PRENATAL PARENT COACHING 1 Evaluation of a Prenatal Parent Coaching Program by Anna Belle Brown A proposal submitted in partial fulfillment of the requirements for the degree of MASTER OF EDUCATION with an emphasis in FAMILY LIFE EDUCATION WEBER STATE UNIVERSITY Ogden, Utah July 26, 2024 Approved C. Ryan Dunn, Ph.D. Mark Adams. Ph.D., LMFT Daniel Hubler, Ph.D., CFLE PRENATAL PARENT COACHING 2 Acknowledgments I would like to begin by extending gratitude towards the amazing faculty and staff at Weber State University. The incredible support and encouragement I have received throughout my educational career allowed me to learn and grow an incredible amount. The undergraduate faculty encouraged me to take on graduate school, and the graduate faculty supported me each step of the way, even as life threw curveballs. Specific faculty members I would like to thank include Dr. Dunn, Dr. Adams, and Dr. Hubler, who served as my committee members and offered me guidance through the process of writing this thesis paper and my graduate education. The study would not have been completed without the participation of the research participants, who not only allowed me to complete my project but also offered valuable insight into the program I have created. Their words of encouragement, suggestions for improvement, and praise for the project gave me the motivation to turn the contents of this paper into a real-life business that is now being offered to actual parents. Additionally, I would like to thank my amazing family for the words of encouragement, the prayers, and the environment of love and support that each person has created. They have all cheered me on as I attempted what felt impossible to complete, and offered any support they could provide. Their praise for each small accomplishment gave me the ability to keep going even when I thought I had nothing left. Finally, my husband, Josh, deserves the most thanks, as he has provided an invaluable amount of support, encouragement, dinners, video game breaks, and date nights. He did not bat an eye when I told him plans to not only attend graduate school but also to stop working outside the home and create my own business. His level of support is unmatched, and without him, my dreams would not be coming true. I could not have done any of this without him. PRENATAL PARENT COACHING 3 Abstract First-time parents embark on the journey of parenthood largely unprepared for what they will find ahead. A lack of adequate resources that prepare parents for addressing parenting habits they learned as early as their childhood, facing the social pressure to perform perfectly as a parent, managing expected and unexpected intense emotions as they traverse parenthood, and navigating the challenges of co-parenting with a partner leave parents surprised when issues like these come up, and unsure of how to handle them. Prenatal parent coaching programs that specifically focus on preparing first-time parents in these areas can effectively fill the supporting resource gap that currently face parents. PRENATAL PARENT COACHING 4 Table of Contents Literature Review.........................................................................................................................6 Roles of First-Time Parents..................................................................................................... 6 Emotions of Parents................................................................................................................ 7 The Influence of Childhood on Parenting Practices.................................................................7 The Couple Experience........................................................................................................... 8 Lack of Sufficient Preparation Supports................................................................................ 10 Need for Prenatal Parent Coaching Programs...................................................................... 11 Purpose...................................................................................................................................... 13 Methods...................................................................................................................................... 14 Production of Coaching Content............................................................................................14 Context.................................................................................................................................. 15 Procedures............................................................................................................................ 15 Selection of Participants........................................................................................................ 16 Evaluation.............................................................................................................................. 16 Findings......................................................................................................................................18 Common Themes in Feedback..............................................................................................18 Modifications Made to Program............................................................................................. 18 Limitations..................................................................................................................................18 Discussion..................................................................................................................................18 Future Research.................................................................................................................... 18 Conclusion................................................................................................................................. 18 References................................................................................................................................. 19 APPENDIX A...............................................................................................................................21 APPENDIX B...............................................................................................................................22 APPENDIX C...............................................................................................................................23 APPENDIX D...............................................................................................................................24 APPENDIX E............................................................................................................................... 25 APPENDIX F............................................................................................................................... 26 APPENDIX G...............................................................................................................................27 APPENDIX H...............................................................................................................................31 APPENDIX I................................................................................................................................ 35 PRENATAL PARENT COACHING 5 Evaluation of a Prenatal Parent Coaching Program First-time parents often find themselves with unanticipated barriers to the expected happiness and bliss of parenthood. With few supporting resources that adequately prepare first-time parents for challenges such as the several roles of parenthood (Dayton et al., 2016; Henshaw, et al., 2018; Melnick, 2014; Warren, 2020), the challenges of parenthood to the couple relationship (Brazelton & Sparrow, 2003; Dayton et al., 2016; Gestwicki, 2016; Henshaw et al., 2018; Lachmar et al., 2019; Melnick, 2014; Parfitt & Ayers, 2014; Warren, 2020), the deeply ingrained parenting patterns learned in their childhood (Brazelton & Sparrow, 2003; Dayton et al., 2016; Gestwicki, 2016; Melnick, 2014; Warren, 2020), and the feelings of low-confidence and guilt (Gestwicki, 2016; Henshaw et al., 2018; Parfitt & Ayers, 2014; Warren, 2020), many first-time parents are left unsure of what they are doing “right” or “wrong”, and struggling to find reliable information (Henshaw et al., 2018). Without reliable support that addresses these common challenges for first-time parents (Dayton et al., 2016; Henshaw, et al., 2018; Melnick, 2014; Warren, 2020), many first-time parents find themselves on a parenting journey that is drastically different than what they imagined (Brazelton & Sparrow, 2003). Prenatal parent coaching for first-time parents has the potential to fill the support gap, providing an opportunity to reflect on parenting experiences from their childhood, explore the normative changing of roles that occurs when a baby is born, and communicate plans to navigate the challenges of co-parenting. PRENATAL PARENT COACHING 6 Literature Review Roles of First-Time Parents The many roles a person plays change throughout the course of life. These roles often make demands on a person’s resources, such as time, energy, knowledge, and more. Adding the role of a parent to the list makes significant demands on a first-time parent’s resources, often leaving little room for other roles to be attended to. This can create significant stress for a first-time parent who was not adequately prepared for the role change to be so jarring, or who does not have the resources to appropriately cope with the change. Gestwicki (2016) described the parenting role as consisting of seven main roles: nurturer, individual, worker, consumer, community member, educator, and a member of adult relationships. These roles overlapped and influenced each other, rather than being individually isolated. When one role demands resources, it can stress the parent in the other roles. Further, parents often feel confidence in some roles, and fear or apprehension in others. Warren (2020) suggested that the way the parenting role, as a whole, is fulfilled has been passed down by previous generations (p. 235). With the world rapidly changing, parenting as it has been passed down is often insufficient for the modern needs of families and children. The world is drastically different than it was even one generation ago, with increased technology and media, increased demands on parents in multiple roles, more availability for remote work, and different expectations of parents regarding parenting, social life, career, and couple relationships. The perception of the parent regarding what parenthood is or is not, is influenced by the society and culture of the parent. Dayton et al. (2016) suggested that the parenting role is influenced by this perception of the parent. For example, fathers commonly view the fathering role as most important when their children are older, rather than earlier in the child’s life. Until PRENATAL PARENT COACHING 7 very recently, American society has not seen the father as a caretaker of very young children, and the fathers in the study may have been influenced by this. A first-time parent’s perception of what parenthood will be can leave them unprepared for the demands of parenting reality. Emotions of Parents Gestwicki (2016) described parenthood as an emotional experience, and the transition to parenthood comes with a wide array of emotions, both expected and unexpected. Often, parents look forward to experiencing feelings such as happiness, joy, satisfaction, and pride as they become parents. While these emotions are frequently a part of parenthood, parents often find themselves unprepared for other common emotions such as guilt, anger, unworthiness, low confidence, or loss (Gestwicki, 2016; Henshaw et al., 2018; Parfitt & Ayers, 2014; Warren, 2020). Mental health problems in pregnancy and postpartum can exacerbate these emotions, leading parents of any gender to experience anxiety or depression (Parfitt & Ayers, 2014). Emotions that conflict with societal parenting images can lead to a cycle of parents feeling unworthy and uncertain of their decision to become a parent, yet apprehensive about the irrevocability of the choice already made (Gestwicki, 2016). Parent’s legitimate love for their child is often overshadowed by worry about inability to perform to personal and social standards regarding the parenting experience. The Influence of the Parent’s Childhood on Parenting Practices Despite parents’ best intentions, the stress of parenting can often bring out the influence of their past experiences they may have wanted to avoid repeating. "We tend to act reflexively in ways we may consciously reject but which are deeply instilled in us as children" (Melnick, 2014, p. 139). Stressful situations can stretch parents to their limits, possibly leading them to engage in parenting behaviors that they may not normally endorse as appropriate (Melnick, 2014, p. 138). PRENATAL PARENT COACHING 8 Although the influence of childhood experiences is strong, parents are not slaves to their pasts. Recognizing the incredible influence that childhood experiences have on adults, Jacobson (2008) states “we cannot escape the patterns we experienced, but we can respond with intelligent awareness rather than knee-jerk reactions” (p. 93), suggesting that although it may be difficult, parents can be in control of the influence of their pasts. Gestwicki (2016) acknowledged that “adults tend to parent as they were parented” (p. 70), because children gather basic information about parenting by observing their parents as they grow up. This often serves as the only “training” people ever receive for parenthood (Gestwicki, 2016). Brazelton and Sparrow (2003) suggested that “parents should be aware of the influence of their own pasts” (p. 41), because parents rely on their own childhood to know how to parent (p. 42). Through their own childhood experiences, parents gain their parenting style (Melnick, 2014), and through reflection on these experiences, parents often decide to either repeat the parenting pattern with their own children or to parent differently, possibly in the opposite extreme (Brazelton & Sparrow, 2003, Dayton et al., 2016). The Couple Experience Couples often enter the parenting journey together, and the quality of their relationship affects their experience transitioning to parenthood (Lachmar et al., 2019; Parfitt & Ayers, 2014). In addition, the relationship of the couple encounters drastic changes once a baby enters the picture. To optimize the parenting experience, co-parenting couples need to be on the same page regarding their expectations of parenthood, values, ideas, and practice in parenting as they enter parenthood. The transition from couple-hood to parent-hood is, to some degree, seen by experts as a time of potential crisis in the relationship (Gestwicki, 2016). Couples must not only work to PRENATAL PARENT COACHING 9 maintain and grow their relationship but also answer to the demands of parenting, while effectively learning to co-parent, in addition to the other roles they may have such as employee, friend, hobbyist, etc. In a study done by Henshaw et al. (2018), many participating parents reported co-parenting “as involving great learning, negotiating, or communication efforts" (p. 1672). Co-parenting is a demand that is often overlooked until a couple is unable to do so effectively, and requires intervention to maintain, or obtain, a functional co-parenting practice. Parents often have different priorities, goals, and expectations regarding parenting (Melnick, 2014). Reconciling differences and learning to work as a parenting team can be a significant challenge to first-time parents, however, it is essential to the development of the child, the satisfaction in the parenting experience, and even potentially the length of time both parents are involved with the child. Henshaw et al. (2018) identified co-parenting as an area that needs support and information for parents, and Dayton et al. (2016) stated that early interventions offering support for co-parenting may also support continued involvement of the father, even if the parents’ relationship ends (p. 233). The transition to parenthood brings many changes to couples’ lives, potentially creating stress for the couple, but their relationship itself can give them support during the transition. Parfitt and Ayers (2014) stated that "the quality of the relationship between the mother and the father is one of the key contributors to the adjustment to parenthood, especially for first-time parents" (p. 265). Lachmar et al. (2019) described how the couple’s relationship can be a protective factor for parents with a strong relationship (p. 357). It is clear that the relationship of the couple before the baby arrives is an important area to support in order to protect the mental health and ease the transition into parenthood for first-time parents (Parfit & Ayers, 2014). PRENATAL PARENT COACHING 10 Support for first-time parents developing co-parenting skills should include education on communication strategies (Warren, 2020), discussions about the expectations of each partner at different stages of the transition to parenthood (Warren, 2020), as well as each parent’s past experiences and current ideas regarding parenting and discipline (Brazelton & Sparrow, 2003). Supportive resources for first-time parents that include these aspects may better prepare couples to parent together and to use their relationship strength as an internal resource during the transition. Lack of Sufficient Preparation Supports Parenting is a long-established experience, however, in recent decades it has undergone major change. Specifically, society, and its expectations of parents, have changed. Speaking of the social expectations of today’s fathers, Warren (2020) stated: "he is now expected to share in all of the pregnancy and newborn care responsibilities, but he has no generational or even common cultural references to support him in it" (p. 231). In the past, many first-time parents were able to use social references and memories of their own childhoods to serve as a sufficient guide to learn how to parent their own children. When this was not enough, first-time parents had the informal support of friends and family to help, as well as formal support such as community resources. These supports are no longer available in the same capacity today. The supports that are available to first-time parents today often fail to meet the needs of modern parenting. The pace of the ever-changing world has created an environment for children that today’s parents cannot relate to. Gestwicki (2016) suggested that, because the childhood experiences of today are so different from that of past generations, memories of what parents’ parents did will likely not serve them well. Parents are also unable to rely on the common informal support of the past. Melnick (2014) stated that “parents can no longer rely on the geographic proximity and PRENATAL PARENT COACHING 11 psychological closeness of natural supports such as family, religious institutions, or long-term friends” (p. 141), which means that a well-used resource of the past is no longer sufficient for modern parents. The rapid change in expectations and demands on parents has resulted in generational or cultural references being insufficient to guide new parents today (Warren, 2020, p. 1). Melnick (2014) suggested that currently available support for first-time parents specifically lacks a focus on the development of skills that parents need. These skills include recognizing the strengths of one's parenting style, appreciating one's own parenting style and values, taking responsibility for the influence of one’s parenting, and establishing consistent and predictable parenting behaviors (p. 134). Without support that prepares first-time parents with these skills, parents often feel inadequate to parent in a way that meets their expectations. Need for Prenatal Parent Coaching Programs With a lack of appropriate support to address modern first-time parenting challenges, there is a need for intervention that empowers parents and prepares them for the unexpected aspects of parenting in today’s world. Prenatal parent coaching has the potential to address the needs of today’s first-time parents by providing guidance through managing roles as a parent, expectations of emotion during the transition to parenthood, a plan to take responsibility for the influence of one’s childhood and communicating expectations of co-parenting and the couple role. Lachmar et al. (2019) stated that traditional interventions for the transition to parenthood have “used group psycho-education or couple therapy formats" (p. 358). This format can be helpful and effective, but Lachmar et al. (2019) acknowledged that they require awareness, access, time, and motivation to attend which many parents do not have. Interventions need to be PRENATAL PARENT COACHING 12 accessible to parents with limited resources to be effectively used. Prenatal parent coaching can be accessible by offering information in an online format, with flexible scheduling, allowing parents to access support from the comfort of their home, at times that work for them. Dougherty (1995) suggested a five-level hierarchy of involvement in parent and family education. As the levels increase, so does the level of involvement. According to his description of each level (1995), parent coaching would fall in level three: Feelings and Support. This level involves the capacity to explore the thoughts and feelings of parents, without delving too deeply into psychological distress that would be better served by a qualified therapist. Parent coaching would allow parents a space to explore their expectations of parenthood, feelings about their childhood, and how these feelings impact their current parenting expectations, and facilitate discussion of these feelings and expectations between couples. It will not, however, treat severe trauma from parents’ childhood experiences as therapy would (Dougherty, 1995). Parent coaching can guide parents through the feelings that influence their actions, and take control of them, to create a better experience for parent and child together. Dayton et al. (2016) suggested that pregnancy may be the ideal time for parenting intervention. Pregnancy is the time during which the parent-child relationship begins to develop (Dayton et al., 2010), and is when early parenting behaviors begin to develop (Dayton et al., 2010; Zvara et al., 2013). Parent coaching can be offered as a preventative prenatal intervention to support parents in developing healthy parenting and co-parenting behaviors during the ideal intervention time frame, rather than a reactive postnatal intervention to address parenting problems. Melnick (2014) suggested that "knowing what we desire our parenting style to be helps to safeguard against our revisiting or recreating past, ineffective ways of parenting" (p. 139). PRENATAL PARENT COACHING 13 Prenatal parent coaching can give first-time parents the opportunity to plan for their parenting, rather than parent reactively. The coaching experience may also help parents understand and prepare for the normal difficulties that come with first-time parenting (Lachmar et al., 2019), rather than relying on the stereotypical image of perfect parenthood. Coaching offers a level of intervention that can allow parents to reflect on their childhood experiences and their influence on their emerging parenting, an opportunity that is inadequate in other interventions (Melnick, 2014). Coaching also offers fathers a chance to receive socially appropriate support in their roles and may increase their understanding of the importance of their role in early parenting (Dayton et al., 2016). Coaching is a strengths-based approach (Melnick, 2014), empowering parents to build on what they already have. This empowerment can help defend parents against feelings of overwhelm or inadequacy, as they will be supported in identifying what they do well rather than what they lack. Coaching can also help parents build skills (Melnick, 2014) that will support their parenting over time, rather than trying to retroactively solve a problem. Purpose Since first-time parenthood is an experience many parents find they are not adequately prepared for, and existing support does not sufficiently address this lack of preparation, a supportive, educational program for first-time parents is needed to help them prepare for parenthood. This program needs to help parents build parenting skills (Melnick, 2014), taking a preventative approach rather than a reparative approach. A coaching program is well suited to present information to parents, and then give the opportunity for parents to apply the information in their daily lives with practice and guidance, building parenting skills. PRENATAL PARENT COACHING 14 The purpose of this quality improvement project is to gain the feedback from several vantage points in the community that are related to first-time parenthood on the content of the parent coaching program that was designed to support first-time parents in their transition to parenthood. The objectives guiding this project are: ● Prepare a quality, evidence-based parenting resource for first-time parents ● Parents participating in the program will learn the definition and the merits of intentional parenting ● Parents participating in the program will practice self-reflection regarding their childhood experiences ● Parents participating in the program will gain and practice skills related to co-parenting ● Gather the feedback of key community members regarding the content of a parent coaching program Methods Production of Coaching Content This program was designed after spending time with families in the early childhood education setting and hearing many parents say something similar to “I wish I knew how to work with my child like you do”. Throughout my career, I have freely shared tips and techniques to make everyday life easier for both parent and child, but this is often not enough for families. I have long had the desire to address the lack of parenting skills that many families in my classrooms crave in a more comprehensive way, so I began studying the topic of parenting PRENATAL PARENT COACHING 15 education for my thesis project. Through study and increased understanding of parenting, a prenatal parent coaching course was developed for first-time parents. Content for the course was created using the themes of identified needed support for first-time parents derived from the literature review. A total of three coaching sessions were created, addressing the topics of the pressure of perfect parenting, the influence of childhood on parenting, and coparenting. In the future, more sessions will be developed based on continuing research and feedback from clients and other family life education professionals. The coaching course will be implemented in the community by a for-profit business. Sessions will be divided by topic, and clients will choose if they would like to purchase a package including sessions covering all topics, or individual sessions covering one topic. Each session will be one hour in length, conducted by the researcher. The content of each session will include research-based parent education, private discussion time, reflection time, and an assigned homework activity. Context The content of the coaching sessions is based on current parenting research, and incorporates easily digestible parenting education. The content is adaptable to individual parent’s needs, however the focus of the content is to guide parents to a focus on intentional parenting, an understanding of the influence from their childhoods, and a plan to co-parent with a partner. The target population of the coaching program is first-time parents, as their inexperience in parenting offers an opportunity to build parenting skills rather than change already developed parenting habits. Procedures For the completion of this thesis project, the following was completed: PRENATAL PARENT COACHING 16 ● Three coaching sessions were created based on research surrounding the pressure to be a perfect parent, the influence of childhood on parenting, and co-parenting. ● The details of the coaching sessions were typed up, including a guiding script, an outline of the session goals and agendas, and a powerpoint presentation. ● The coaching sessions were presented to key members of the community, including a labor and delivery nurse, a pair of expecting, first-time parents, and a pair of first-time parents of an infant, and feedback was gathered about the value of the content for future clients. Selection of Participants Feedback on the content of the coaching sessions were solicited from a labor and delivery nurse, a couple expecting their first baby, and first-time parents of an infant. The labor and delivery nurse can provide the perspective of professionals who work with first-time parents daily, while the expecting first-time parents can provide the perspective of what parents may anticipate they will need to know for parenting, and first-time parents of an infant can provide the perspective of what parents may wish they had known going into parenthood. Combined, all three vantage points provided valuable feedback that informed the adaptation of the coaching content to be more comprehensive and well-rounded. Evaluation In order to collect feedback from different vantage points, feedback forms have been tailored to solicit specific information from each community member. Each form includes five questions regarding the content of the coaching program. The forms are listed below: Feedback was gathered from a labor and delivery nurse about how the coaching content meets the needs of first-time parents from a medical perspective. The questions are listed below. PRENATAL PARENT COACHING 17 Labor and Delivery Nurse Feedback Form: 1. In your field of practice, what needs do you notice are the greatest among first-time parents? 2. In what ways does the content of the coaching program address those needs? 3. In what ways does the content of the coaching program fail to address those needs? 4. Would you recommend this coaching program to first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? Feedback was gathered from a couple expecting their first child about how the coaching content meets their anticipated needs as first-time parents. The questions are listed below. Expecting First-Time Parents Feedback Form: 1. In what ways do you feel most unprepared for parenthood? 2. In what ways does the content of the coaching program help you feel more prepared for parenthood? 3. In what ways does the content of the coaching program fail to help you feel more prepared for parenthood? 4. Would you recommend this coaching program to other expecting first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? Feedback was gathered from a first-time parenting couple of an infant about how the coaching content meets their actual needs as first-time parents. The questions are listed below. Infant First-Time Parents Feedback Form: PRENATAL PARENT COACHING 18 1. In what ways were you most unprepared for parenthood? 2. In what ways would the content of the coaching program have helped you prepare for parenthood? 3. In what ways would the content of the coaching program have failed to help you prepare for parenthood? 4. Would you recommend this coaching program to expecting first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? Findings Common Themes in Feedback The feedback provided by the participants was overwhelmingly positive. When asked if they would recommend this program to first-time parents, all five participants responded positively with comments such as “it gets them discussing how they want to parent their children with each other”, and “it sets clear expectations about how it feels to be a new parent and what you can plan for emotionally and mentally”. Additionally, one participant mentioned in another comment that they felt more prepared for parenthood after participating in the program because they learned that perfection is not expected. With these comments, it is determined that the goals of each session of the program were met. Four of the five participants mentioned in their feedback that being prompted to have discussions with their partners about parenting goals was helpful or would have been helpful, in preparing for parenthood. The discussion was a large component of the content of the program, with partners receiving ample time throughout to discuss prompts related to the topic of each session. Participants were also encouraged to continue discussions beyond the program. According to the feedback, this discussion time was helpful for participants. PRENATAL PARENT COACHING 19 Four of the five parents mentioned an element of “not knowing” in regard to feeling unprepared for parenthood before their baby was born, which was addressed in some way by the content of the program. The content of the program emphasized an active approach to creating flexible plans for approaching the unknowns of parenthood and was lauded by participants as being helpful by giving “clear expectations” and providing a “starting point” whereas before, they did not know where to start. These plans were encouraged to be flexible, as they would need to adapt and change over time. Only two out of five participants left comments regarding suggestions for improvement. This feedback included recommendations that the program be completed in a format other than a group setting to provide for adequate discussion time and more specific guidance throughout the discussions. Also recommended were more specific recommendations on what to discuss or practice during activities, which could also be addressed by changing the format of the program. Modifications Made to Program After presenting the program to a live audience, adjustments were made to the time expectations of each session. Sessions are now advertised as taking “up to” one hour per one-on-one session, but often take less time, as they did in the presentation to participants. This change in wording regarding the expectation of the time commitment for sessions can be helpful for parents who need to know how long to block out their schedules to commit to the session. In addition, the format of the program has changed to an online course, which can be self-paced and allow for as much discussion time as needed by the couple or individual. This is in response to feedback from one participant who mentioned that she and her husband could have had much longer conversations but did not want to hold the group up. The online course PRENATAL PARENT COACHING 20 also allows for more specific directions and suggestions for participants, which was requested by two participants. Limitations It was not within the scope of this project to include a representative sample of participants, and thus the generalizability of this data is incredibly limited. The generalizability of the data is further limited by the participant sample being universally of the same race, general geographical location, socioeconomic status, and religious background. It would not be appropriate to attempt to generalize findings beyond the American culture and viewpoint without further research of a larger scope to offer more insight. Each of the participants was a personal acquaintance of the researcher which, while appropriate for this particular project, limits the reliability of the data collected. Discussion Future Research Future studies conducted should include a broader representation of participants, to increase the validity of data collected and make it more generalizable to the general population. In addition, it would benefit future studies to include input from professionals of other disciplines such as child and family therapy, early childhood education, pediatrics, and more. Future studies should be structured as randomized controlled trials with some participants receiving the intervention and participants not receiving intervention to give the best data on the effectiveness of the intervention. Conclusion Many first-time parents find themselves faced with unexpected challenges in parenthood. Few supporting resources to adequately prepare first-time parents for challenges such as the PRENATAL PARENT COACHING 21 several roles of parenthood (Dayton et al., 2016; Henshaw, et al., 2018; Melnick, 2014; Warren, 2020), the challenges of parenthood to the couple relationship (Brazelton & Sparrow, 2003; Dayton et al., 2016; Gestwicki, 2016; Henshaw et al., 2018; Lachmar et al., 2019; Melnick, 2014; Parfitt & Ayers, 2014; Warren, 2020), the deeply ingrained parenting patterns learned in their childhood (Brazelton & Sparrow, 2003; Dayton et al., 2016; Gestwicki, 2016; Melnick, 2014; Warren, 2020), and the feelings of low-confidence and guilt (Gestwicki, 2016; Henshaw et al., 2018; Parfitt & Ayers, 2014; Warren, 2020), are available for first-time parents. Many first-time parents are left unable to accurately measure the quality of their parenting and fear they are doing things wrong, while also struggling to find reliable information to address their fears (Henshaw et al., 2018). Countless first-time parents find parenting different than what they imagined (Brazelton & Sparrow, 2003), at least partially due to a lack of reliable supporting resources that prepare first-time parents on what to expect in parenthood (Dayton et al., 2016; Henshaw, et al., 2018; Melnick, 2014; Warren, 2020). The prenatal parent coaching program that was explored and discussed throughout this paper offers first-time parents a unique opportunity to discuss with their partner or reflect individually, on their expectations for parenthood, their own childhood experiences and potential impact on their parenting, and the societal pressure to parent perfectly. 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Journal of Creativity in Mental Health, 14(2), 138-151. https://doi.org/10.1080/15401383.2019.1566040 Smith, S., & Hamon, R., (2021). Exploring Family Theories (5th ed). Oxford University Press. Warren, J. (2020). Supporting men in their transition to fatherhood. Journal of prenatal & Perinatal Psychology and Health, 34(3), 230-237. Zvara, B. J., Schoppe-Sullivan, S. J., & Dush, C. K. (2013). Fathers’ involvement in child health care: Associations with prenatal involvement, parents’ beliefs, and maternal gatekeeping. Family Relations, 62, 649-661. https://doi.org/10.1111/fare.12023 PRENATAL PARENT COACHING 24 APPENDIX A PRENATAL PARENT COACHING 25 APPENDIX B PRENATAL PARENT COACHING 26 APPENDIX C PRENATAL PARENT COACHING 27 APPENDIX D Labor and Delivery Nurse Feedback Form: 1. In your field of practice, what needs do you notice are the greatest among first-time parents? 2. In what ways does the content of the coaching program address those needs? 3. In what ways does the content of the coaching program fail to address those needs? 4. Would you recommend this coaching program to first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? PRENATAL PARENT COACHING 28 APPENDIX E Expecting First-Time Parents Feedback Form: 1. In what ways do you feel most unprepared for parenthood? 2. In what ways does the content of the coaching program help you feel more prepared for parenthood? 3. In what ways does the content of the coaching program fail to help you feel more prepared for parenthood? 4. Would you recommend this coaching program to other expecting first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? PRENATAL PARENT COACHING 29 APPENDIX F Infant First-Time Parents Feedback Form: 1. In what ways were you most unprepared for parenthood? 2. In what ways would the content of the coaching program have helped you prepare for parenthood? 3. In what ways would the content of the coaching program have failed to help you prepare for parenthood? 4. Would you recommend this coaching program to expecting first-time parents? Why? 5. What other comments regarding the content of the coaching program do you have? PRENATAL PARENT COACHING 30 APPENDIX G Session 1 Session 1 Topic: The Pressure of Perfect Parenting Session 1 Goals ● Clients understand the difference between perfect parenting and intentional parenting. Session 1 Agenda ● Introduction: ○ “Thanks for joining me for this session today. The topic for this session is The Pressure of Perfect Parenting. We will look at the difference between perfect parenting and intentional parenting, find out what exactly that looks like for you, and come up with an action plan for when you mess up as a parent”. ● Presentation: Presenter shares definitions and examples of perfect parenting and intentional parenting (5 minutes) ○ “Here are the definitions of perfect parenting and intentional parenting. To be perfect is to be free of any faults, or to be as good as it is possible to be. Therefore, perfect parenting is parenting that is free of any mistakes.” ○ “To be intentional is to do things on purpose, deliberately, or with intent. Intentional parenting is parenting deliberately, with intent to be the best you can be at the moment. In reality, there is no such thing as perfect parenting, so intentional parenting is what we strive for”. ● Activity: Clients will write on a piece of paper a description of themselves as a perfect parent (5 minutes) PRENATAL PARENT COACHING 31 ○ “Please take a second to write a short description of yourself as a perfect parent. What things do you do and say? How do you react to stressful situations? What do you do when you make a mistake? Be detailed!” ○ We will discuss how this is unrealistic and unachievable. (5-10 minutes) ○ “It may seem noble to strive to be the parent you wrote about, but really it is impossible. It is unfair to you (and your children!) to have an impossible expectation of yourself. In what ways does your description seem unrealistic?” ○ To drive home the idea that this is not the expectation, clients will be asked to destroy (crumple and throw away, rip up, etc) the paper. (5 minutes) ○ “Since this is an unrealistic expectation of ourselves, we won’t be needing this description any more. Let’s get the idea of perfectionism out of our heads. Let’s destroy the paper to show yourself that you will not be placing such an unrealistic burden on yourself”. ● Activity: Clients will then write on another piece of paper a description of themselves as an intentional parent (5 minutes) ○ “Let’s do this again, but this time write a description of yourself as an intentional parent. What do you do and say? How do you say it? What do you do when you make a mistake (because you will!)? How do you respond when your child throws a tantrum?” ○ We will discuss how with intentional parenting, mistakes are allowed but the goal is still to strive to be our best. (5-10 minutes) ○ “Mistakes are made during parenting, there is no way around it. What really matters, for both you and your child, is how you handle the mistakes when they PRENATAL PARENT COACHING 32 happen. You can use words like “I didn’t mean to yell at you. I felt very frustrated at the time, but I’m not proud of yelling. Can I try again?” Intentional parenting is all about being authentic but deliberate in how you parent. Intentional parenting not only takes the burden of perfectionism off of you, but it also has built in opportunities to teach our children how to handle life when mistakes are made, whether by them or by someone else.” ● Presentation: Presenter will show a slide about a plan of forgiveness for not being perfect (2-5 minutes) ○ “It’s true that our world is full of the expectation to be a perfect parent. Try as we might, we can’t get the idea of perfectionism completely out of our heads. So to guard against the feelings of guilt, depression and hopelessness that may occur when you inevitably find that you are an imperfect parent, we are going to make a plan for responding to mistakes. An example of a plan you could use is to take steps like reading your description of yourself as an intentional parent, repeating to yourself “I don’t have to be perfect” or “I’m doing the best I can with what I have”. You could also take a break from social media if that is the source of the problem. Identifying another adult to confide in can also help, and then when those feelings arise, reach out for support.” ● Activity: Clients will be asked to add to their description a plan of forgiveness for themselves when they are not the “perfect parent”. (Can also be done as homework assignment if time does not allow) (5 minutes) PRENATAL PARENT COACHING 33 ○ “Take a second to add to your description of you as an intentional parent a plan of forgiveness for yourself for when you mess up. Use what would work for you individually, not what you think I want to see”. ● Homework: Clients will be asked to post the description of themselves as intentional parents somewhere meaningful to them (journal, mirror, fridge, etc) as a homework assignment.. (5 minutes) ○ “Now that you have gone through the work of writing all this down, think of a place where you can post it that will remind you of the parent you want to be. It can be a mirror, the fridge, your car, anywhere that you see often and is meaningful to you”. Materials Needed for Session 1 ● Computer (both) ● Access to Zoom (both) ● Powerpoint (presenter) ● Journal (client) ● Writing Utensil (client) ● Client file to record expectations (presenter) ● Google forms version of the pre-test (presenter) ● Tape, a push-pin, or something else to post a paper (client) PRENATAL PARENT COACHING 34 APPENDIX H Session 2 Session 2 Topic: The Influence of Your Childhood Session 2 Goals ● Parents will discuss or journal prominent memories from their childhood(s). ● Parents will discuss or journal similarities and differences in how they want to parent. ● Parents will decide on one action they can take to parent how they would like to. Session 2 Agenda ● Introduction: ○ “Thanks for joining me for this session today. The topic for this session is The Influence of Your Childhood, and we will primarily ponder your memories of your childhood, discuss how you want to parent, and we will come up with an action plan to be the parent you want to be. Please remember that this will not serve as a therapeutic intervention, but instead give you the opportunity to reflect on your own experiences”. ● Presentation: Use Powerpoint to present information about reflecting on your childhood emotions, and what that means for you now. (5 minutes) ○ “Here are a couple of quotes from experts that explain why it is critical that parents look at their childhood experiences as they prepare to parent their own children. T. Berry Brazelton is a pediatrician who wrote several books on parenting topics. Tamar Jacobson has a PhD in early childhood education. As we prepare to ponder your childhood experiences, what do you think you will gain?” PRENATAL PARENT COACHING 35 ● Activity: Privately, either as a couple or an individual, clients will discuss prominent memories of their childhood(s). If the client is an individual, ask them to journal to reflect. If clients are a couple, use a breakout room to maintain privacy. (5 minutes) ○ “Take a few moments to think back and discuss the most readily available memories of your childhood(s). Think of things like: How did your parents respond when you were angry? How did your parents respond when you voiced your opinion? How did your parents show you love? Discuss (or journal) what comes to mind,” ○ *This discussion may require more than 5 minutes, depending on the client. ○ Use the message feature of Zoom to give a 2 minute wrap-up warning in breakout rooms, and ask if more time is needed. ● Activity: Again, privately, either as a couple or individual, clients will discuss and decide if they want to parent similarly or differently, or a mix of both. (5 minutes) ○ Clients will then each describe, in writing, specifically how they want to parent. This should include specific actions. ○ *If the client uses negative actions like “I will never spank my child”, help them come up with a positive action like “when my child does something I’ve asked them not to, I will explain why I can’t let them do that”. ○ If the client is an individual, ask them to journal to reflect. If clients are a couple, use a breakout room to maintain privacy as they write and discuss. ■ “Take a few moments to decide how you will parent. Write down, in detail, specific parenting actions you will take. For example, you could decide PRENATAL PARENT COACHING 36 that as a parent, you will kiss your child and say I love you every night at bedtime”. ■ *This activity may require more than 5 minutes, depending on the client. ■ Use the message feature of Zoom in breakout rooms to give a 2 minute wrap-up warning in breakout rooms, and ask if more time is needed. ● Transition (1 minute) ○ “I hope that activity was insightful for you. Now that we have the beginnings of an action plan for how you will parent, we need to make specific plans to make that a reality.” ● Activity: Privately, as a couple or an individual, clients will choose and write down one of their parenting actions to practice. (5 minutes) ○ “Take a moment to pick one specific action from your list that you will practice” ○ Use a breakout room and journal, and give a 1 minute warning using the chat feature in Zoom. ● Discussion of the action item they chose (5 minutes) ○ “Welcome back. What specific item did you discuss and choose to practice?” ○ “You may have to get creative with practicing this action before your child is born. If we use the example from earlier, kissing your child and saying I love you every night at bedtime, some ways you can practice this before your child is born is to blow a kiss and say I love you to the belly bump, or to write a quick journal entry to your child saying you love them even though they aren’t born yet” ● Assign homework: Clients will practice their chosen action and journal about the practice. (5 minutes). PRENATAL PARENT COACHING 37 ○ “Please take the opportunity to practice this action item in your daily life, and journal about it. It’s ok if you end up having to change the action over time or even if you change your mind and that is no longer something you want to do”. ○ “The actions you need/want to take will likely change over time as you settle into parenthood, as your child grows, and as living situations change. This is ok! Your ideal parenting may even change over time, and that’s ok too. We have to start somewhere, and adaptation over time is healthy”. ○ “Practicing the action before your child is born builds the habit of doing it. This will make it easier to do the action even when you are tired or overwhelmed”. ● Presenter will share additional resources slide that has pictures of the books referenced in the presentation (1 minute) ○ “Here are the covers of the books I referenced today. These are fantastic resources that have great information for parents, and can help you dive deeper into exploring the effect of your childhood on your parenting. The exploration into your past should be a lifelong process, rather than a single coaching session, and these books might be able to support you on that journey”. Materials Needed for Session 2 ● Computer (both) ● Access to Zoom (both) ● Journal (client) ● Writing Utensil (client) ● Client file to record notes (presenter) ● Powerpoint (presenter) PRENATAL PARENT COACHING 38 APPENDIX I Session 3 Session 3 Topic: The Challenge of Co-parenting Session 3 Goals ● Coupled clients will discuss their expectations of each partner regarding parenthood ● Coupled clients will discuss how they will be united in parenting Session 3 Agenda ● Introduction: (1 minute) ○ “Thanks for joining me for this session today. The topic for this session is The Challenge of Co-parenting, and we will primarily discuss the expectations that each of you have regarding each other and parenting, and we will come up with an action plan for how you will be united in your parenting”. ● Activity: Clients will individually journal about their expectations for themselves and their partner in parenting. (5 minutes) ○ “Let’s take a few minutes to write individually your expectations for yourself and for your partner after the baby is born. For example, who do you expect will be getting up at night with your baby? Will this be negotiable at all? Who do you expect to arrange and attend Dr. appointments?” ● Discussion: Privately, clients will discuss what they have written. Use a breakout room to maintain privacy. (5 minutes) ○ “Take a few moments to discuss what you’ve written. You may disagree on some things: this session is laying the foundation for an ongoing discussion to come to PRENATAL PARENT COACHING 39 an agreement. That may or may not happen in the next 15 minutes, but whatever happens, please be respectful to your partner. Hear what they have to say, and remember that you are a team working together to find what is best for your family, rather than enemies trying to get your way”. ○ *This discussion may require more than 5 minutes, depending on the client. ○ Use the message feature of Zoom to give a 2 minute wrap-up warning in breakout rooms, and ask if more time is needed. ● Presentation: Presenter shares insights from Brazelton on unified parenting (10 minutes) ○ “T. Berry Brazelton, author and pediatrician, talks in his book Discipline: The Brazelton Way about the importance of parenting in unity”. ○ Share quote ○ “It can be difficult to sacrifice parts of our views on parenting topics, but it’s important to remember the huge benefit to your family if you parent as a united front. This does NOT mean that you cannot disagree on parenting sometimes, but remember in front of your children you need to be a team. If you disagree with a way your spouse is parenting, discuss it in private, not in front of your kids”. ○ “Thinking from a child’s point of view, how can having unified parents be beneficial to the family?” ● Activity: Privately, coupled clients will discuss and write down specific actions they will take to parent in unity. (5 minutes) ○ “Take a few minutes together to discuss and write down specific actions you will take to parent in unity. For example, you could say “when my partner disciplines PRENATAL PARENT COACHING 40 in a way I disagree with, I will discuss my concerns with them privately, but be united with them in front of the children”. ● Assign homework: Coupled clients will be asked to continue the discussion of their expectations. (5 minutes) ○ “For homework, I’d like to ask you to continue the discussion of your expectations. These conversations help get you on the same page as parents from the beginning, rather than figuring it out as you go. It can also help reduce frustration, since you can better understand the expectations of your partner. It’s ok if you don’t have a plan for everything mapped out, because as you practice having these conversations, it will be easier to adjust in real life. Brazelton shared in his book some examples of things parents should be united on: chores, allowance, bedtime and bedtime ritual, between-meal snacks, hitting and fighting, and rules regarding TV. If you find continued discussion hard, you can pick one of these topics to talk about together”. ● Presenter will share additional resources slide that has pictures of the books referenced in the presentation (1 minute) ○ “Here is the cover of the book I referenced today. It is a fantastic resource that has great information for parents, and has suggestions on discipline that are incredibly useful”. Materials Needed for Session 3 ● Computer (both) ● Access to Zoom (both) ● Journal (clients) PRENATAL PARENT COACHING 41 ● Writing Utensil (clients) ● Client file to record notes (presenter) ● Powerpoint (presenter)