time through a working mothers network.

Amidst all this choice and individuality certain trends do seem to have emerged to define the family currently: the delaying of having children into the late twenties or early thirties, smaller families, mothers returning to work, and so on.This probably says something about how we are trying to balance these issues. The delaying of children can allow a woman to establish herself in her career, for some financial stability to be achieved and returning to work to provide for both financial and social or intellec-tual needs.Whether we are more 'mature' in our thirties, i.e. able to delay our own needs while dealing with a child and therefore better parents, or whether we find it even harder to give up the social and financial advantages of being childfree is something of a delicate balance.