The impact of husband involvement in pregnancy and childbirth on maternal wellbeing : a study in west Java province, Indonesia

Abstract

Husband’s involvement in maternal health care has been claimed to contribute to maternal health outcomes. However, the results from previous investigations on the impacts of expected husband roles on physical and psychosocial wellbeing of mothers are not conclusive, due to different definitions and measurements across studies. By considering husband’s involvement in maternal healthcare as a whole process of support, this study was aimed to develop a specific tool to identify and measure multidimensional aspects of husband’s involvement in pregnancy and childbirth, and to examine the extent to which the involvement would contribute to maternal wellbeing. A survey was carried out among 336 two-to-six-week postpartum mothers who received maternal care in 27 midwives’ independent clinics in seven regions of West Java Province, Indonesia. The measurement models of husband involvement comprising of four dimensions which are maternity care engagement, instrumental support, emotional support and informational support were validated using confirmatory factor analysis. A structural equation model was identified to operationalize the relationship among postpartum mother’s and husband’s characteristics, spousal relationship, husband involvement, maternal health behavior, physical wellbeing and emotional wellbeing. The study findings revealed significant associations between spousal relationship and the four dimensions of husband’s involvement. Emotional support from husband and number of children were found to have significant associations with maternal emotional wellbeing while maternity care engagement was found to have indirect effect on maternal emotional wellbeing through maternal health behavior. This model explained 14 percent of the variance in maternal emotional wellbeing. However, no significant predictor for maternal physical wellbeing was found. The study results indicate a necessity to include husband’s involvement in maternal healthcare in order to promote maternal health. In future research, maternal physical wellbeing could be differently operationalized to represent bodily symptoms rather than clinical outcomes to capture the direct effects of support on the overall maternal health.