Characteristics of stepfamilies and maternal mental health compared with non-stepfamilies in Japan
Sugimoto and Yokoyama Environmental Health and
Preventive Medicine
Characteristics of stepfamilies and maternal mental health compared with non-stepfamilies in Japan
Masako Sugimoto
Background: Stepfamilies remain poorly understood in Japanese society, and the support needs of stepfamily mothers are unclear. This study aimed to identify characteristics of stepfamilies and maternal mental health as compared with nonstepfamilies in Japan to utilize as a primary resource for providing effective support through community-based health care for stepfamilies. Methods: From December 2011 to July 2012, we conducted this questionnaire survey with mothers at 3- and 4-month checkups for infants. The response rate was 75.1%. The sample for analysis included responses of 2246 mothers, excluding single mothers. Results: Respondents comprised 47 (2.1%) stepfamilies and 2199 (97.9%) non-stepfamilies. There were significantly higher rates of parents with not more than a high school education and ?3 children among stepfamilies compared with non-stepfamilies. Stepfamily mothers had significantly higher rates of feeling a lack of economic resources, absence of participation in childbirth education classes, smoking during pregnancy, and unplanned pregnancy. Furthermore, they also had significantly higher rates of depression and a lack of confidence in the parent role. Maternal depression was associated with factors such as maternal age, self-perceived health, stress level, confidence in breastfeeding, confidence in the parent role, and number of children. Conclusions: These findings suggest that stepfamilies exhibit many characteristics related to social disadvantage and problems with community-based health care in Japan. Healthcare providers should be aware of stepfamily mothers' support needs and should put in place a support system for stepfamilies. Moreover, compared with non-stepfamily mothers, stepfamily mothers have a significantly higher prevalence of depression. However, stepfamily composition does not necessarily increase the risk of maternal depression. Therefore, healthcare providers should put in place a system for obtaining more thorough information about stepfamilies and conduct an early assessment to identify their support needs.
Stepfamily; Mother; Depression
Background
According to the Ministry of Health, Labour and Welfare
[
1
], Japan had 222,107 divorces, with an incidence rate of
1.77 per 1000 population. The divorce rate in Japan is still
lower than that in Western countries but has trended
upward since the 1990s. In addition, 58.4% of these divorces
involved dependent children. Whereas approximately
120,000 children experienced a parental divorce in 1975,
approximately 220,000 did so in 2014. Since the latter half
of the 1990s, every year more than 200,000 children
experienced a parental divorce in Japan [
1
]. Meanwhile, the
rate of remarriage has increased along with Japan?s
increasing divorce rate. In 1975, 12.7% of marriages involved
at least one partner who had been married previously
compared with 26.4% in 2014 [
1
]. Therefore,
approximately one out of every four new marriages is remarriages,
giving rise to various family forms, such as stepfamilies, as
seen in Japan today.
Ganong and Coleman broadly defined a stepfamily as a
family ?in which at least one of the adults has a child (or
children) from a previous relationship? [
2
]. However,
although many stepfamilies are formed after the
remarriage of one or both partners, that is not always the case
[
3
]. We must also emphasize that stepfamily membership
is not necessarily confined to those who are in the same
household [
2
]. In the USA, the stepfamily was actualized
socially after the 1970s when divorce and remarriage had
increased and stepfamily research drastically increased
after the 1980s [
2, 4, 5
]. In contrast, the stepfamily in
Japan has received little attention socially and
academically until recently [
6
]. However, stepfamily research in
Japan has increased since 2000. Several studies on
stepparents and biological parents have shown that difficulties
during the family formation process can easily occur in
stepfamilies, and particularly for stepmothers, who
experience higher stress levels [
5?8
]. These findings accord with
stepfamily research in Western societies [
9?11
]. In
addition, several studies have shown that residing in a
stepfamily is a risk factor for child abuse [
12, 13
].
Although these findings suggest the need to support
mothers in stepfamilies, Japanese society has a poor
understanding of the stepfamily, and even the need for
support is not yet recognized [
8
]. Furthermore, no clear
academic distinction has been drawn between stepfamilies
and non-stepfamilies (i.e., families with both biological
parents), and there are no population-based studies on
stepfamilies. As a result, the support needs of stepfamily
mothers remain unclear. Against this background, the
purpose of this study was (...truncated)