Conference Abstracts Society for Reproductive and Infant Psychology (SRIP) 32nd Annual Conference St. Anne’s College, University of Oxford September 12th & 13th 2012

Abstract

What helps parents when premature babies need Intensive Care? Luki Adama, Fiona Alderdicea, Geraldine Macdonaldb, Joy V. Brownea aNursing and Midwifery Research Unit, Queen’s University, Belfast, UK, bInstitute of Child Care Research, Queen’s University, Belfast Background: Premature birth can precipitate parents into a crisis of need and vulnerability with significantly increased levels of stress. However, despite evidence that parents can adapt to their situation, there is limited research into why some parents cope well, and other parents do not, when faced with similar risks. Aim: It is intended that this review will examine published literature on inherent and external resilience resources which parents access to help them cope in NICU and post-discharge. Methods: Eight electronic databases (PsycINFO; PsycARTICLES; MEDLINE; EMBASE; M&IC; HMIC; CINAHL; Web of Science) were searched to end February 2012 for MESH terms and keywords pertaining to prematurity, parents and resilience resources. The resulting 104,348 studies were screened for inclusion criteria of positively influencing well-being, using a quantitative methodology, incorporating a defined sample of premature infants, and period of data collection not exceeding infant age of six months (corrected for prematurity). Results: 37 studies were identified examining one or more resilience resource. Synthesis of findings was hindered by variations in samples studied and timing of data collection. Social support was associated with reduction of distress. Mothers of term and preterm infants showed similar levels of self-efficacy. Heightened distress was related to increased use of emotion-focused coping styles in mothers; fathers coped using problem-solving strategies. Discussion: Research into coping mechanisms and resilience has proven to be limited in certain areas and focused on negative outcomes. An analysis of the range and variability of factors contributing to resilience in parents of premature infants is proposed. Measuring well-being in pregnancy Fiona Alderdicea, Oliver Perrab and Jenny McNeilla aSchool of Nursing and Midwifery, Queen’s University Belfast bInstitute of Child Care Research, Queen’s University Belfast Well-being is often conceptualized as a broad domain of interest and has been widely reported to consist of two distinctive affective and cognitive components. In addition domain satisfaction represents a focused evaluation of some specific aspect of one’s well-being such as job, health or relationship satisfaction, but surprisingly little has appeared in relation to pregnancy. Objectives: To identify the reliability and validity of a pregnancy-specific well-being measure in a cohort of pregnant women. Methods Design: cohort study. Participants: 300 primparous and multiparous women attending hospital antenatal clinics during two weeks of data collection. Recruitment was based on consecutive attendances at antenatal clinics in the hospital over a two week period. Measures: Pregnancy specific well-being measure, General Well-being Measure, The Satisfaction With Life Scale, the WHO-5 Well-being Questionnaire. Results: The Well-being in Pregnancy scale (WIP) had positive significant relations with the emotional wellbeing, vitality and trust and belonging subscales of the General Well-being measure. The scale also significantly positively correlated with the SWLS scale and the WHO-5 scale. The overall Chronbach’s alpha for the scale was 0.73. There was a significant association between WIP scores and reported health problems with a one-unit increase in well-being in pregnancy scores being associated with a 0.05 decrease in the odds of reporting health problems during pregnancy. Conclusion: The Well-being in Pregnancy scale, is a short and easy to use questionnaire that demonstrated good reliability and validity. Birth Trauma and postpartum PTSD Susan Ayers University of Sussex Labour and giving birth to a baby is a challenging event which can involve a range of potential complications and physical harm. Research shows that between 20 and 48% of women appraise their experiences of giving birth as traumatic and between 1 and 6% may develop post-traumatic stress disorder (PTSD) following birth. Factors associated with PTSD after birth include pre-existing vulnerability (e.g. a history of psychological problems or trauma, fear of childbirth), birth factors (e.g. complications of delivery, quality of care), and postnatal factors (e.g. maladaptive appraisals, support). This talk gives an overview of the evidence for PTSD after birth – including prevalence, symptom presentation, vulnerability and risk factors. In particular, the effect of care during labour on women’s experiences of birth is examined. The effect of support on birth outcomes has been well established by experimental studies providing lay women (‘Doulas’) to support women during birth. Reviews of this work show doula support is associated with shorter labours, less use of analgesia, fewer operative or assisted births, and greater satisfaction with birth (Hodnett et al., 2011). There is also increasing evidence that support and interpersonal factors are critical in birth trauma. Interpersonal factors associated with PTSD after birth include poor interaction with medical personnel (Soet et al., 2003), inadequate intrapartum care (Creedy et al., 2000), low staff and partner support (Czarnocka & Slade, 2000), feeling poorly informed and not listened to (Czarnocka & Slade, 2000), inadequate contact with the staff (Wijma et al., 1997), and low perceived and desired support or help (Cigoli et al., 2006; Maggioni et al., 2006). Recent research suggests support is particularly important for women with a history of trauma, or for those who have complications during birth (Ford et al., 2010). Experimental studies using birth vignettes to examine the interaction between support and stressful events during birth show that support has a greater effect on women’s perceived control, trauma, anxiety and mood than stressful events (Ford & Ayers, 2009). In addition, these studies provide preliminary evidence that neutral support (where healthcare professionals provide reasonable obstetric care but with no emotionally positive interaction) is similar to negative support (where healthcare professionals are actively unsupportive) in the effect on women’s experiences of birth. The implications of this research for maternity services and interventions to reduce postpartum PTSD are discussed. The voices of Maltese parents raising young children born with intellectual disability risks Elayne Azzopardi, Jois Stansfield, Julie Marshall Research Institute for Health and Social Change, Manchester Metropolitan University Studies show that parents of children born with risks for intellectual disability identify a series of unmet needs that are critical in the first five years of the child’s development. To date, Malta does not have family-centred early intervention services to children born with risk factors for intellectual disability from a tender age. Hence, the study aimed to explore the experiences and needs of Maltese parents of children who have a biological risk to develop intellectual disability during childhood. Four groups of Maltese parents (N=37) whose children were born with a biological risk at birth for intellectual disability participated in a cross-sectional qualitative study. Parents were invited to participate in this project based on their child’s risks at birth and age: six months, two years, three-and-half years and five years. Semi structured interviews were analysed using Interpretative Phenomenological Analysis (Smith et al., 2009). Ethical issues were prioritised. Preliminary analysis uncovered six main themes: 1) family functioning; 2) services-needs-resource cycle; 3) micro-system sociological framework; 4) info-emotional cycle; 5) experiencing is true understanding, and 6) experiential challenges. The results highlight the importance and need for parent-to-parent support. There is a dire need for more family friendly services. Findings support the setting up of a family-centred service geared towards the needs of these parents. Older motherhood-purposeful delay or inadvertent retiming? Irenee Daly Centre for Family Research, University of Cambridge Background: Women in high resource countries over the last three decades have been having children at an increasingly older age. In doing so they expose themselves to the risk of age-related infertility. This trend has been attributed to educated middle-class women who are thought to be postponing motherhood so as to pursue further education and establish their careers. Rationale: This study aimed to provide a psychologically nuanced account as to why women are waiting until they are older to have children. Method: This study used a sequential mixed methods design. It incorporates semi-structured interviews with 30 university-educated childless women aged 28-32. 486 childless women between the ages of 26-37 also completed a questionnaire. Results: The women in this sample did not consider themselves to be postponing motherhood. Rather, they had not yet passed developmental milestones, which they believed preceded childbearing. It appears that passing these milestones indicates to women that they are adults, a status they consider necessary before considering themselves ready to be mothers. These results are discussed in the context and influence of the theory of emerging adulthood. Conclusion: Although delayed childbearing is seen as a result of fundamental social, cultural and economic changes, women’s views on these issues have rarely been sought. This study addressed this by focusing on the views and attitudes of women who have yet to make the decision to have children. By doing so it better illuminates the factors involved in the trend towards older childbearing and the retiming of motherhood. Multi-site evaluation of a volunteer doula service in England: A reflection on using Realistic Evaluation Zoe Darwin, Josephine M. Green, Helen Spiby, Helen Willmot, Jenny McLeish Mother and Infant Research Unit (MIRU), University of York Objective: To investigate the impacts and implications of a multi-site volunteer doula service for service users, volunteers doulas and NHS services. Background: There has been growing interest in the role of ‘doulas’- trained lay women who support child-bearing women – with research reporting a range of positive outcomes. Doulas are typically paid-for in western settings; however, the Goodwin Volunteer Doula Project in Hull offers a free service to socially disadvantaged women, delivered by trained volunteers and covering the third trimester, birth and six weeks postpartum. The scheme is being replicated at sites across England. Methods: A Realistic Evaluation perspective is being adopted, which involves identifying and testing possible ‘CMO’ configurations: Context, Mechanism and Outcome. These are derived both from reviewing the literature and from interviewing key informants. Findings: Interviews and focus groups with 32 key informants at five sites has highlighted that, rather than aspiring to intervention fidelity (true replication), the intervention being delivered at each site varies in unanticipated ways, including: intervention content, the problems that the interventions target (at both service user and volunteer level), and the emphasis placed on the voluntary status of the doulas. Conclusion: Every element of the CMO configurations varies across the sites, which has implications for subsequent testing of ‘what works for whom in what context’. Our experience therefore highlights that defining the intervention should be an explicit aim of initial data collection to facilitate identification and structuring of implicit CMOs. This is likely to be particularly beneficial for multi-site or multi-agent evaluations. Men’s experiences of antenatal screening: a grounded theory analysis Sandi Dheensaa, Alison Metcalfeb, Bob Williamsa aHealth and Population Sciences, University of Birmingham; bFlorence Nightingale School of Nursing and Midwifery, King’s College London Objective: To explore men’s experiences of antenatal screening. Background: While pregnant women’s views of antenatal screening have been widely researched, those of expectant fathers remain under-explored. Method: Grounded Theory analysis of in-depth interviews with twelve men and six women. Results: Five categories were constructed, (1) juggling roles, (2) shattered schemata and fragmented identity, (3) the elusive nature of genes, (4) information, control and support, and (5) a clash of structures. Overall, findings suggest that the men began to develop a cognitive schema of their unborn child, integrating it into their perception of their family. Men also started to take on a paternal identity and enact the perceived normative responsibilities of a being a father. Participating in screening was part one such responsibility. However men’s ideas, beliefs and feelings about being a father and about the future child were challenged by the information that antenatal screening provided. Screening thereby caused disruption in men’s transition to fatherhood, eliciting ambivalence and confusion. These processes are summarised in the central category, ‘the family in flux’. Conclusion: Men require engagement from healthcare professionals and support in the antenatal setting. Nevertheless, screening—because it lacks a specific role for men—is not an optimal way to engage all men in pregnancy. Findings have been explored further with 200 expectant fathers using survey research. An exploration of midwives’ attitudes to giving weight related advice to obese pregnant women with a Body Mass Index (BMI) of 30 or more Christine Fostera, Dr Janet Hirstb aYork NHS Trust, UK; bUniversity of Leeds This presentation will present the findings from a qualitative study which explored midwives’ attitudes towards giving weight related advice to obese pregnant women with a Body Mass Index (BMI) of 30 or more. Annually, approximately 38,478 pregnant women are obese posing significant risk to maternal, fetal and newborn mortality and morbidity. A challenge is for maternity services to implement specific obesity guidance particularly from midwives as the front- line professionals. A non-probability, purposeful sampling approach was used to recruit 9 participants following NHS ethical and research governance approval. In-depth interviews were audio recorded, transcribed and Colaizzi’s seven stage thematic analysis applied. Four theme-clusters emerged from the data: Practice Challenges; Proficiency; Advice Giving and Relationships. In summary, midwives knowledge of the risks of maternal obesity was generally good; advice was mainly confined to community practice, and the amount and consistency of weight related advice was determined by maternal responses, midwives’ motivation and midwives’ perceptions as a role model i.e. how a midwife’s BMI hindered or facilitated advice giving. In conclusion, midwives need to reflect on their personal attitudes to weight and body image and the influence of this on providing weight related advice; and reconsider the perceived tension and risk between maintaining a good relationship with obese women and providing effective advice. Puerperal psychosis – querying existing models of understanding Lesley Glovera, Julie Jomeena, Tracey Urquhartb aFaculty of Health & Social Care, University of Hull; b Lincolnshire Partnership NHS Foundation Trust Background: One or two women per 1,000 will develop Puerperal Psychosis (PP), an acute severe mental health condition characterised by a rapid onset following childbirth. PP is currently explained and managed solely within a medical model with virtually no consideration of the condition from a psychological perspective. This is in stark contrast to well-developed multi-factorial understandings of other perinatal mental health problems, particularly post-natal depression, and psychosis in the general population. Objective: This study aimed to gain a clearer understanding of women’s experience of PP and their perceptions of its cause with a view to generating alternative models of PP causation and management. Method: In a qualitative study using a phenomenological approach, seven women who had previously been diagnosed with PP were interviewed and the data were subjected to thematic analysis. Results: Four themes were identified: 1. The path to madness; 2. The madness: unspeakable thoughts and unacceptable self; 3. The madness: ‘Snap out of it’; 4. Perceived causes. The majority of women attributed their PP to the physiological changes associated with childbirth; however their accounts of PP began before or in early pregnancy. Women highlighted fertility issues, stressful pregnancies with a range of significant challenges and emotions, difficult births and unsupportive family relationships postnatally. The experience of PP was extremely distressing and aspects of it were unspeakable. Conclusion: Findings are considered within a material, discursive, intrapsychic framework with implications for more multifaceted care for women experiencing PP. Women’s satisfaction with the childbirth – comparison of home and hospital births Magdalena Grabowicz, Eleonora Bielawska-Batorowicz University of Lodz Objective: The aim of the study is to investigate the level of childbirth satisfaction and its correlates after home or hospital deliveries. Another aim is to evaluate the Polish version of measures of childbirth satisfaction. Background: Home births become gradually popular in Poland, however their total number does not exceed 1% of deliveries. Polish analyses of the satisfactory childbirth are scarce, and home and hospital deliveries are seldom compared. Method: The participants – 93 women aged 20-37 yrs – were recruited through community midwives and through internet. Thirty two of them gave birth at their homes. The measures included: Mackey Childbirth Satisfaction Rating Scale (MCSRS), Support and Control in Birth (SCIB), demographic questionnaire. Polish versions of MCSRS and SCIB had acceptable psychometric characteristics. The level of satisfaction, the amount of pain, the perception of control over birth, and first contacts with the newborn were compared in univariate analyses. Multiple regression analyses were used to identify aspects of childbirth experience most strongly related to satisfaction. Results: Women delivering at home evaluated their general level of satisfaction, the level of perceived control, contacts with medical personnel and support higher than their counterparts. The amount of perceived control over birth, woman’s evaluation her own performance during childbirth, and support from medical personnel were consistently related to satisfaction. Conclusion: Some factors related to satisfaction with childbirth are equally important in home and hospital births. Polish versions of MCSRS and SCIB are useful in studies on childbirth experiences. Father’s engagement in pregnancy and childbirth Jane Henderson, Maggie Redshaw National Perinatal Epidemiology Unit, University of Oxford Introduction: Early engagement of fathers with their children has been shown to improve cognitive and socio-emotional development. However, there is little quantitative information about fathers’ levels of involvement in pregnancy, childbirth and postnatally and how this varies by socio-demographic characteristics. Thus, the aim was to understand who was involved during pregnancy and after birth, and how paternal engagement may influence women’s uptake of services and outcomes. Methods: This study used data from a 2010 survey of new mothers which collected data on care in the antenatal, intrapartum and postnatal periods, as well as on socio-demographic factors. Data were available on partner’s involvement in the pregnancy, birth and postnatally. Univariate analyses, binary logistic regression and generalised linear modelling were used to estimate the effects of socio-demographic variables on fathers’ reactions to pregnancy, engagement during pregnancy and in labour and involvement in postnatal infant care. Results: Data were available on 4616 fathers. Most fathers’ reaction to the pregnancy was positive; most were present for the pregnancy test and for one or more antenatal checks; almost all were present for ultrasound examinations and for labour. Maternal age, ethnicity, deprivation and parity were all strongly associated with partner involvement which influenced early contact with health professionals and attendance at antenatal classes. Discussion: This study has confirmed the striking differences in paternal involvement by socio-demographic characteristics affecting reaction to the pregnancy as well as antenatal and postnatal engagement. Where prospective fathers were involved, women accessed care earlier and more fully. SRIP Undergraduate Prize: Women’s experiences of coping with termination of pregnancy due to foetal abnormality Caroline Lafarge University of West London Pregnancy termination for fetal abnormality (TFA) can have significant psychological consequences for those involved. Most research focuses on measuring post-TFA psychological outcome, and little is known about how women cope with TFA. Therefore, this study examined women’s coping strategies both during and after TFA and their relation to perinatal grief. A cross-sectional, retrospective study was conducted using both qualitative and quantitative methodologies. Participants were recruited from a support group. Nineteen semi-structured interviews and 32 questionnaires were completed by 32 women. The Short Perinatal Grief Scale (Potvin, Lasker & Toedter, 1989) and the Brief COPE (Carver, 1997) were used to assess perinatal grief and coping strategies. Qualitative data were analysed using Interpretative Phenomenological Analysis, and quantitative data through descriptive and inferential statistics (i.e. regression analyses). Women’s coping during the procedure involved seeking/providing support, acknowledging the baby and self-distraction. The baby’s delivery, although not a coping strategy per se, also influenced the way women coped. Post-termination coping centred on seeking/providing emotional support, remembering the baby, avoidance and looking to the future. Women’s coping strategies were generally adaptive and similar during and after the procedure. Grief levels were high, with some women at greater risk of complicated grief, and grief levels were influenced by variables related to the termination. These findings have implications for healthcare professionals in understanding women’s coping with TFA. This understanding can underpin client-centred clinical practice and inform interventions to enhance psychological adaptation both during and after the termination. Women need more integrated and longer-term support, including during subsequent pregnancies. SRIP Postgraduate Prize: Choosing the parenting lifestyle: A manualized psycho-educational primary intervention for couples regarding reproductive decisions Nicole Massey-Hastings Argosy University, Shaumberg, IL Choosing the Parenting Lifestyle (CPL) is a psycho-educational, therapeutic program designed to assist couples with making the decision to become parents or not. The assumption underlying CPL is that to be effective parents who raise happy, healthy children in a functional familial environment, couples must choose a lifestyle centred around parenting rather than simply trying to fit children in to their current lifestyle. The fundamental goal of CPL is to help couples to realistically assess their motivations for both having children and remaining childfree. Couples are also guided through assessing the personal, emotional, relational, and financial costs associated with both choosing the parenting lifestyle and choosing the childfree lifestyle. Fittingly, the point of intervention is preventative rather than reactive in that it seeks to help couples think through this important decision prior to becoming parents. In addition to seeking to reduce the overall incidence of child maltreatment, CPL seeks to increase the quality of life for both childbearing couples and childfree couples by giving the couple permission to explore goodness of fit and congruence of parenting with their personalities and their lifestyle. CPL is theoretically grounded in attachment theory, theories of family structure (including the critical role of marital quality, parenting style, and Structural Family Therapy), the importance of parental role identification and its relationship to parental satisfaction, and finally, the decision-making process of choosing to become parents or not. CPL’s therapeutic stance is derived from both couples and individual Emotion Focused Therapies and from an enduring respect for diversity. Midwives knowledge, attitudes and beliefs about physical activity during pregnancy. Catherine McParlina,b,c, Stephen C. Robsonb, Vera Agaujo-Soaresc, Debbie Carrick-Sena, Ruth Bellc aRoyal Victoria Infirmary, Newcastle upon Tyne, bInstitute of Cellular Medicine, Newcastle University, 3Institute of Health and Society, Newcastle University Background: One in six women in the UK is obese at pregnancy confirmation. Obesity is associated with increased risk of adverse pregnancy outcomes such as gestational diabetes, pre-eclampsia, and macrosomia. Physical activity, (PA), during pregnancy may regulate energy balance, reducing excessive weight gain and improve pregnancy outcome. Research indicates that pregnant women receive little, conflicting or no advice regarding PA. As midwives are key health professionals during pregnancy the aim of this study was to ascertain which factors influence whether midwives advise obese pregnant women regarding PA in accordance with national guidelines. Methods: An anonymous, self completion questionnaire was distributed to all midwives working within 2 maternity departments in Tyne and Wear. The questionnaire was designed using the theoretical domain framework approach proposed by Michie et al. (2005), which describes 11 domains of behaviour determinants. Basic demographic questions were included along with space for comments. Results: 335 questionnaires were distributed and 162 returned (48.4%). Questionnaires were pre-coded and analysed using SPSS. Midwives scored highest in the ‘knowledge’ and ‘social-professional-role’ domains and lowest in the ‘skills’, ‘beliefs-about-capabilities’ and ‘environment/resources’ domains. There were no differences between hospitals. Community and clinic midwives had significantly higher scores for most domains than delivery/rotational midwives. Further analysis will be performed to identify factors influencing the behaviour. Comments will be coded thematically. Conclusion: Midwives have the knowledge, and believe that it is part of their role to advise women, but lack the skill and capabilities. Completed results will be used to plan support and training for midwives. State-Trait Anxiety Inventory (STAI) scores during pregnancy following intervention with complementary therapies James Newhama, John D. Aplina, Melissa Westwooda, Anja Wittkowskib aMaternal and Fetal health Research Centre, University of Manchester; bDivision of Clinical Psychology, School of Psychological Sciences, University of Manchester Objective: We review intervention trials that have used the State-Trait Anxiety inventory (STAI) as a measure of maternal anxiety in pregnancy in order to provide ranges in scores before and after participation in complementary therapy-based interventions. Background: The STAI is the most commonly used measure of anxiety but it is unclear whether, when administered in pregnancy, changes in scores reflect change in somatic symptoms rather than mood. Methods: Using combinations of key words, a systematic review of publications between January 1970 and 2011 was performed. Studies eligible for inclusion recruited low risk, adult women to a non-pharmacological intervention or a comparator group, and measured anxiety at baseline and post-intervention. Results: Ten studies were eligible. Studies examining the immediate effects of an intervention consistently reported significantly lowered STAI scores after a single session. Likewise, studies examining the effect of interventions consisting of multiple sessions over the course of pregnancy found that those in the intervention group were more likely to show an improvement in STAI scores compared to control groups receiving standard care. Scores for comparison groups receiving standard care did not show an elevation in STAI scores as gestation increased. Conclusion: Scores on the STAI appear amenable to change during pregnancy, both after a single session and multiple sessions of interventions designed to reduce maternal anxiety, while scores in those without intervention show no change. This review offers a guideline for the expected range of scores for future studies examining the efficacy of interventions in pregnancy when using the STAI. Factors influencing men’s attitudes towards preconception health Efearue E. Oluwatosin, Olga B.A. van den Akker Dept. of Psychology, Middlesex University Introduction: Traditionally, men are perceived to be less likely to seek for help for health care related issues generally and for preconception care in particular. This study investigated factors that may influence men’s help seeking in relation to preconception care. Method: One hundred and sixty-one (161) men aged 18-55 completed measures of current health status, knowledge about (in)fertility, perceived barriers to help seeking and general self-efficacy. Results: Half the men (52.5%) were willing to visit preconception health care clinics and 51% would be interested in knowing more about preconception health, supporting previous research. There was no significant difference between self-efficacy and religious practice, ethnicity, education or being single or in a relationship (all P’s >.05). However, men in a relationship and men with higher education scored significantly lower on some of the barriers to help seeking subscales. Significant negative relationships were found between age and some of the barriers subscales and Total health, with younger men scoring higher on barriers and having better current health. Total knowledge about (in)fertility, on the other hand, was higher in older men and they were also more likely to seek preconception care. Conclusion: Men’s health status and health behaviours are affected by their age and knowledge of factors that affect (in)fertility. The results confirm previous reports (van den Akker, 2012) showing that preconception health care and information should be provided earlier to young men before they embark upon a pregnancy, and that this should be maintained throughout the lifespan. Sexual Self Concept, Stigma & Shame following a Chlamydia Diagnosis Anne Parry, Lesley Glover, Julie Jomeen University of Hull Despite evidence that women testing positive for Chlamydia have less adaptive scores on domains of sexual self-concept, (Gottlieb et al., 2011) no research has been conducted in this area in the UK. Stigma has emerged as a main theme when women with Chlamydia were interviewed (Duncan et al., 2001). The way that sexual self concept may link with shame and stigma following a diagnosis is not currently understood. The current study aimed to investigate the relationship between sexual self-concept, stigma and shame, and to explore their relationship to demographic factors and screening circumstances. 51 participants recruited from a sexual health clinic completed questionnaires following their treatment session for Chlamydia. Quantitative data were collected using a cross sectional design. There were no differences between those who had previously had an STI and those who had not, on the five dimensions of sexual self-concept. Sexual anxiety was significantly, positively correlated with both stigma (rho=.465, p=.001) and shame (rho=.593, p=<.0001). Females scored significantly higher than males on the measure of shame (F(1, 49)=7.59, p=.008). However, women did not score significantly higher than men on the measure of stigma. There were no significant differences between screening circumstances and scores of stigma and shame. These findings are discussed with reference to literature on sexual self-concept, sexual risk taking and stigma and shame. Limitations of the study, clinical implications of its findings and areas for future work are identified and discussed. The mental health of fathers and their young children’s development Dr Paul Ramchandani Imperial College, London Psychiatric disorders affecting parents are associated with an increased risk of psychological problems in their children. Most psychological research has focussed on mothers alone, however increased attention is now being paid to the influence of fathers. The aim of this talk is to consider research on the mental health of fathers, and the current understanding of its impact on young children’s psychosocial development. Some potential implications for positive preventative intervention early in the lives of children will be considered. Disabled women’s experience of maternity care Maggie Redshaw, Reem Malouf, Haiyan Gao, Ron Gray National Perinatal Epidemiology Unit, University of Oxford Introduction: An increasing number of women with disabilities wish to become mothers. The objectives of this research study are to describe and compare the care provided for women with disability to women with no disability and to explore disabled women’s perceptions of care. Methods: Data were collected in the trust level national survey carried out by the Care Quality Commission (CQC) using structured questionnaires in 2010. Descriptive statistical analysis using Chi-square tests and multivariate analyses adjusted for age, ethnicity, parity and partner status were conducted. Results: The response rate in the survey was 52% representing 24,155 women. Disabled women comprised 6.14% of the total sample. There was no difference in parity and ethnicity between the two groups. However, disabled women were slightly older and less likely to have a partner. Five disability types were distinguished (mental, sensory, learning disability, chronic diseases, and physical and long lasting conditions). Mental and chronic disease disorders were the most frequently cited reasons (57%). More disabled women (20% compared with 16%) made their booking appointment at less than eight weeks gestation. They had significantly more antenatal checks (15% compared with 6%) and had more scans during pregnancy - 50% had 4 or more scans in comparison with 32%. They were less likely to be offered and attend antenatal NHS classes - 28% in comparison with 31%. They were more likely to be delivered by caesarean section, more commonly planned. Perceptions of care were generally positive; however, in describing the quality of care, more disabled women were less likely to use the most positive response available. Conclusion: Equality of care for pregnant disabled women was apparent. Post-partum mental health and exercise in ethnically diverse, priority groups – A framework for data collection Mary-Anthea Row, Denise Bellingham-Young, Alan Nevill, Elvidina Nabuco Adamson-Macedo University of Wolverhampton Background: Frameworks as tools for research and design of health promotion interventions often do not provide sufficient contextual detail when utilised with deprived, ethnically diverse (particularly Black and Minority Ethnic) groups. In addition to the stages outlined by health promotion approaches, there is a need to understand socio-cultural and socio-economic influences alongside the context of practice, in order to inform programme design, implementation and evaluation. Objective: To use a questioning framework for data collection, based on a health promotion framework linked to a diversity framework, to define a culturally sensitive delivery model. The combined framework was developed for this study in the context of researching exercise to promote post-partum mental health in ethnically diverse, deprived groups. Methods: Study design is qualitative, influenced by the principles of grounded theory. Data were collected through focus groups and interviews from 25 women in an ethnically diverse (predominantly Black and Minority Ethnic) area of multiple deprivation, in Birmingham, UK. Participants were service users, professionals, service providers and commissioners. Findings: Four main themes emerged: ‘Exercise Content’ as applied to post-partum mental health, ‘Beliefs, Values and Behaviours’, ‘Support and Influence’, and ‘Planning, Provision and Resources’. Concepts from the data integrated considerations that are typically studied in isolation such as needs, norms, context, values, settings and evolving social structures particularly relevant to post-partum health, mental health and ethnically diverse, migrant populations. Conclusion: Using a combined framework led to the development of a promising, culturally sensitive, delivery model at three levels of influence individual, relational and strategic. Women’s experience of transfer from midwifery unit to hospital during labour: “in limbo”? Rachel Rowe National Perinatal Epidemiology Unit, University of Oxford Background: Midwifery units offer care to women with straightforward pregnancies, but unforeseen complications can arise during labour or soon after birth, necessitating transfer to a hospital obstetric unit. In England, 21% of women planning birth in freestanding midwifery units are transferred; in alongside units, the transfer rate is 26%. There is little high quality contemporary evidence on women’s experience of transfer. Method: A qualitative interview study was carried out, using semi-structured interviews, with 30 women who had been transferred from a midwifery unit (freestanding or alongside) in England up to 12 months prior to interview. Thematic analysis using constant comparison and exploration of deviant cases was used. This presentation will focus on the experience of transfer by ambulance. Results: Most women hoped for or expected a natural birth and did not expect to be transferred. Transfer was disappointing for many; sensitive and supportive care and preparation for the need for transfer helped women adjust to their changing circumstances. A small number of women, often in the context of prolonged labour, described transfer as a relief. For women transferred from freestanding units, the ambulance journey was a “limbo” period. Women wondered, worried or were fearful about what was to come and could be passive participants who felt like they were being “transported” rather than cared for. For many this was a direct contrast with the care they experienced in the midwifery unit. Conclusion: Some apparently straightforward changes to practice have the potential to make an important difference to women’s experience of ambulance transfer and will be considered in this presentation. Midwives’ experiences of trauma: Results from a large survey Kayleigh Sheena, Pauline Sladea and bHelen Spiby aUniversity of Sheffield; b Mother and Infant Research Unit (MIRU), University of York Objective: To explore the nature of traumatic perinatal events from the perspective of the midwife, encountered whilst providing care to women. Background: Whilst the birth of a baby within the developed world is often considered to be a normal and positive event, sometimes adverse events can occur where the mother or her baby is at serious risk. In these instances, the experience of childbirth can be traumatic. Little is understood about whether some midwives experience some perinatal events as traumatic and, if so, the potential impact that this could have. Methods: A large number of midwives provided a description of a traumatic event. Thematic analysis was used to identify commonalities between descriptions in terms of the type and nature of events encountered by midwives. Criteria for a traumatic event experienced by a midwife was defined as witnessing an event during the perinatal period where mother or her baby was considered to be at serious risk of injury or death, and where the midwife felt a sense of fear, helplessness or horror in response. Results: Several contextual factors contributing to the perception of an event as traumatic were identified. These broadly related to the midwife, the organisational climate and the context of the childbirth event. Conclusion: This study is one of the largest to explore midwives’ experiences of traumatic perinatal events. Findings contribute to the current limited understanding of midwives’ experiences in relation to this potentially difficult aspect of practice. Views and experiences of postpartum weight loss among women in Ireland: a qualitative study Emily Shortta, Mary Delaneyb and Patrick Walla aSchool of Public Health, University College Dublin, Ireland; bDepartment of Food Business and Development, University College Cork Background: Postpartum weight retention has been associated with obesity development, yet there has been little research exploring women’s views in relation to postpartum weight loss. Methods: A purposive sample of 21 second-time mothers, who varied in terms of early pregnancy BMI were recruited from the control arm of a randomised trial in a large Irish maternity hospital. Semi-structured interviews were conducted at 6 and 12 months postpartum. Inductive thematic analysis was used to analyse the transcripts. Results: Four dominant themes were identified. The mothers’ prioritisation of the needs of others influenced their own weight concerns and lifestyle practices postpartum. For some mothers, healthy eating and exercise had taken on an increased importance since having children, as they wanted to model healthy behaviours and keep fit for their children. Others perceived that they were so focused on meeting their baby’s needs that they neglected their own weight and lifestyle practices. The mothers were more concerned about their weight and dissatisfied with their bodies postpartum, than during pregnancy. Nonetheless, body image was a peripheral concern for many of the mothers, as they wanted to concentrate on looking after their family. In contrast, a small number of mothers were highly concerned about their weight and found difficulties losing weight distressing. Finally, irrespective of weight attitudes, a demanding postpartum lifestyle and in some cases physical conditions were perceived to reduce women’s control over their weight. Conclusion: The findings suggest that interventions to promote postpartum weight loss should take women’s demanding lifestyles and particularly their childcare priorities into account. Maternal care paradigms as predictors of adjustment and birth experience Elizabeth Soliday, Jumana Sayyam Dept of Psychology, Washington State University Objective: To examine a measure of maternal care paradigms and its value in predicting birth experiences. Background: Maternal care paradigms have been described as technocratic, humanistic, and holistic (Davis-Floyd, 2001). Beyond these original compelling descriptions, there has been little systematic study of how maternal views of care paradigms relate to central childbirth outcomes (Soliday, 2012). Methods: Prospective longitudinal study with maternal reports collected in pregnancy and postpartum. Measures completed by 64 US mothers include care paradigms (adapted from Wachdorf, 2003), anxiety (STAI; Speilberger, 1984), birth intervention plans, childbirth satisfaction, and birth interventions received. Results: During pregnancy, no significant relationships between care views and anxiety or planned interventions resulted. However, regression equations controlling for maternal age and provider type indicated that a greater orientation towards humanistic and lower orientation towards technocratic care in pregnancy predicted higher postpartum anxiety (adjusted R2 = .62, p < .05). Greater technocratic care orientation in pregnancy predicted greater childbirth satisfaction (adjusted R2 = .65, p < .05) and more childbirth interventions (R2 = .86, p < .05). Conclusion: Maternal care orientation in pregnancy significantly predicted variables important in maternal functioning, mother-child relations, and future childbearing plans (e.g., Grant et al., 2008; Heron et al., 2004; Pang et al., 2008 Wenzel, 2011). Maximizing maternal prospects for optimal birth experiences and postpartum well being may involve counselling on the match between individual care views and those operating within care settings. “Daddy Cool becomes Father Figure”: Stability and change in fathers’ internal representations of their infants over time Hedwig van Bakel, Charlotte Vreeswijk, Janneke Maas, Kathinka Rijk Tilburg University, The Netherlands Background: During pregnancy, also fathers develop feelings, thoughts and wishes (internal representations) about their (relationship with their) unborn child. Few studies –and only in mothers- examined stability and change in representations from the pre- to postnatal period (Theran et al., 2005). This study is the first to examine stability and change of paternal representations from pregnancy to six months after birth. Method: During a home-visit at 26 weeks gestational age and six months after birth, the ‘Working Model of the Child Interview’ (WMCI; Zeanah et al., 1996) was administered in 171 expectant fathers to elicit paternal representations of the (unborn) child. Representations were classified into one of three main categories: Balanced, Disengaged or Distorted. Fathers also filled in a personality questionnaire. Results: The distribution of fathers’ representations during pregnancy (44% balanced, 49% disengaged, and 7% distorted) significantly differs from the distribution in community samples of expectant mothers (i.e., 62%, 17%, and 21% respectively; χ2 =162.00, p<0.000). This difference is also found postnatally (χ2 =22.00, p<0.000). Results further showed that significantly more fathers changed from non-balanced to balanced than vice versa (χ2 =18.53, p<0.000). Finally, MANOVAs with planned contrasts showed that fathers who became balanced after birth were more agreeable than fathers who remained non-balanced (t = 3,37, p<.01). Conclusion: Although the majority of fathers had stable representations from pregnancy to infancy, some changed over time. Especially, more agreeable fathers changed from non-balanced to balanced, which may imply that their warm, caring, and empathetic character will be triggered by the real experiences of having a child. Parenting intentions and expectations: The role of attachment and caregiving Judi Walsh, Gaynor Britten, Lucy Smith, Laura Hoppitt University of East Anglia Previous research has shown attachment avoidance in adulthood to be a strong negative predictor of desire to have children, bonding in pregnancy, and ability to relate to children after birth (Rholes, Simpson, & Blakely, 1995; Rholes, Simpson, Blakely, Lanigan, & Allen, 1997). Other research has shown that relationships between adult attachment and prenatal bonding and parenting style are sometimes mediated by caregiving style (Walsh et al., 2011; Millings, Walsh, & O’Brien, 2008). The two studies presented here explore the roles of attachment and caregiving in how individuals without children think about their intentions to become a parent and their expectations of what future parenting will be like. Study 1 demonstrated that, in accordance with other literature, attachment avoidance was a good negative predictor of desire to have children, but that caregiving style did not mediate this relationship. There appeared to be different predictors for young men and young women such that attachment avoidance predicted desire to have children for women, but caregiving responsiveness to partner predicted desire to have children for men. The second study sought to replicate and extend these results by examining attachment, caregiving, and relationship influences on expectations of future parenting. This research adds to our understanding of the correlates and predictors of parenting intentions and expectations, and the relative importance of relationship and individual processes. Mother’s Trauma Experiences and Attachment Styles: potential implications for the mother-infant relationship Ayse Meltem Budak, Gillian Harris, Jackie Blissett School of Psychology, University of Birmingham Introduction: Perinatal loss and childbirth traumas have been identified as predictors for postnatal mental health problems (Soet et. al., 2003). Mothers with mental health problems are less responsive to their children (Bailham & Joseph 2003). Both anxious and avoidant attachment have been shown to affect adjustment to trauma and vulnerability to mental health problems (Mickelson et al. 1997, Bifulco, 2006).The present study investigated whether trauma with or without loss of the infant resulted in greater psychological distress. Also, the role of attachment styles was examined in determining adjustment to trauma. Methods: 144 women (Mean age=31.5) from UK, US/Canada, Europe, Australia/ New Zealand who experienced trauma with loss including miscarriage (n=52), stillbirth (n=17), neonatal-loss(n=4), or ectopic pregnancy (n=4) or trauma without loss (experience of difficult child birth with a surviving infant, n=67) completed the Psychiatric Diagnostic Screening Questionnaire (Zimmerman & Mattia 2001); and the Experience in Close Relationships–Revised Scale (Fraley, Waller & Brennan (2000). Results: The trauma without loss group reported significantly higher mental health problems than the trauma with loss group (F (1,117)=4.807 p=.03). This difference remained in the subtypes of OCD, Panic, PTSD and GAD but not for Major Depression, Agoraphobia and Social Phobia. Further analysis indicated that both attachment anxiety (r=.54 p<.001) and avoidance were correlated positively (r=.39 p <.001) with PDSQ scores. Discussion: We speculate that maternal attachment styles may be one predictor of adjustment after trauma. Difficult childbirth may leave women prone to experiencing ruminations concerning possible risk to their infants which may interfere with bonding and infant attachment. Incidence, Prevalence, and Risk Factors for Postnatal Depression in Women with Gestational Diabetes Isabela O. Caramlau, Arie Nouwen, Kirstie McKenzie-McHarg School of Psychology, University of Birmingham Background: Postnatal depression is a common affective disorder following childbirth, affecting around 13% of women. Posnatal depression has been shown to affect both the mother and her baby, leading to mother-infant relationship difficulties and long-term child behavioural and cognitive problems, particularly for boys from disadvantaged backgrounds. Previous research showed that women with diabetes in pregnancy were almost twice as likely to experience depression as women without diabetes in the perinatal period. Aims: The current project is a prospective longitudinal study and aims to: i) establish the incidence and prevalence of postnatal depression in women with gestational diabetes in a general hospital UK population; ii) to investigate whether known risk factors for postnatal depression predict depression in women with gestational diabetes; iii) to investigate whether diabetes specific risk factors (e.g. diabetes-related distress, diabetes-specific social support etc.) predict depression in women with gestational diabetes over and above general risk factors. Results: The incidence of postnatal depression in the current study was 11.5%. The prevalence of postnatal depression in the current study was 15.8%, indicating that the majority of women who are depressed postnatally are also depressed antenatally. Antenatal depression was a significant predictor of postnatal depression in women with gestational diabetes. Diabetes-specific factors were not significant predictors of postnatal depression, over and above known risk factors. Conclusions: Further research is needed to examine the role of diabetes-specific factors in predicting postnatal depression. Multi-site evaluation of volunteer doula support for childbearing women in low income communities Josephine M Green, Helen Spiby, Zoe Darwin, Helen Willmot, Ms Jenny McLeish Mother Infant Research Unit, University of York Objective: To describe the context of an ongoing evaluation of a volunteer doula service. Background: A doula is a woman who provides non-clinical support and care to a child-bearing woman. Support during labour from trained doulas is associated with reduced length of labour; less pharmacological pain relief, and fewer instrumental and operative births as well as increased breastfeeding rates and improved psychosocial outcomes. Evidence of benefit is particularly striking for women in situations of social or economic disadvantage, those with lower educational attainment and where supportive contact starts during pregnancy. However there is a dearth of evidence from the UK to date where doula support is rare, especially for disadvantaged women. The focus of our research is the Hull Goodwin Doula Project which offers free lay support to women in disadvantaged circumstances provided by volunteer ‘doulas’ who receive specialist accredited training for the role. Methods: Our evaluation, funded by the NIHR HS&DR, is studying the implementation and outcomes of the original project in Hull and in four roll out sites in England using a ‘Realistic Evaluation’ approach (Pawson & Tilley, 1997). This addresses the question: ‘what works, for whom, in what context?’ We are focusing on impacts for the NHS, for women receiving the service and for the volunteer doulas, as well as implementation and sustainability issues. Results: Our experiences so far are reported in a linked oral presentation, while this poster presents the background. Perinatal health after induced abortion: a nationwide register-based study of first births in Finland Reija Klemettia, Mika Gisslera,b, Maarit Niinimäkic, Elina Hemminkia,d aNational Institute for Health and Welfare (THL); bNHV, Nordic School of Public Health; 3 Department of Obstetrics and Gynaecology, University Hospital of Oulu; 4 University of Helsinki Introduction: We studied the perinatal health of first-born children by mother’s induced abortion (IA) history in Finland. Methods: All first-time mothers with a singleton birth (obtained from the Medical Birth Register) in the period 1996–2008 (N=300 858) were linked to the Abortion Register for the period 1983–2008. The perinatal health of the children: preterm births (< 28 or < 37 weeks), low birth weight (<2500 or <1500 g), low Apgar scores (0–6) and perinatal death was compared by the number of previous IAs of the mother and adjusted by logistic regression for social background, previous miscarriages and ectopic pregnancies. Results: Of the first-time mothers (N=31 083), 10.3% had one, 1.5% had two, and 0.3% had three or more IAs. Most IAs were surgical (88%), performed before 12 weeks (91%), and carried out for social reasons (97%). After adjustment, perinatal deaths and very preterm birth (<28 gw) suggested worse outcomes after IA. The risk for very preterm birth was seen in all subgroups (by the number of IAs), as was a dose response relationship. Risk for preterm birth (<37 weeks) and low birth weight (<2500g and <1500g) was seen only among mothers with 3 or more IAs. Conclusions: Our results suggest that prior IAs, particularly repeat IAs, increase the risk of some health problems at first birth; even in a country with good health care quality. The increased risk may be due to mothers’ characteristics not controlled for or sequence of repeat abortions. Using concurrent analysis to determine the domains embedded within the Birth Satisfaction Scale Caroline J. Hollins Martina, Austyn Snowdenb, Colin R. Martinb aSchool of Nursing, Midwifery and Social Work, University of Salford; bSchool of Health Nursing and Midwifery, University of the West of Scotland Objectiveand background: The 30-item Birth Satisfaction Scale (BBS) was developed by Hollins Martin and Fleming (2011) to construct a meaningful picture of what constitutes like or dislike of childbearing women’s experiences of labour and its outcomes. The aim of the current investigation was to establish the parsimony of the BSS with women’s actual experience of childbirth. Methods: Concurrent analysis is a method of analysing narrative data for the purpose of articulating salient connections. It uses Thagard’s (2007) concept of coherence to connect representations on the basis of analogy or explanation. The product is a qualitative domain analysis that accounts for frequency, analogy and explanation of all the narrative data. The initial pilot of the BSS took place in the West of Scotland in 2011. Participants were postnatal women (n = 207) who had delivered at term (37-42 weeks gestation) and were willing to complete the BSS within their first 10 postnatal days. Results: Utilising the six step process the data was examined in this iterative manner for patterns, outliers, and associations. The aim of this process was parsimony: to reduce all the data to as few as possible explanatory associations within the BSS. The final model was condensed from these multiple associations into 3 main themes: (1) Being in control, (2) Being supported and (3) Birth going as planned. Conclusion: Results show close harmony between the BSS and the narrative data concurrently analysed. This study adds to the growing evidence for the robust and valid nature of the BSS. A review of postnatal mental health websites: help for healthcare professionals and patients Donna Moore University of Sussex Objective: The current study aimed to review postnatal mental illness websites and evaluate their quality on a variety of dimensions. Background: The internet offers an accessible and cost-effective way to help women suffering with various types of postnatal mental illness and also can provide resources for healthcare professionals. Many websites on postnatal mental illness are available but there is little information on the range or quality of information and resources offered. Methods: A systematic review of postnatal mental illness websites was conducted. Searches were carried out on four search engines (Google, Yahoo, Ask Jeeves and Bing) which are used by 98% of web users. The first 25 websites found for each key word and their hyperlinks were assessed for inclusion in the review. Websites had to be exclusively dedicated to postnatal mental health or have substantial information on postnatal mental illness. Eligible websites (n = 114) were evaluated for accuracy of information, available resources and quality. Results: Results showed that information was largely incomplete and difficult to read; available help was limited and website quality was variable. Conclusions: The top five postnatal mental illness websites were identified for (1) postnatal mental illness sufferers and (2) healthcare professionals. It is hoped these top websites can be used by healthcare professionals both for their own information and to advise patients on quality online resources. Postnatal outcomes of CALMA study (Can Antenatal yoga Lower Maternal Anxiety) James Newhama, Janine Hurleyb, Anja Wittkowskic, Melissa Westwooda, John D. Aplina aMaternal and Fetal Health Research Centre, University of Manchester; bYoYogis, Bury; 3Division of Clinical Psychology, School of Psychological Sciences, University of Manchester Objective: Examine whether anxiety reduction in the antenatal period, through attending yoga, improves maternal bonding postnatally. Background: High maternal anxiety and fear of childbirth during pregnancy have been associated with an increased likelihood of postpartum depression and difficulties bonding with the infant (Skouteris, 2009; van Bussel, 2006). Consequently, the National Institute of Clinical and Health Excellence (NICE) in the UK have emphasised the need for interventions that tackle sub-threshold symptoms of anxiety in the antenatal period to help women prepare for becoming a mother. Yoga may be a suitable non-pharmacological intervention as it incorporates relaxation techniques with physical exercise customised for pregnant women. Methods: Participants (n=37; mean maternal age (±SD) = 31±4 years; gestational age at consent =22±2 weeks; nulliparous) completed the Trait Anxiety Inventory (STAI-T), Wijma Delivery Expectancy Questionnaire (WDEQ) and the Edinburgh Postnatal Depression Scale (EPDS) both before and after an 8-week course of antenatal yoga. Participants completed the same questionnaires and the Postnatal Bonding Instrument (PBI) one month after childbirth. Results: WDEQ scores decreased significantly after the 8 week course (51 [46-65] vs. 38 [29-51] [Median (95% CI)]; p=0.003). This reduction was significantly correlated with increased PBI scores (r=0.35; p=0.05) while T-STAI and EPDS scores showed no correlation. There were no significant differences between antenatal scores post-intervention and postnatal scores. Conclusion: The yoga course was effective in reducing fear of childbirth in the antenatal period and this correlated with improved infant bonding. These findings suggest that antenatal yoga may improve maternal bonding in the postnatal period. “Getting the most out of your relationship with your baby”: A review of the Brazelton Neonatal Behavioural Assessment in Flying Start Wales Emily Savage-McGlynn National Perinatal Epidemiology Unit, University of Oxford Background: In the postnatal period, new parents can have difficulties understanding the needs of their babies which can influence outcomes for both parent and child. In disadvantaged communities, negative outcomes can be more pronounced. Flying Start is a targeted intervention programme for 0-3 year-olds in disadvantaged communities in Wales. Through enhanced health visiting provision and the inclusion of targeted parenting programmes, it aims to improve outcomes for children and families. As part of the postnatal Flying Start, the Neonatal Behavioural Assessment Scale (NBAS) can help show mothers the capabilities of their newborn and support them in getting to know the meaning of their newborns’ signals and cues. This helps parents develop effective caregiving strategies which can lead to more positive outcomes such as: decreased issues relating to sleep, feeding and crying, maternal self-confidence, greater paternal involvement, and significant reduction in postnatal depression. Methods: Mothers received weekly visits from their health visitor. The NBAS was administered during week 2 and week 4. Participants (Mean maternal age = 28.2; Mean infant age=9.5weeks) completed a questionnaire rating their experiences of the first few weeks of their child’s life, including the Edinburgh Postnatal Depression Scale (EPDS) and the Condon Maternal Postpartum Attachment Scale (MPAS). Results: Significant associations were found between Parenting Experiences and Parenting Confidence, Parenting Experiences and Mother-Infant Attachment, Parenting Confidence and Health Visitor Support, and Parental Confidence and Attachment. These will be discussed. Conclusions: Participation in Flying Start and increased Health Visitor involvement, including the NBAS, can have positive outcomes for the mother and child. Single Embryo Transfer and persuasive communication strategies in young British women O. B. A. van den Akker, A. Patel, S. Purewal Dept of Psychology, Middlesex University Introduction: Elective Single Embryo Transfer (eSET) is the preferred option for infertility treatment to halt the escalating numbers of multiple births across the world (HFEA, 2008). The aims of this study were to persuade women to choose SET. Two health campaigns based on the Framing Effect and the Fear Appeal to promote hypothetical future intentions to select single embryo transfer were developed for a non-patient sample. The immediate effectiveness of the two campaigns was assessed using an RCT. Materials and methods: 400 women were randomly allocated to one of two Intervention groups (Framing condition or Fear Appeal condition) or a Control group. The effectiveness of the messages were assessed using the Attitudes towards Single Embryo Transfer questionnaire (adapted from Murray et al. 2004), and previously used by van den Akker and Purewal, (2011), which measured knowledge, attitudes and hypothetical intentions towards eSET before exposure to the messages (T1) and immediately afterwards (T2). Results: No differences on sociodemographics were found between women randomly allocated to one of the conditions. Women in the High Fear and Education condition improved their knowledge of infertility significantly from T1 to T2. Ordinal logistic regression predicted intentions to choose eSET ‘In principle’ (B=-1.085; SE=0.397; p = 0.006) and ‘Willingness to choose eSET for their own treatment’ (B=-9.16; SE = .392; p=0.019) in the Gain Frame condition. Conclusions: The use of complex persuasive communication techniques on a female student population to promote immediate and hypothetical eSET preferences is successful at promoting eSET. A critical discourse analysis of private 3D ultrasound scan providers’ websites Franziska Wadephula, Julie Jomeena, Lesley Gloverb aFaculty of Health & Social Care, University of Hull; bDepartment of Clinical Psychology & Psychological Therapies, University of Hull Background: In the UK, 3D ultrasound scans have become increasingly popular among prospective parents over the last decade. Scans are carried out in private clinics with advertising appearing on clinic websites. This study explores the discourse constructed around 3D scans by these websites. Methods: The websites of private scanning clinics in the UK were reviewed and a subsection analysed using a modified version of Fairclough’s (2003) critical discourse analysis. The analysis focuses on how the websites construct identities for themselves, scans, pregnancy, the fetus/baby and the clients, as well as relationships between these. The way the clinics generally represent scanning in pregnancy was also explored. Results and discussion: A number of common themes were identified. There is a persistent, parallel dichotomy in the identities constructed: clinics provide an experience and a gateway to the ‘baby’s world’ but also provide a medical service; parents are clients and audience as well as patients; scans are assigned a social as well as medical purpose; pregnancy is given an idealised, sentimentalised identity as well as a medicalised one. These dual identities reflect the fact that 3D scans are both social and medical in nature. All websites emphasize the importance of bonding with the fetus and the ability of 3D scans to provide reassurance. Generally, the clinic websites reflect socio-cultural discourse on pregnancy and scans, but also contribute to this discourse. Society for Reproductive and Infant Psychology (SRIP) 32nd Annual SRIP Conference St. Anne’s College, University of Oxford 2012 The SRIP is an international organisation that recognises that reproduction is a complex, challenging, and multi-faceted area of social, scientific, and medical concern. We believe the key importance of the psychological, socio-cultural, and political implications of reproduction, birth, and infancy. These non-biological aspects of reproduction are often neglected or widely dispersed in the research literature and we feel there is a genuine need for a multi-disciplinary society.