First-time parents may benefit from couples counselling.
When Brisbane couple Rachel Bekessy and Chris Clarkson were expecting their first child, they were apprehensive about how starting a family might affect their relationship.
But it wasn't because they didn't know much about each other's personalities. Having been together for 15 years by the time Bekessy fell pregnant, they were more than aware of their individual flaws.
"We knew each other too well maybe," Bekessy says. "We knew what each other's weaknesses were."
So when Bekessy came across a brochure asking for volunteers to join a study looking at how expectant parents can keep their relationship happy and healthy, they decided to sign up.
"We just saw it as a chance to work on [our relationship] and make sure we were rock solid before the baby came along," she says.
"[Parenthood] was such a huge unknown. I was after anything that could make it a bit less mysterious and a bit easier. I think we were feeling a bit daunted by the whole thing."
The study, a randomised-controlled trial by Griffith University and the University of Queensland published in August in the Journal of Consulting and Clinical Psychology, aimed to examine whether couples who received extra relationship support before and after the birth of their first child were more satisfied than those who only received standard newborn-care training.
Previous research around the world has shown that starting a family leads to a sudden decline in relationship satisfaction in up to three-quarters of new parents, the project manager of the study, Relationships Australia Queensland psychologist Jemima Petch, says.
"It's a really stark contrast at the birth of the first child," Dr Petch says. "The usual stresses are the change in gender roles, the lack of time for yourself and just the shock of 24-hour care on the dependent child."
The study recruited only those expectant couples who reported being satisfied in their relationship. Of the 250 pairs who signed up, half joined a midwife-led course then known as CoupleCARE for Parents, which combined standard newborn training with extra skills about how to maintain a relationship. The other half acted as a control group, signing up to a regular infant-care course.
Before enrolling, couples were assessed on demographic risk factors such as low income, poor education, cohabitation, parental divorce or psychological distress. Those with a score of three or more were considered at high risk of relationship distress.
Researchers interviewed each couple at intervals after birth to measure their relationship satisfaction.
Overall, the researchers found that the CoupleCARE for Parents course was most effective for couples they had determined were "high risk" and particularly the women in those couples. Twenty-eight months after birth, about 20 per cent of the high-risk group enrolled in the course were in relationship distress compared with 40 per cent among the control group.
"Generally couples with few risk factors in their lives and some robust protective factors can weather the usual stresses of the transition to parenthood," Petch says.
Petch cautions more research is needed to confirm the same effect with a larger sample size but she is already working on a simple screening tool based on the research. Designed for midwives and nurses, the "cumulative risk index" would help clinicians identify which expectant parents would be most likely to experience relationship difficulties and therefore benefit from extra relationship support before and after birth.
Petch says the research shows that conventional infant training offered by midwives and nurses should be expanded to include relationships, too.
"A lot of us have rose-coloured glasses on about what keeps relationships healthy and strong," Petch says. "These days … we generally believe that we feel in love and if that loving feeling goes then the relationship has run its course whereas a lot of experts say you've got to put into the relationship, particularly around the transition to parenthood, because the infant takes up the majority of the couple's time and energy."
For Bekessy and Clarkson, who joined the CoupleCARE for Parents course, the program has brought long-term benefits. Their first child, William, is now six and they also have a two-year-old, Alexander. The couple find they still apply many of the lessons learnt from the program, such as providing support, balancing workloads and managing conflict and stress. They also learnt about assessing expectations, listening and communicating, and coping with changing gender roles.
"Things we could get away with before we couldn't get away with once we were under pressure with a baby," Bekessy says. "You actually need skills to [maintain your relationship] - it's not just about love.''
Public sector is still catching up
CoupleCARE for Parents received funding as an intervention for study purposes only. Relationships Australia (relationships.org.au), however, runs courses in each state that cover some of the same territory, such as Plus Baby Makes Three in NSW. Petch says public sector services have yet to catch up with the research in parenting and relationships and that antenatal and relationship courses have traditionally been kept separate. It’s an area ripe for change, she says. Interrelate Family Centres (interrelate.org.au) runs Becoming Parents courses in NSW and CatholicCare (ccam.org.au) offers Bringing Your Baby Home in Victoria.
There are also several privately run parenting/relationship courses such as those run by Dr Melanie Strang in Melbourne (wellmumwellbaby.net.au) and Nadine Richardson in Sydney (shebirths.com.au).