Mindfulness and individual,relational,and parental outcomes during the transition to parenthood

Abstract

With more than one million couples transitioning to parenthood each year, finding ways to enable healthier transitions is salient. Trait mindful awareness and sexual mindfulness were examined in an Actor Partner Interdependence Model (APIM) framework using 169 mixed-sex, married couples to evaluate their association with individual, relational, and parental outcomes. For couples who have transitioned to parenthood, mothers’ trait mindfulness was associated with their own higher mental health and fathers; trait mindfulness was associated with their own higher quality mental health; mothers’ and fathers’ sexually mindful nonjudgment, an ability to remain mindful during sex, was associated with fathers’ higher quality mental health and mothers’ sexually mindful nonjudgment was associated with their own higher quality mental health. Mothers’ trait mindfulness was also associated with their report of lower pregnancy and delivery stress. Higher reports of sexual nonjudgement by both mothers and father were also associated with higher parenting satisfaction for fathers. Thus, mindfulness and sexual mindfulness may be particularly important skills to support new parents’ mental health, relational satisfaction, sexual satisfaction, and parenting satisfaction. Transition to parenthood scholars and practitioners have long been invested in understanding risk and protective factors for new parents and are commonly seeking important points of education and/or intervention to support this transition. Our study suggests mindfulness may both reduce risk and promote healthy behaviors that support mothers, fathers, and their relationship.

Keywords

Transition to parenthood mindfulness sexual mindfulness sexual satisfaction relational satisfaction parenting satisfaction pregnancy

While associated with many benefits, the transition to parenthood is accompanied by considerable challenges (e.g., Holmes et al., 2021; Ko et al., 2004; Le et al., 2016). Past research found significant associations between the transition to parenthood and individual, relational, and parenting outcomes. Individually, mothers navigate feelings of isolation, lack of sleep, lower self-evaluations, and feelings of being trapped (Romito & Saurel-Cubizolles, 1997). Furthermore, 1 in 9 US mothers experience post-partum depressive symptoms in the year following a birth (Ko et al., 2004), which is associated with diminished satisfaction within interpersonal relationships longitudinally (Le et al., 2016), lower quality co-parenting skills longitudinally (Le et al., 2016), and lower levels of fulfillment in sexual relationships cross-sectionally (Leavitt et al., 2017). Relationally, the transition to parenthood is linked with longitudinal declines in relationship satisfaction (Moretensen et al., 2012), which may persist for years after the birth. Declines in relationship satisfaction likely result from shifting familial roles and increases in physical stress associated with caregiving and sleep deprivation. When considering parenting outcomes, as early as conception, anxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for children such as preterm birth and low birth weight (Dunkel Schetter & Tanner, 2012), both of which are known to stifle future child, adolescent, and adult development in a meta-analysis of 31 studies (Bhutta et al., 2002). Additionally, as early as infancy, excessive maternal stress negatively impacts mother-child relationships, with long lasting influences on mother-child interactional behavior (Muller-Nix et al., 2004; Potharst et al., 2017).

Because trait mindfulness is related to positive changes in mental health, lower stress (Creswell et al., 2014), and higher resiliency (Brown et al., 2012), it could be utilized to promote mental wellness during the transition to parenthood (Abbass-Dick et al., 2020). Mindful individuals can consciously slow down, breathe deeply, intentionally focus on the present moment, and accept their current experience. Mindfulness changes how stress is appraised (Creswell et al., 2014) and modifies physical responses to stress (Brown et al., 2012; Potharst et al., 2017), Additionally, sexual mindfulness, a state of mindfulness during a sexual activity, has been linked with higher self-esteem, more communication and connection, more satisfying romantic and sexual relationships and better sexual functioning (Leavitt et al., 2019; Leavitt et al., 2020a, 2020b; Leavitt et al., 2021b). Because few studies have examined the role of mindfulness or sexual mindfulness during the transition to parenthood, we seek to fill that gap. In this cross-sectional study about the transition to parenthood, we include couples who are first time parents. This study evaluates data from their pregnancy and up to a year postpartum. Although this study comes from a longitudinal data set, we use only one wave to assess the associations of mindfulness, sexual mindfulness and individual, couple, and parenting outcomes due to limited availability in the survey.

It is important to understand that while mindfulness may share some similarities with measures such as coping, connectedness, or commitment, it also contributes additional benefits (Hoffmann et al., 2014; Kaiseler et al., 2017). The unique mechanisms of mindfulness may be captured by the quality of awareness. Coping with the stresses and anxieties of daily life, connectedness to a partner, and commitment within a relationship are skills that undoubtedly contribute to individual and relational well-being. However, these skills can only be practiced to the degree that an individual is aware. Awareness breaks open the opportunity for evaluation and more importantly re-perceiving (Lucas et al., 2018). Mindfulness encourages the higher functioning skills of awareness, reevaluation, and diminishes lower-level functioning, such as defensiveness or hostility (Lucas et al., 2018). Consequently, mindful individuals who have the mental space, skill, and awareness to regulate, and who use curiosity (instead of negative appraisal) to find a connection to their body, are able to use higher functioning responses when ruptures in their environment occur.

In this study, we draw on the work of Karremans and colleagues (2017), who set out a framework through which the mechanisms of mindfulness within relationships can be better understood. The mechanism emphasized by Karremans was an ability to be aware in the present moment, and to use that awareness in an open and reflective manner. Awareness is key. Individuals who are tuned into this awareness may be able to engage in less automatic responses, regulate their impulses, and allow for more intentional behavior (Karremans et al., 2017). Additionally, awareness may let a couple see their partner more holistically and with more empathy, thereby creating a stronger self-other connection that benefits the relationship (Karremans et al., 2017).

We further utilize a family systems framework which acknowledges that the transition to parenthood occurs across individual and relationship levels, including the potential for one partner’s experiences to impact the other partner (Holmes, et al., 2013). This interdependence necessitates a test of models that assess not only the individual experiences of new mothers and fathers, but also assess relational processes, such as the potential for actor and partner effects on attachment promoting behaviors, relational satisfaction, and sexual satisfaction.

Mindfulness and Individual Outcomes

Mindfulness can be measured as a trait quality, a state of being, or an intervention of change. Although we present research that includes all these types of mindfulness, in this study we measure trait mindful awareness and sexual mindfulness, specifically. Being mindful includes a host of mechanisms that are relevant to individual well-being – lower negative self-talk, slowing down, breathing, and centering yourself in the present moment. Mindful individuals are less judgmental of themselves as a person and cope better with the emotional demands of parenting (Corthorn & Milicic, 2016). As Karremans and colleagues (2017) describe, mindful individuals may experience an awareness of automatic or implicit responses that allows them to pause and make more intentional choices.

Accordingly, past research has found that trait mindfulness positively related to a broad range of mental and physical health outcomes, for example, improved sleep (Howell et al., 2010), reduced stress and worry in pregnant women (Guardino et al., 2014), healthier emotional functioning in intimate relationships (Khaddouma et al., 2017), and sexual functioning for women (e.g., Leavitt et al., 2021a). Further, mindfulness interventions have been shown to effectively reduce women’s depression and negative affect (Duncan & Bardacke, 2010).

Although many studies have examined the positive link between trait mindful awareness and individual well-being, there is a paucity of studies examining the association of trait mindful awareness during the transition to parenthood. Participants in an exploratory study reported their knowledge, interest, and preferences in learning about mindfulness, with overwhelming (over 85%) interest in learning more about mindful breathing, everyday mindfulness, body scan, and loving kindness (Abbass-Dick et al., 2020). This, along with the positive associations between trait mindfulness and mental health, led Abbass-Dick and colleagues (2020) to conclude that mindfulness needs to be utilized to promote mental wellness during the transition to parenthood. A recent qualitative study examined mindfulness during the transition to parenthood and found that mindfulness helped couples work together and focus on the present moment during childbirth. Women who practiced mindfulness also reported lower levels of stress, pregnancy anxiety, negative emotion, and more positive emotion (Duncan et al., 2017). Another longitudinal quantitative study showed that mindful women’s perception of delivery was more positive (Hulsbosch et al., 2021). However, one meta-analysis using nine randomized and non-randomized control studies of women during the perinatal period found no significant effects on stress, depression, and anxiety as compared to the control group (Lever Taylor et al., 2016).

An additional gap in our current understanding resides in sexual mindfulness. Very few studies have measured sexual mindfulness explicitly. The measurement of sexual mindfulness may be important as it evaluates mindfulness during a time of heightened stress or arousal, either of which can disrupt a mindful state. Initial studies on sexual mindfulness and reduced anxiety show that sexual mindfulness is associated with both adult and adolescent self-esteem (Leavitt et al., 2019, Leavitt et al., 2020a, 2020b). Sexual mindfulness may be particularly important during the transition to parenthood when individuals are vulnerable to higher anxiety, lower self-esteem, and decreased sexual satisfaction.

Mindfulness and Couple Relationship Outcomes

Just as mindfulness and sexual mindfulness may improve individual well-being, they may also positively impact the quality of the romantic relationship for the couple. Mindfulness is related to an accepting, non-judgmental stance towards a romantic partner’s shortcomings (Karremans et al., 2017). Further, mindful individuals possess more emotional and executive control as well as more awareness of implicit responses (Karremans et al., 2017). Sexual mindfulness is associated with more connection and better communication about sex (Leavitt et al., 2020a, 2020b). All of this may lessen conflict and frustration and/or improve conflict-resolution tactics. In fact, mindfulness and sexual mindfulness have been found to provide more conflict resolution satisfaction (Smedley et al., 2021). Additionally, mindful and sexually mindful individuals report self-other connectedness, which encourages positive relationship motivations and behavior (Karremans et al., 2017; Leavitt et al., 2020a, 2020b). Therefore, there are many theoretical reasons to suspect that mindfulness would be associated with more positive relationship outcomes.

Past research has provided support for theories suggesting a positive connection among couple outcomes and mindfulness and sexual mindfulness. For example, a recent meta-analysis confirmed that trait mindfulness is positively related to relationship satisfaction across marital status, age, and gender (Quinn-Nilas, 2020) and it is likely that mindfulness also may be positively linked to relational satisfaction during the transition to parenthood. However, we also note that while these findings found positive association for relationship outcomes across age, gender, and relational status, the effect size was small.

Individuals’ trait mindful awareness is also tied to forgiveness, gratitude, awareness, which contributes to greater couple relational and sexual well-being (Eyring et al., 2020). Further, several studies have found that mindfulness training is associated with benefits for couples with insecure attachment styles (Jones et al., 2011). The transition to parenthood is a time when relational and sexual satisfaction are expected to diminish, yet mindfulness has been shown to have particularly strong connections with sex outcomes like sexual and relational satisfaction (Leavitt et al., 2020a, 2020b). Additionally, couples trained in mindfulness experienced higher sexual frequency, communication, and partner satisfaction among women, and lower levels of sexual avoidance and impotence among men (Leavitt et al., 2021a). Links between mindfulness training, trait and state mindfulness and positive couple outcomes are abundant and indicate that trait mindfulness may provide an important tool for couples during the transition to parenthood.

Importantly, the benefits of mindfulness expand beyond the individual and have been shown to be positively related to partners’ outcomes. Being mindful requires no partner buy-in, but partners of mindful spouses report improved relational quality (Khaddouma et al., 2017). Further, individuals who scored higher in mindfulness were more likely to perceive their partners as being more responsive while discussing a negative event as well as notice the ways their partner offers daily support, which improved their relationship satisfaction (Adair et al., 2018). Spouse’s mindfulness has also been associated with a greater tendency to forgive their partner’s transgressions, which was then related to greater relationship satisfaction (Eyring et al., 2020). During the transition to parenthood, one partner’s ability to remain mindful may be particularly important even if the other partner is not able to be mindful.

Mindfulness and Parenting Outcomes

Finally, there are many reasons to believe that mindfulness would be positively related to infant parenting outcomes. Mindfulness may help parents make more intentional choices (Dumas, 2005) by creating space to regulate their own emotions and appropriately consider their child’s needs and the shared relationship (Duncan et al., 2009).

Past research has provided support for positive connections between trait mindfulness, mindful practices, and parenting. Trait mindfulness has been found to be positively associated with parenting methods and subjective experiences (Gouveia et al., 2016; Leavitt et al., 2021b), attunement and responsiveness to children, and feelings of connection to children (Campbell et al., 2017). Further, following a mindfulness-based intervention for parents of children with developmental delays, parents reported greater life and parenting satisfaction (Neece, 2014). Several studies have also reported associations between mindfulness and lower parental stress (e.g., Burke et al., 2020). These findings have been fairly consistent across geographical location (Gouveia et al., 2016) and among parents of children with disabilities (Rayan & Ahmad, 2017). Despite these favorable findings, some studies have reported that mindfulness interventions resulted in no improvements on (Rayan & Ahmad, 2017) or even a negative impact on parental stress (Zhang et al., 2017). These studies were limited by small sample sizes and other elements of the interventions may explain the negative findings.

We know of no studies that examine the associations between mindfulness and parenting outcomes during the transition to parenthood. Trait mindfulness may be particularly important for new parents as they navigate these issues for the first time. Further, no previous studies have examined sexual mindfulness and parental outcomes. Sexual mindfulness may represent a more difficult skill to master as it measures mindfulness within a state of heightened anxiety or arousal (Leavitt et al., 2019). However, the ability to be aware, intentional, and connected during sex may be especially important for parents transitioning to parenthood. The ability to remain mindful even during the intensity or anxiety of sex likely will transfer to other situations such as the adjustment to parenting for the first time.

The Current Study

Using the mindfulness and relationships framework (Karremans et al., 2017), a family systems approach that is sensitive to the importance of assessing both individual and relational levels of transition (Holmes et al., 2013), and drawing from the previous research, we examined the association between trait mindfulness and sexual mindfulness during couples’ transition to parenthood (i.e., couples with a child under 1) and their individual, relational, and parenting outcomes. We examined actor/partner effects among fathers and mothers. We build on past research by examining these relationships following the transition to parenthood, explicitly measuring sexual mindfulness, and using a sub-sample of new parents drawn from a nationally representative sample of newlyweds. Because trait mindfulness has been found to be stable, absent an intervention (Himes et al., 2021), we felt comfortable asking participants to report on their mindful awareness during their pregnancy and delivery.

After controlling for the demographic variables of age, education, race, and work and student status, we hypothesize (H) that:

H1: For mothers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with perceived healthier pregnancy, healthier childbirth, heathier post-partum physical health markers, and lower depression of mothers in the post-partum period.

H2: For fathers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with heathier post-partum physical health markers and lower depression of fathers in the post-partum period.

H3: For mothers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with relational and sexual satisfaction, and attachment promoting behaviors of mothers.

H4: For fathers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with relational and sexual satisfaction, and attachment promoting behaviors of fathers.

H5: For mothers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with parenting satisfaction and parenting competency, and negatively associated with parenting stress of mothers.

H6: For fathers, trait mindful awareness, sexual awareness, and sexual non-judgement in the post-partum period for both actor and partner will be positively associated with parenting satisfaction and parenting competency, and negatively associated with parenting stress of fathers.

Method

Data and Sample

The data for the study came from the CREATE project, a nationally representative study of newlyweds in the United States, which began in 2016 and continues annually in successive waves (James et al., 2021; Yorgason et al., 2019). Participants were sampled through two-stage cluster stratification. The first stage sampled 239 counties, and the second stage sampled 11,889 recent marriages within sampled counties. To meet inclusion criteria, couples had to be selected through sampling procedures, be married at Wave 1, live in the United States, have one spouse between the age of 18 and 36 years, and be the first marriage for at least one partner. There were 1220 marriages that were excluded based on a failure to meet inclusion criteria. The study sampled 2187 couples who responded to recruitment. The response rate for the study was 21%, considered a successful response rate for studies of dyads (Dillman et al., 2008). The CREATE project designed sampling weights to facilitate inference on the population of married couples in the United States (Yorgason et al., 2019).

This study primarily used information collected in the third wave in 2018 because this is the wave when mindfulness measures were added to the survey. We excluded 501 couples due to sample attrition by the third wave and three couples who opted out of the study. We excluded 1484 couples who did not transition to parenthood during the year preceding the third wave. (i.e., both parents had a first birth within the 12-month period prior to Wave 3). The survey measured which gender a respondent most identified with. We used respondents’ gender identity to identify heterosexual and same-sex couples. We excluded 5 non-heterosexual couples; we did not have enough couples to analyze experiences of these couples, and we suspected that these couples differed in actor and partner associations compared to heterosexual couples. Because the research questions focus on couple relationships, we excluded 25 couples who had separated by the third wave of the study. Finally, three couples were excluded because they had substantial levels of missing information. This left a final analytical sample of 169 couples. As shown in Supplemental Table S1, excluded couples were slightly less likely to be White and more likely to have a bachelor’s degree. Otherwise, excluded and included couples were quite similar on demographic measures. The survey provided high-quality data, with less than 7% of missing data among included variables in the analytic sample. Most demographic control variables were not missing information. The parenting outcomes and labor and delivery outcomes had the most missing data. The results of Little’s MCAR test demonstrated that missing values were not MCAR and that there were systematic patterns of missing values. Given that listwise deletion would bias results when data are MCAR, we used Full-information maximum likelihood (FIML) to handle missingness in all models as FIML performs better than listwise deletion and Multiple Imputation when managing missing data (Allison, 2003).

Table 1 includes a demographic description of the sample. Of the final sample, mothers were on average 26.14 years old (SD = 3.98), and fathers 27.92 years old (SD = 4.91) at the time of their marriage. The racial and ethnic makeup of the sample was similar to national trends; of the sample, 5% of mothers and 8% of fathers were Black, 8% of mothers and 3% of fathers were Asian, 2% of mothers and 2% of fathers were Native American, 13% of mothers and 9% of fathers were Hispanic, 76% of mothers and 77% of fathers were White, and 1% of mothers and 1% of fathers did not have an identified race/ethnicity. Regarding education, 68% of mothers and 60% of fathers reported having earned a bachelor’s degree or higher. Regarding employment, 98% of fathers reported being employed full-time; full-time employment for mothers was lower (88%), which is unsurprising given the recent birth of a child.

Table 1.

Sample Description (N = 169).

	Mothers				Fathers
	Mean	SD	Min	Max	Mean	SD	Min	Max
Age in years at time of marriage	26.14	3.98	18.00	40.00	27.92***	4.91	19.00	50.00
Black non-Hispanic	.05	.22	.00	1.00	.08	.27	.00	1.00
Hispanic	.13	.34	.00	1.00	.09	.29	.00	1.00
White non-Hispanic	.76	.43	.00	1.00	.77	.43	.00	1.00
Some college	.20	.40	.00	1.00	.28	.46	.00	1.00
Bachelor’s degree	.68	.47	.00	1.00	.60	.50	.00	1.00
Currently enrolled in school	.06	.24	.00	1.00	.07	.27	.00	1.00
Currently employed full-time	.88	.33	.00	1.00	.98***	.13	.00	1.00
Mindfulness	4.24	.98	1.07	6.00	4.28	.89	2.07	6.00
Sexual mindfulness awareness	3.12	.80	1.00	5.00	3.28*	.82	1.00	5.00
Sexual mindfulness non-judgement	3.68	.95	1.00	5.00	4.09***	.83	1.00	5.00
Stress of pregnancy^a	3.27	1.75	1.00	7.00	—	—	—	—
Stress of delivery^a	4.00	1.85	1.00	7.00	—	—	—	—
Depression	6.23	4.69	.00	23.00	5.88	4.95	.00	28.00
Overall health	2.36	.87	1.00	5.00	2.35	.90	1.00	5.00
Relationship satisfaction	4.09	1.06	.50	5.25	3.98*	1.05	.75	5.25
Sexual satisfaction	3.56	.79	1.00	5.00	3.42*	.88	1.20	5.00
Attachment promoting behavior	4.27	.64	2.33	5.00	4.12**	.67	2.33	5.00
Parenting satisfaction	6.47	.57	4.67	7.00	6.35	.66	4.33	7.00
Parenting stress	2.34	.66	1.00	4.40	2.16	.65	1.00	3.60

Data: CREATE Study, 2016–2018.

^aSub-sample consisting of 103 women. Asterisks represent significant difference between mothers and fathers.

*p < .05, **p < .01, ***p < .001.

Measures

Outcome Variables

Perceived Pregnancy and Delivery Stress

Childbearing women reflected on their recent pregnancy, which was sometime during the prior year and responded to three questions: “How stressful was your overall pregnancy?” and “How stressful was your overall labor experience?” on a 7-point scale from 1 (not at all stressful) to 7 (as stressful as possible). The questions were developed for the CREATE study to assess basic characteristics of a mother’s labor and delivery experience and have not been validated (Yorgason et al., 2019). These two questions were retrospective and each evaluated individually.

Mental Well-being in the Post-partum Period

We used depressive symptoms to measure mental well-being at the time of the Wave 3 survey. This scale used 10 items from the short form of the CES-D developed by Andresen et al. (1994). The items assessed the number of times during the week in which the respondent e.g., “felt depressed,” or “lonely,” including three items on depressed affect, five somatic symptoms, and two items on positive affect (reverse coded). The responses were recorded on a three-point scale with 0 (Rarely or none of the time, less than 1 day) to 3 (Most or all the time, 5-7 days). Total scores range from 0 to 30. Higher scores represented more depressive symptoms, with a score equal to or higher than 10 suggesting a person is experiencing clinical levels of depression. 11 percent of mothers and 14 percent of fathers had depressive symptoms above the threshold. This variable was modeled as a continuous variable.

Perceived Physical Health

Individuals self-rated their health at the time of the Wave 3 survey in response to the prompt, “In general, would you say that your health is:” with scores ranging from 1 (poor) to 5 (excellent). This item was developed by the RAND-Medical Outcomes Study to assess problems with work or regular daily activities as a result of poor physical health (Ware & Sherbourne, 1992). This single item was evaluated individually as a continuous variable.

Relationship Satisfaction

We measure several domains of couple well-being at Wave 3. Couple relational satisfaction was measured using four items—such as “In general, how satisfied are you with your relationship?”—from the Funk and Rogge relationship scale (2007). These items were measured on a six-point scale from 0 (not at all) to 5 (completely), with higher scores representing higher satisfaction. Reliability was good: (mothers: α = .93; fathers: α = .95).

Sexual Satisfaction

Sexual satisfaction, a quantitative measure of the quality of sexual intimacy, was measured with a 4-item scale (Busby et al., 2001). Items included, for example, “How satisfied are you with how often you currently have sex with your partner?” Responses ranged from 1 (very unsatisfied) to 5 (highly satisfied). Higher scores represented higher levels of sexual satisfaction. These scales were reliable (mothers: α = .80; fathers: α = .83).

Attachment

Attachment promoting behavior was measured using the BARE scale developed by Sandberg et al. (2012). Participants rated their own responsiveness, engagement, and accessibility with six items and used a 5-point Likert-type scale ranging from 1 (never true) to 5 (always true). Example statements include, “I am rarely available to my partner” and “It is hard for me to confide in my partner.” Respondents answered similar statements about their partner. Some items were reversed so that higher scores corresponded with stronger attachment. The scale was reliable (mothers: α = .78; fathers: α = .86).

Infant Parenting and Parent Well-being

Three items intended to assess parenting satisfaction were adapted from a measure developed by (Kurdek & Fine, 1991). This scale asks respondents to rate how satisfied they are with their relationship with their child, their role as a parent, and the job they are doing as a parent on a scale from 1 (extremely dissatisfied) to 7 (extremely satisfied). Higher scores represent higher parenting satisfaction. These scales were reliable (mothers: α = .77; fathers: α = .79). Parenting stress was assessed using 5 items from the Fragile Families study (Osborne & McLanahan, 2007). The scale asked for personal feelings of being stressed as a parent. Example items include, “I feel trapped by my responsibilities as a parent” and “I feel I am not able to do the things I like since having children.” Items were measure on a scale from 1 (never) to 5 (very often) with one item being reverse scored. Higher values represented higher stress felt by parents. These scales were reliable in the analytic sample (mothers: α = .78; fathers: α = .76).

Predictor Variables

Trait Mindful Awareness

Trait mindful awareness was assessed using the validated Mindfulness Attention Awareness Scale (MAAS; Brown & Ryan, 2003), a 15-item scale designed to measure the current expression of a core characteristic of mindfulness. Example items included “I find myself doing things without paying attention,” and “I find myself preoccupied with the future or the past.” Responses were on a six-point scale from 1 (almost always) to 6 (almost never), with higher scores indicating higher mindfulness. Matching previous research, these scales were reliable (mothers: α = .93; fathers: α = .90). This measure only examines awareness, not other elements of mindfulness

The Sexual Mindfulness Measure (SMM; Leavitt et al., 2019) is a measure that examines mindfulness during sex. It has two components—awareness and non-judgement. This measure has shown reliability in several samples and in other cultures (Leavitt et al., 2019; 2020a, 2020b, 2021a; Dusault et al., 2021)

Sexual Awareness

The sexual awareness scale is one subcomponent of the SMM. The measure used 4 items. An example item for awareness was, “I pay attention to sexual sensations.” Participants respond on a Likert-type scale ranging from 1 (never or rarely true) to 5 (very often or always true), with higher scores indicating greater levels of mindfulness during sexual experiences. The scale was reliable (mothers: α = .82; fathers: α = .83).

Sexual Non-judgement

The sexual non-judgement scale is one subcomponent of the SMM. The measure used 3 items. An example item was, “During sex, I sometimes get distracted by evaluating myself or my partner.” Participants respond on a Likert-type scale ranging from 1 (never or rarely true) to 5 (very often or always true). Items were reverse coded so that higher scores indicated greater levels of non-judgement during sexual experiences. Matching previous research, the scale was reliable (mothers: α = .85; fathers: α = .82).

Control Variables

Respondents self-reported invariant demographic variables in Wave 1. Demographic controls included age at marriage (for the marriage of interest to the CREATE study). For wives, the mean age at marriage was 26.14 years old. For husbands, the mean age at marriage was 27.42 and the median age was 27. We used race and ethnicity to generate a categorical variable indicating whether a respondent was Black non-Hispanic, Hispanic, or neither. For demographic variables potentially varying over time, we measured at the transition to parenthood in Wave 3. These included a binary indicator for whether the respondent was currently a student (residing in the United States) and whether they are currently employed fulltime. We also included a categorical measure for educational attainment.

Analytical Approach

Correlations were calculated for all explanatory and outcomes of interest. Next, we used an Actor Partner Interdependence Model (APIM) to estimate how mindfulness and sexual mindfulness of a respondent and their partner predicted outcomes for each partner in a couple, while accounting for individual socio-demographic controls. The model included four individual-level outcome variables (depressive symptoms, general health, stress of pregnancy for mothers only, and stress of delivery for mothers only), three couple-level outcome variables (relationship satisfaction, sexual satisfaction, and own attachment to partner), and two parenting outcome variables (parenting satisfaction, and parenting stress). The APIM model related trait mindfulness of each partner (mothers and fathers separately) and sexual mindfulness of each partner (mothers and fathers separately) at the transition to parenthood to outcomes in a structural equation model format with the format of the following equation for each outcome included in the model.

$O u t c o m e = β_{0} + β_{1} {T r a i t M i n d f u l n e s s}_{w 0} + β_{2} {T r a i t M i n d f u l n e s s}_{h 0} + β_{3} {S e x u a l A w a r e n e s s}_{w 0} + β_{4} {S e x u a l A w a r e n e s s}_{h 0} + β_{5} {S e x u a l N o n j u d g e m e n t}_{w 0} + β_{6} {S e x u a l N o n j u d g e m e n t}_{h 0} + X Γ + ϵ_{i 0}$ The model included all outcome variables for both partners (except pregnancy and delivery outcomes only for mothers). The model included control variables, as represented by X and described in the above text. We implemented full information maximum likelihood when estimating the APIM model to account for missingness and retain all observations. The use of APIM allowed us to account for correlations between outcomes within a group and in outcomes between partners. To further adjust for the potential of multiplicity in outcomes, we applied a Benjamini-Hochberg adjustment to the APIM model as a statistical adjustment to significance levels using a false discovery rate of .10 (Cribbie, 2007).

Results

Descriptive Results

Table 1 shows descriptive statistics for outcomes. Descriptive results indicate that on average, mothers reported higher relationship satisfaction (p = .02), sexual satisfaction (.02), and attachment promoting behavior (.004) compared to fathers. Otherwise, mothers and fathers were similar. Correlations in Table 2 showed that trait mindful awareness negatively correlated with own depressive symptoms and parenting stress for mothers and fathers, and it positively correlated with own physical health, relationship satisfaction, and attachment to partners. For mothers, sexual awareness positively correlated with relationship satisfaction, sexual satisfaction, and parenting satisfaction. For fathers, sexual awareness correlated with higher parenting satisfaction. Sexual non-judgement positively correlated with own physical health, relationship satisfaction, sexual satisfaction, attachment, and parenting satisfaction of fathers; it negatively correlated with depressive symptoms and parenting stress.

Table 2.

Bivariate correlations of Outcome and Predictor Measures.

		Variable	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19
1	M	Trait mindful awareness	—
2	F	Trait mindful awareness	.23*	—
3	M	Sexual mindful awareness	−.03	.03	—
4	F	Sexual mindful awareness	−.11	.13	.18*	—
5	M	Sexual mindful non-judgement	.33*	.27*	.01	.01	—
6	F	Sexual mindful non-judgement	.13	.28*	−.15*	−.15	.16*	—
7	M	Depression	−.36*	−.29*	−.11	.02	−.34*	−.22*	—
8	F	Depression	−.17*	−.48*	.00	.05	−.29*	−.38*	.45*	—
9	M	Overall health	.16*	.19*	.13	−.13	.18*	.03	−.32*	−.34*	—
10	F	Overall health	.00	.16*	−.05	.00	.05	.18*	−.16*	−.43*	.31*	—
11	M	Relationship satisfaction	.19*	.22*	.19*	−.07	.30*	.17*	−.37*	−.28*	.30*	.17*	—
12	F	Relationship satisfaction	.17*	.28*	.10	.01	.32*	.22*	−.31*	−.46*	.31*	.27*	0.66*	—
13	M	Sexual satisfaction	.09	.23*	.30*	.04	.36*	.16*	−.30*	−.22*	.24*	.09	0.45*	0.40*	—
14	F	Sexual satisfaction	.15	.31*	.16*	.06	.32*	.17*	−.26*	−.40*	.18*	.18*	0.31*	0.55*	0.52*	—
15	M	Attachment	.35*	.20*	.07	−.04	.31*	.25*	−.22*	−.16*	.25*	.14	0.63*	0.48*	0.20*	0.17*	—
16	F	Attachment	.24*	.35*	.07	.15	.39*	.27*	−.31*	−.35*	.19*	.14	0.48*	0.65*	0.27*	0.36*	0.50*	—
17	M	Parenting satisfaction	.06	.24*	.19*	.12	.15	−.01	−.12	−.13	.20*	.25*	0.15	−0.04	0.03	−0.04	0.16	0.02	—
18	F	Parenting satisfaction	.10	.36*	−.14	.25*	.36*	.30*	−.18	−.47*	.21*	.23*	0.17	0.42*	0.19	0.27*	0.29*	0.57*	0.30*	—
19	M	Parenting stress	−.21*	−.14	−.05	.15	−.25*	.03	.33*	.21*	−.03	−.17	−0.24*	−0.11	−0.13	−0.20*	−0.18	−0.17	−0.41*	−0.21	—
20	F	Parenting stress	−.12	−.34*	.12	−.15	−.27*	−.05	.17	.37*	−.02	−.06	−0.21	−0.36*	−0.11	−0.29*	−0.18	−0.42*	−0.08	−0.47*	0.25*

Note: *p < .05; M = mother, F = father.

Actor-Partner Interdependence Model: Individual Outcomes

APIM results displayed significant associations for individual, relational, and parenting outcomes during the postpartum period. Model fit metrics indicated the model fit remained good overall with RMSEA = .000 and CFI = 1.000.

Trait Mindful Awareness

Results in Figure 1 showed that trait mindful awareness of mothers associated with lower depressive symptoms in mothers (b = −1.08, p = .002), lower stress during pregnancy (b = −.48, p = .004), and lower stress during delivery (b = −.51, p = .01). Trait mindfulness of mothers did not associate with depressive symptoms of their partners, their own physical health, or the physical health of their partners. Trait mindful awareness of fathers associated with their own lower depressive symptoms (b = −1.90, p = .000). Trait mindful awareness of father did not associate with depressive symptoms of their partners, their own physical health, the physical health of their partners, partners’ stress during pregnancy or partners’ stress during delivery.

Figure 1.

APIM Associations between Trait Mindful Awareness, Sexual Awareness, and Sexual Non-judgement and Individual Outcomes. Note: *p < .05, **p < .01, ***p < .001 | M = Mother, F = Father. Individual, relational, and parenting outcomes were testing in one complete model and were presented in 3 separate figures. For parsimony, coefficients for mothers and fathers were reported on the same arrow although they were included in separately in the same model.

Sexual Awareness

Sexual awareness of mothers postpartum did not associate with any individual-level outcomes for themselves or their partners. Likewise, sexual awareness of fathers did not associate with any individual-level outcomes for themselves or their partners.

Sexual Non-judgement

During the postpartum period, sexual non-judgement of mothers associated with their own lower depressive symptoms (b = −.94, p = .02) and lower depressive symptoms of their partners (b = −1.11; p = .01). Sexual non-judgement of mothers associated with higher stress during labor (b = .50, p = .02). Sexual non-judgement of mothers did not associate with stress during pregnancy, postpartum physical health of mothers or physical health of their partners. Sexual non-judgement of husbands associated with their own lower depressive symptoms (b = −1.25; p = .01). Sexual non-judgement of husbands did not associate with their partners’ depressive symptoms, their own physical health, the physical health of their partners, the stress of pregnancy experienced by their partners, or the stress of delivery.

In sum, the findings on individual outcomes were mixed for our first hypothesis for mothers. We found actor associations but no partner associations between mindfulness predictors and individual outcomes. Contrary to our hypothesis, we found a positive association between wives’ sexual non-judgement and stress of labor. There was mixed support for our second hypothesis, with significant negative associations between mindfulness predictors (actors and partners) and depressive symptoms of fathers, but no associations between mindfulness predictors and physical health of fathers.

Actor-Partner Interdependence Model: Relational Outcomes

Trait Mindful Awareness

APIM results in Figure 2 displayed significant associations between trait mindful awareness and couple-level outcomes. For mothers, trait mindful awareness associated with own attachment to their partners (b = .16, p = .002). Mothers’ trait mindful awareness did not associate with any other couple-level outcomes. For fathers, trait mindful awareness associated with their own attachment to their partners (b = .15, p = .005). Father’s trait mindful awareness did not associate with any other couple-level outcomes.

Figure 2.

APIM Associations between Trait Mindful Awareness, Sexual Awareness, and Sexual Non-judgement and Relational Outcomes. Note: *p < .05, **p < .01, ***p < .001 | M = Mother, F = Father. Individual, relational, and parenting outcomes were testing in one complete model and were presented in 3 separate figures. For parsimony, coefficients for mothers and fathers were reported on the same arrow although they were included in separately in the same model.

Sexual Awareness

Sexual awareness of mothers associated with higher levels of their own relationship satisfaction (b = .26, p = .002) and higher levels of their own sexual satisfaction (b = .34, p = .000). Sexual awareness of mothers did not associate with partners’ relationship satisfaction or partners’ sexual satisfaction; it also did not associate with any attachment measures. Sexual awareness of fathers associated with their partners experiencing higher levels of attachment (b = 0.15, p = 0.006), and no other associations were found between fathers’ sexual awareness and couple-level outcomes.

Sexual Non-judgement

Mothers’ sexual non-judgement related to higher relationship satisfaction for themselves (b = .28, p = .01) and their partners (b = .31, p = .000). Sexual non-judgement of mothers related to higher own sexual satisfaction (b = .24, p = .001) and higher sexual satisfaction of their partners (b = .27, p = .000). Mothers’ sexual non-judgement associated with higher own attachment to their partners (b = .15, p = .01) and higher attachment of fathers to their partners (b = 0.19, p = .002). Fathers’ sexual non-judgement did not relate to any couple-level outcomes for themselves or their partners.

In sum, support for our third hypothesis was mixed. We found expected significant actor associations; however, we found no partner associations for mothers’ relational outcomes. The findings were generally supportive of our fourth hypothesis, with expected actor and partner associations (or non-significant paths) between mindfulness predictors and fathers’ relational outcomes.

Actor-Partner Interdependence Model: Parenting Outcomes

Trait Mindful Awareness

Figure 3 show that there were no significant associations between trait mindful awareness for postpartum mothers and any infant parenting outcomes. Fathers’ trait mindful awareness related to higher parenting satisfaction for their partners (b = .16, p = .01) and lower levels of fathers’ parenting stress (b = −.33, p = .001). Fathers’ trait mindful awareness did not relate to their own parenting satisfaction or the parenting stress of their partners.

Figure 3.

APIM Associations between Trait Mindful Awareness, Sexual Awareness, and Sexual Non-judgement and Parenting Outcomes. Note: *p < .05, **p < .01, ***p < .001 | M = Mother, F = Father. Individual, relational, and parenting outcomes were testing in one complete model and were presented in 3 separate figures. For parsimony, coefficients for mothers and fathers were reported on the same arrow although they were included in separately in the same model.

Sexual Awareness

Mothers’ own sexual awareness did not associate with their own parenting satisfaction, their partner’s parenting satisfaction, their own parenting stress, or the parenting stress of their partners. Sexual awareness of fathers related to their own higher levels of parenting satisfaction (b = .20, p = .008). Sexual awareness of fathers did not relate to their partners’ parenting satisfaction, their partners’ parenting stress, or their own parenting stress.

Sexual Non-Judgement

Mothers’ sexual non-judgement related to higher levels of parenting satisfaction for their partners (b = .18, p = .01). Mothers’ sexual non-judgement did not relate to their own parenting satisfaction, their own parenting stress, or the parenting stress of their partners. Fathers’ sexual non-judgement related to higher levels of their own parenting satisfaction (b = .19, p = .003). Fathers’ sexual non-judgement did not associate with their partners’ parenting satisfaction, their partners’ parenting stress, or their own parenting stress. In sum, the findings on parenting outcomes generally confirmed our fifth hypothesis, with expected actor and partner associations or non-significant paths found between mindfulness predictors and mothers’ parenting outcomes. Similarly, findings generally confirmed our sixth hypothesis, with expected actor and partner associations found between some mindfulness predictors and fathers’ parenting outcomes.

Discussion

Using the mindfulness and relationships framework (Karremans et al., 2017), including a family systems approach (Holmes et al., 2013) to the transition to parenthood, we examined the association between trait mindful awareness and sexual mindfulness during couples’ transition to parenthood and their individual (stress of pregnancy and childbirth and lower depression in the post-partum period), relational (relational and sexual satisfaction and attachment), and parenting outcomes (parenting stress and satisfaction). Our findings underscore that trait mindful awareness and sexual mindfulness have broad implications for couples as they transition to parenthood, demonstrated by many significant associations across multifaceted domains for fathers and mothers during this difficult period, including both actor and partner effects. Transition to parenthood scholars and practitioners have long been invested in understanding risk and protective factors for new parents and are commonly seeking important points of education and/or intervention to support this transition. Our study suggests mindfulness may both reduce risk and promote healthy behaviors that support mothers, fathers, and their relationship. This study also provides additional support of Karremans and colleagues’ (2017) relational framework for how mindfulness provides an environment that may benefit relationships through mechanisms such as other-connectedness and increased awareness.

Mindfulness and Individual Outcomes

We found several significant associations between trait mindful awareness and individual outcomes. Mothers’ trait mindful awareness and sexual mindful non-judgment was associated with their own lower depression. Mothers’ trait mindful awareness was associated with lower stressful pregnancy and lower delivery stress. This is a particularly important finding as the difficulty of pregnancy can have lasting effects (Lobel & Ibrahim, 2018) and mindfulness seems to ease this potential challenge. Fathers’ trait mindful awareness was associated with their own lower depressive symptoms. Sexual mindful non-judgement of both fathers and mothers was associated with fathers’ lower depressive symptoms. We expected these findings because mindfulness encourages more personal acceptance and less judgment (Karremans et al., 2017), which may be particularly salient during this transition to parenthood where physical, mental and relational changes and stresses are occurring for the individual and may create feelings of being overwhelmed or discouraged.

As individuals are more mindful, they may engage in small or large efforts to re-evaluate their motivations and maintain better executive control and emotion regulation (Karremans et al., 2017), which likely improves individuals’ self-care including how they eat and attend to their mental and physical health. As men and women transition to parenthood they are at higher risk for stress, isolation, and health problems (Brandel et al., 2018).

Although mindfulness may provide one tool to help alleviate some of the burdens during this transition, it was not a cure-all. Despite previous research that suggests mindful awareness has individual health and well-being benefits, these benefits may not manifest in certain circumstances, such as the additional stress of pregnancy. One unexpected finding that will need further research is that mother’s sexual mindful non-judgement was associated with lower health for fathers. This finding is contrary to expectations and previous research. It may be that mothers who were married to less healthy spouses reported higher use of sexual mindful non-judgement. We also found no significant associations between most of the mindfulness elements and general health and pregnancy stress. While mindfulness and sexual mindfulness may offer some benefit during this transition to parenthood, future research can further examine the benefits, possible negative associations, and null findings.

Mindfulness and Relational Outcomes

Caring for a child necessarily changes the dynamics of both the romantic and sexual relationship. Mindfulness appears to ease this transition in a number of ways. Although there were many significant findings, we will discuss a few. Mothers and fathers who reported higher trait mindful awareness also reported healthier attachment. These findings are supported by Karremans et al.’ (2017) framework, which posits that mindfulness encourages positive relationship motivations and behavior, resulting in higher quality relationships. Individuals are able to be more other focused, empathetic, and create feelings of connectedness. Other research has found a similar association between mindfulness and attachment promoting behaviors and identified that couples make more benign attributions to their partners’ motivations (Kimmes et al., 2017).

Higher reports of sexual nonjudgement by mothers were associated with both parents’ positive outcomes of healthy attachment, relationship satisfaction, and sexual satisfaction. Fathers’ sexual mindful awareness related to higher relational and sexual satisfaction for his partner. Higher mothers’ sexual mindful non-judgment was associated with both actor and partner higher relational and sexual satisfaction as well as attachment. These findings indicate that fathers’ sexual mindful awareness and mothers’ sexual mindful non-judgment play important roles in adjusting to parenthood.

As couples slow down their daily interactions and their sexual interactions, they likely increase their capacity for acceptance of one another (Karremans et al., 2017; Kimmes et al., 2017). Greater awareness and acceptance may produce a more flexible environment during this demanding transition to parenthood.

We acknowledge that trait mindful awareness had no association with either the individual’s or their partner’s relational or sexual satisfaction, despite recent research that showed mindfulness training had a positive impact on sexual satisfaction (Najiabhary et al., 2022). However, during this stressful time of transition to parenthood state mindful awareness and non-judgement may provide mothers and fathers a needed buffer to pause reactions and make more intentional evaluations and responses. State mindfulness may also play a more important role in the sexual relationship than the ability to be generally aware. This is not surprising but is an indication that couples may benefit from learning how to be mindful during their sexual encounters (Leavitt et al., 2021b, 2021).

These findings are particularly hopeful. As couples engage in the stressful phase of becoming parents, physicians, therapists, and other educators could encourage new parents to take a few minutes to be more mindfully aware and let go of judgement. Instead of reactive responses during this steep learning curve, they could employ curiosity as an intentional protective strategy for their romantic and sexual relationship (Karremans et al., 2017).

Mindfulness and Parenting Outcomes

We found connections between trait mindful awareness as well as sexual mindfulness and parenting outcomes. Higher reports of fathers’ trait mindful awareness were associated with higher mother’s parenting satisfaction and fathers’ own lower parenting stress. Higher reports of sexual nonjudgement by both mothers and father were associated with higher parenting satisfaction for their fathers, suggesting more domains where mothers’ sexual mindful nonjudgement may be associated with positive family life during the sensitive transition. Sexual awareness was positively associated with parenting satisfaction and lower parenting stress.

The findings that trait mindful awareness and sexual mindfulness were important for fathers’ parenting outcomes and are aligned with earlier research that found mindful parents experience higher satisfaction (Campbell et al., 2017) and lower stress (Burke et al., 2020). Again, Karremans et al.’ (2017) framework suggests that mindfulness may provide an improved quality of presence for the individual and within relationships with the use of mindful practices. Future research could investigate whether fathers who are more mindfully aware are more likely to see outside their own perspective and find mutually beneficial solutions. It may be that mindful fathers are more able to tend to a new baby and balance their own individual needs and the new demands of an infant. Although not specifically tested in this study, fathers who are more mindfully aware may be more likely to change their motivations and aligned with others (Karremans et al., 2017), which during this transition to parenthood, would allow for flexibility and creative management of new tasks and responsibilities with both spouse and new child. However, it may also be that fathers are benefitting from not being the primary caregiver and not going through the physical recovery during this time. Future research could examine other factors surrounding fathers’ transition to parenthood. These skills may be particularly useful during the transition to parenthood as individuals are able to attune to their own needs as well as their spouse and new child and find motivations that are not self-sacrificing, but instead relationally expanding and nurturing.

Limitations and Conclusion

We acknowledge limitations in our study. Although our data came from a nationally representative study of newly-married couples, our sub-sample is not nationally representative and we excluded a small number of same-sex couples from our study—thus generalizability is limited in that our sample was composed of newly married couples in their 20s and 30s, who were mostly White and highly educated. Future research could examine how mindfulness may be associated among other demographic groups. Further, future research could examine whether mindfulness helps at-risk couples cope during the additional stress of transition to parenthood. Mindfulness may be particularly important for couples who experience added stresses such as chronic health problems or conflict within their relationship, for example.

Additionally, this study is cross sectional and does not imply causation. Mindfulness has consistent positive links to individual, relational, and parenting outcome, however, some studies have also shown small to null effects (Lever Taylor et al., 2016). Because of this reality, caution should be used when planning mindfulness interventions aimed at alleviating negative outcome during the transition to parenthood. The measure of sexual mindfulness was introduced in the most recent wave of data collection and therefore limited our use of earlier data. As future waves of data are collected research can examine the longitudinal effects of mindfulness and sexual mindfulness in couples’ transition to parenthood. Additionally, the measure of mindfulness (MAAS, Brown & Ryan, 2003) is a unidimensional measure of mindfulness, which measure awareness only. Future research could employ more complex measures of mindfulness. We also asked participants to report on their trait mindfulness at the same time they we recalling how their pregnancy and delivery went. Although trait mindfulness is considered to be stable, absent an intervention (Himes et al., 2021), we suggest future studies examine the longitudinal associations as well as an intervention where mindfulness skills are taught and outcomes evaluated.

We also acknowledge that associations between mindfulness and individual and relational outcomes are not always large. This is likely, in part, due to our small sample size. Our data measured gender identity throughout, and we were unable to control for differences in experiences for cisgender versus non-cisgender individuals, and this is an area for future research. We did not have information on disability status.

Despite these limitations, this study is the first multifaceted examination of mindfulness during the transition to parenthood. We found that mindfulness is significantly associated with individual- and couple-level measures, signaling the need for more research examining mindfulness at this crucial transition. Mindfulness and sexual mindfulness are teachable concepts and may reduce a host of negative individual and couple outcomes such as depressive symptoms, stress of pregnancy and delivery, and parenting stress. Additionally, in this study mindfulness and sexual mindfulness enhanced couple outcomes such as relational and sexual satisfaction, parenting satisfaction, and attachment promoting behaviors. Programs aimed at supporting new parents could include a mindfulness unit that may benefit individual, couple, and parenting outcomes.

Supplemental Material

Supplemental Material - Mindfulness and individual, relational, and parental outcomes during the transition to parenthood

Supplemental Material for Mindfulness and individual, relational, and parental outcomes during the transition to parenthood by Chelom E Leavitt, Jocelyn S Wikle, Erin Kramer Holmes, Hayley Pierce, JB Eyring, Ashley Larsen Gibby, Alyssa L Brown and Virgina Leiter in Journal of Social and Personal Relationships

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Open research statement

As part of IARR’s encouragement of open research practices, the author(s) have provided the following information: This research was not pre-registered.

The data used in the research are available. The data can be obtained by emailing: chelom_leavitt@byu.edu. The materials used in the research are available. The materials can be obtained by emailing: chelom_leavitt@byu.edu.

ORCID iDs

Chelom E Leavitt

JB Eyring

Ashley Larsen Gibby

Supplemental material

Supplement material for this article is available in online.

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