Sex Roles (2017) 76:290–305
DOI 10.1007/s11199-016-0629-7
ORIGINAL ARTICLE
Postpartum Depression in Mothers and Fathers: The Role
of Parenting Efficacy Expectations During the Transition
to Parenthood
Christi L. Gross 1 & Kristen Marcussen 1
Published online: 13 May 2016
# Springer Science+Business Media New York 2016
Abstract Research demonstrates that belief in one’s effec-
tiveness as a parent (parenting efficacy) is linked to numerous
positive outcomes for new parents. Conversely, the perceived
inability to meet expectations is associated with negative men-
tal health consequences for mothers and fathers. In the present
paper we examine the impact of parenting efficacy expecta-
tions on the mental health statuses of new parents. Using three
waves of data spanning from the prenatal period to the 4-
months postpartum period from a sample of 150 first-time
mothers and fathers in the Midwestern United States, we find
that parenting efficacy is negatively associated with postpar-
tum depression (PPD) for both mothers and fathers throughout
the transition period. We also find that mothers and fathers
whose parenting efficacy experiences were more negative
than expected reported higher levels of PPD at 1-month post-
partum. This effect dissipates for mothers, but not fathers, by
4-months postpartum, suggesting differences in the experi-
ences of mothers and fathers during this transition. We con-
clude that research on the transition to parenthood should
continue to include fathers in an effort to better understand
the mental health consequences of becoming a parent for the
first time, as well as enhance interventions designed to assist
couples experiencing this important transition.
Keywords Transition to parenthood . Parenting efficacy .
Unmet expectations . Postpartum depression
* Christi L. Gross
cgross9@kent.edu
1
Department of Sociology, Kent State University, P.O. Box 5190, 215
Merrill Hall, Kent, OH 44242, USA
Despite some inconsistency in the literature concerning the
mental health implications of parenthood throughout the life
course, researchers typically agree that the transition to parent-
hood can be a challenging and stressful period for most indi-
viduals (Doss et al. 2014). For example, in research conducted
in the United States (as are all studies reviewed here unless
otherwise stated), Cowan and Cowan (1995, p. 412) concep-
tualize this transitional period as one in which Bnew challenges
can outstrip existing resources, trigger new problems, or am-
plify pre-existing vulnerabilities and inadequacies.^ Indeed,
the relationship between parenthood and marital disruption is
often attributed to the transition period (Cowan et al. 1985;
White and Booth 1985). More recent examinations of parent-
hood have focused on the context and timing of the parenthood
transition in an effort to understand how becoming a parent can
serve as either a source of well-being or a source of long-term
strain for different individuals (Carlson and Williams 2011;
Umberson et al. 2010). Some of this work has brought atten-
tion to the role that expectations play regarding parenthood. In
particular, expectations about how one will perform as a par-
ent, or parenting efficacy expectations, have been linked to
adjustment and well-being of new parents (Biehle and
Mickelson 2011b; Porter and Hsu 2003).
In the present paper, we draw on self-efficacy theory
(Bandura 1977, 1981, 1986) to explore the transition to par-
enthood among primiparous (i.e., first-time) parents in the
United States, focusing on the role that parenting expectations
play in understanding the mental health consequences of this
important transition. The link between parenting efficacy and
postpartum depression (PPD) has been shown to have impli-
cations on mothers’ sense of competence as a parent, as well
as child outcomes (Coleman and Karraker 2003; Cutrona and
Troutman 1986; Teti et al. 1996). Although most studies that
examine the link between parenting efficacy and mental health
have focused primarily on mothers (for exceptions see Biehle
Sex Roles (2017) 76:290–305
and Mickelson 2011a, b), there is a burgeoning literature on
the transition to fatherhood that shows the importance of un-
derstanding these processes for men (Doss et al. 2009;
Knoester and Eggebeen 2006). A primary contribution of
our research is that we include consideration to the experi-
ences of first-time fathers in addition to mothers; this inclusion
is important because research suggests that the experiences of
mothers and fathers may differ during this critical transitional
period (Cowan et al. 1985). Further, we use three waves of
data to examine the relationship between parenting efficacy
and parental mental health, allowing us to focus on the extent
to which efficacy expectations prior to birth are met at 1-
month and 4-months postpartum for men and women and
the extent to which differences between prenatal expectations
and postpartum experiences contribute to depression in the
postpartum period for new parents.
Our paper has three specific aims. Our first aim is to use
social psychological theory to advance a mechanism (parent-
ing efficacy) that can add to our current understanding of
variation in PPD across the transition period. Our second
aim is to examine the extent to which changes in efficacy,
focusing on a comparison of prenatal expectations and post-
partum experiences, further explain differences in PPD. Our
final and overarching goal is to contribute to the conversation
regarding paternal PPD by examining these processes concur-
rently for first-time mothers and fathers. Although studies ex-
amining fathers are on the rise, we do not know nearly as
much about paternal PPD as we do maternal PPD.
Moreover, much of the work that has examined efficacy pro-
cesses have done so for mothers or fathers, making it impos-
sible to investigate gender specific patterns in parenting effi-
cacy and PPD. Specifying factors that contribute to PPD in
first-time fathers and mothers should allow for a more com-
plete understanding of the experience of transitioning to
parenthood.
Transition to Parenthood
The birth of a child is often a highly anticipated event associ-
ated with positive emotions for expectant parents.
Nonetheless, the transition to parenthood may also be associ-
ated with disruption in various aspects of individuals’ lives
and social relationships, including marriages (Kamp Dush
et al. 2014; Lawrence et al. 2008; Page and Wilhelm 2007),
work and personal networks (Bost et al. 2002; Cowan et al.
1985; Power and Parke 1984), and stress associated with
balancing work and family roles (Perry-Jenkins et al. 2007).
Although both men and women experience these
disruptions when they become new parents, specific
experiences associated with the transition to parenthood
have been found to vary by gender. For instance, Feldman
and Nash (1984) found that mothers reported more changes
291
and role upheavals during the transition, including increased
positive mood and increased negative mood. To some extent,
these differences have been attributed to gender differences in
the ways that parents balance work and family roles, with
women tending to report more responsibility and stress sur-
rounding childcare (Zhao et al. 2011). Other researchers report
that men face Ba complex set of stress processes^ (Fenwick
et al. 2012, p. 8) associated with the transition to fatherhood,
often surrounding the anticipation of changing relationships
and responsibilities. Moreover, first-time fathers may be more
likely to feel ill-prepared for the transition to parenthood rel-
ative to mothers (Curtis et al. 1997). Although researchers
have examined a broad range of stress related outcomes relat-
ed to the transition to parenthood, PPD has been a primary
outcome of interest in numerous studies examining the mental
health effects of the transition to parenthood.
Parenthood and Postpartum Depression
Postpartum depression (PPD) is characterized by symptoms
consistent with Major Depressive Disorder, Bipolar Disorder,
or Brief Psychotic Disorder that onset within 4 weeks after
giving birth (American Psychiatric Association 2013).
Symptoms associated with PPD include feelings of hopeless-
ness, worthlessness, guilt, a loss of satisfaction in one’s activ-
ities, difficulty sleeping, and problems with concentration and
decision making (Page and Wilhelm 2007). PPD affects be-
tween 10 and 20 % of new mothers in the United States each
year, with an estimated 800,000 new cases annually
(American Psychiatric Association 2010). Due to the adverse
consequences associated with maternal depression for both
mothers and their children (Beck 1998), mental health profes-
sionals have called on increased research efforts aimed at
identifying the factors that contribute to PPD. Indeed, most
studies that have examined postpartum mood have focused on
women’s mental health (Goodman 2004b). More recently,
however, researchers have begun to examine postpartum men-
tal health in first-time fathers.
Though understudied, paternal PPD is beginning to gener-
ate a fair amount of attention (Biehle and Mickelson 2011a, b;
Leerkes and Burney 2007). Recent research shows that men
who become parents experience elevated rates of depression
postpartum (Knoester and Eggebeen 2006). Results from two
recent meta-analyses (which included studies conducted in
both the U.S. and internationally) provide further evidence
of this elevated risk. Based on a review of relevant studies
from 1980 to 2002, Goodman (2004b) found that new cases
of paternal PPD ranged from approximately 1–26 %, with
rates of postpartum depression twice as high among men
whose partners also reported symptoms consistent with
PPD. In Paulson and Bazemore’s (2010) review of studies
from 1980 to 2009, the authors found the meta-analytic rate
292
of paternal depression between the third trimester of pregnan-
cy and 1 year postpartum to be 10.4 %, which is higher than
the estimated rate of depression for men as a general popula-
tion. Both of these reviews highlight the need for continued
investigation focusing on the processes by which new mothers
and new fathers experience the transition to parenthood. An
important step in that direction is to specify the mechanisms
that might help explain postpartum depression for both men
and women. We draw on the social psychological literature of
self-efficacy to better understand the transition to parenthood
in the context of parental efficacy and parental expectations.
Parenthood and Self-Efficacy
Self-efficacy refers to one’s feeling of effectiveness in
accomplishing required tasks and activities (Bandura 1977).
According to Bandura (1977), perceptions of efficacy can im-
pact performance through the altering of one’s degree of in-
tensity and effort. Efficacy develops through various means,
including mastery experiences, modeling, social persuasion,
and physiological factors (Bandura 1977, 2012). In turn, self-
efficacy plays an important role in aspects of human life such
as motivation, goal setting, persistence, causal attribution, and
emotional well-being (Bandura 2012). Research has demon-
strated that low self-efficacy is associated with maladaptive
psychological adjustment, including such mental health prob-
lems as anxiety (Bandura 1997) and depression (Maciejewski
et al. 2000). Conversely, high self-efficacy is associated with
positive psychological well-being (Magaletta and Oliver
1999) and has been linked to a number of positive health
behaviors (Strecher et al. 1986) and coping responses
(Bandura 1986).
Importantly, cognitive theories of efficacy such as Bandura’s
(1977) emphasize efficacy expectations that refer to the belief
that one will succeed at a task, whether accurate or not.
According to Bandura, efficacy expectations should be distin-
guished from outcome expectations, which specifically link
behaviors to a specific outcome. We argue that a distinction
between perceived efficacy expectations (i.e., perceptions of
efficacy regarding expectations of a future task) and perceived
efficacy (i.e., perceptions of efficacy in light of one’s perfor-
mance on a task) might be particularly important when exam-
ining a transition into a new role, where one’s efficacy expec-
tations are not yet influenced by experiences within the role or
by perceived efficacy that may result from those experiences.
A key aspect of Bandura’s (1977, 2012) self-efficacy the-
ory is its focus on task-specific or situational expectations as
opposed to generalized expectations that transcend activities
and roles. One such focus has been on efficacy in the parental
role (Coleman and Karraker 2000; Cutrona and Troutman
1986; Teti and Gelfand 1991). According to Coleman and
Karraker (2000), there are several approaches to the
Sex Roles (2017) 76:290–305
conceptualization and measurement of parenting efficacy,
with a common element of focusing on expectations and abil-
ities specifically related to the parent role (e.g., task-specific
and trait-specific measures of ability to parent). Consistent
with Bandura’s (1977, 2012) conceptualization of self-effica-
cy, recent research in this area supports parenting efficacy as a
domain-specific construct distinct from general efficacy
(Coleman and Karraker 2003; Porter and Hsu 2003;
Troutman et al. 2012). Like other types of efficacy, parenting
efficacy has been linked to numerous positive psychological
and developmental outcomes for both parents and their chil-
dren (Leerkes and Burney 2007; Teti and Gelfand 1991).
Looking specifically at first-time mothers and fathers, Biehle
and Mickelson (2011a) found parenting efficacy expectations
to be linked to mental health outcomes for both men and
women in the perinatal period.
Despite differences in the ways in which women and men
experience the transition to parenthood, few researchers have
explored the efficacy beliefs of fathers, and even fewer have
compared the efficacy beliefs of new mothers and fathers in
the same study. Research that has been conducted on this topic
suggests that parenting efficacy processes may differ for
women and men. For example, Leerkes and Burney (2007)
found that predictors of maternal efficacy at 6-months post-
partum included perinatal efficacy and baby’s temperament,
while predictors of paternal efficacy during this same time
period included involvement in childcare and perceived
social support. Biehle and Mickelson (2011a) also find gender
differences in the predictors of parenting efficacy (such as
maternal and co-parent level of education for mothers, and
co-parent support at 1-month postpartum for fathers), as well
as show that the development of parenting efficacy for new
parents changes during the first 4 months of the postpartum
period.
Gender differences in parenting efficacy expectations are
likely tied, at least in part, to differences in gender-role expec-
tations more generally. According to Eagly and Wood (1999),
gender-role expectations precede the parenting role and influ-
ence both psychological qualities of the parent and role related
behaviors upon the birth of a child. Moreover, research has
shown that gender-role attitudes in the United States may be-
come more traditional following the birth of the first child
(Katz-Wise et al. 2010). Differences in societal expectations
of men’s and women’s responsibilities regarding children
have implications for childcare experiences and the
formation of parenting efficacy. Along those lines, Leerkes
and Burney (2007) found that first-time mothers reported
nearly twice as much previous experience with children as
first-time fathers. And unlike fathers, previous experience
with children was a significant predictor of prenatal efficacy
for mothers (Leerkes and Burney 2007).
In addition to differences in experiences, societal expecta-
tions in the respective roles that women and men will (or
Sex Roles (2017) 76:290–305
should) take in the transition to parenthood may also lead to a
greater focus on education and preparedness for women than
men during the prenatal period. As we discussed, one of the
difficulties men face in the transition to parenthood is a sense
that they are ill-prepared for becoming a father, leaving them
unable to form reasonable expectations about parenting during
pregnancy (Curtis et al. 1997). Indeed, Biehle and Mickelson
(2011a) found that mothers’ parenting efficacy at 1-month
postpartum was comparable to their level of perinatal efficacy,
but fathers were much less accurate in their efficacy expecta-
tions, reporting significantly higher efficacy during pregnancy
relative to their efficacy at 1-month postpartum. In a meta-
synthesis of qualitative studies conducted in both the U.S.
and internationally, Goodman (2004a) notes that first-time
fathers tend to form somewhat unrealistic expectations about
fatherhood, including a strong desire for emotional attachment
that might have been absent in their own upbringing. Upon the
birth of the child, these fathers often report emotional reac-
tions including guilt, inadequacy, and sense of helplessness.
Building on previous theory and research regarding the rela-
tionship between efficacy and mental health outcomes, the
first aim in our study is to examine the relationship between
parenting efficacy (prenatal and postpartum) and PPD for
first-time mothers and fathers.
Changes in Efficacy
Given differences in how efficacy expectations are formed, it
would seem an important aspect of understanding the impact
of parenting efficacy on postpartum outcomes requires exam-
ining the extent to which parenting efficacy expectations are
met (or not) in the months following childbirth. Research has
established a link between prenatal expectations and postpar-
tum adjustment (Roy et al. 2014). For instance, Kach and
McGhee (1982) found that the accuracy of parents’ prenatal
expectations of parenthood in relation to postpartum experi-
ences was a significant predictor of adjustment to parenthood.
The link between prenatal expectations and postpartum out-
comes has also been supported in more recent work that ex-
amines the consequences of violated expectations during the
transition to parenthood. Specifically, unmet expectations re-
garding the marital relationship (Holmes et al. 2013) and the
division of childcare labor (Biehle and Mickelson 2012;
Khazan et al. 2008) negatively impact parents’ perceptions
of their postpartum experiences.
As we discussed, the combination of lack of experience
and education may be detrimental to the development of effi-
cacy expectations for new fathers, which may explain why
men are more likely to credit practicing the parent role (as
opposed to experiences with baby care prior to the parent role)
as contributing to increases in their parenting efficacy
(Leerkes and Burney 2007). As Goodman (2004a) suggests,
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fathers find themselves needing to readjust by changing their
expectations and sharpening their skills once they are in the
parenting role. Nonetheless, much of the research that has
examined the mental health implications of a mismatch be-
tween expectations and experiences, particularly concerning
fathers, has taken place outside of the United States.
For instance, in research conducted with first-time fathers in
the United Kingdom, Deave and Johnson (2008) found that the
lack of available and accessible information about what to ex-
pect when becoming a father (relative to resources available to
mothers) served as an impediment to forming expectations
about the months following the birth of a child. These findings
are consistent with qualitative research examining the experi-
ences of Australian fathers (Barclay and Lupton 1999), which
revealed that unrealistic expectations of involvement and bond-
ing prior to the birth of a child was detrimental to fathers’ well-
being and evaluation of self-competence in the first several
months following birth. In research conducted in Poland,
Bielawska-Batorowicz and Kossakowska-Petrycka (2006) ex-
amined the relationship between postpartum depression and
new fathers’ prenatal expectations concerning changes in fam-
ily and social life (e.g., satisfaction derived from contact with
their baby, marital relationship changes). The authors found
that large differences between prenatal expectations and post-
partum experiences (i.e., experiences that failed to meet expec-
tations) were associated with depressed mood for new fathers.
Unfortunately, the authors measured prenatal expectations dur-
ing the postpartum period of their study, making it difficult to
rule out changes in perceptions of expectations after the birth of
the child. Taken together, however, these studies highlight the
mental health implications of meeting expectations during the
transition to parenthood, as well as suggest that the relationship
between expectations and well-being has implications for fa-
thers as well as mothers. These findings cannot, however, be
generalized outside of their respective countries.
To our knowledge, only one study explored this relationship
directly. Specifically, Harwood et al. (2007) examined prenatal
parenting efficacy expectations and postnatal outcomes in a
sample of 71 predominantly lower-middle class women in a
major Australian city. The authors found that the majority of
respondents’ efficacy expectations were matched or exceeded
by their experiences in the postpartum period. However, re-
spondents whose parenting experiences at 4-months postpar-
tum were negative in comparison to their prenatal parenting
efficacy expectations reported higher levels of PPD than re-
spondents with matched or exceeded expectations (Harwood
et al. 2007). The authors suggest that future research explore
the influence of disconfirmed parenting expectations at differ-
ent (and ideally earlier) points throughout the postpartum peri-
od (Harwood et al. 2007). We further suggest that this research
should be examined in the United States to determine whether
the relationship between efficacy expectations and PPD
operates in a similar way. Thus, the second aim of our study
294
is to examine the relationship between prenatal efficacy expec-
tations and postnatal efficacy experiences (or changes in effi-
cacy) and PPD for first-time mothers and fathers.
The Present Study
In this paper we build on previous literature by examining the
impact of unmet prenatal expectations at 1-month and 4-
months postpartum for both new mothers and new fathers
residing in the United States. We examine change in parenting
efficacy (assessed with three waves of data) in an effort to
clarify the relationship between postpartum mental health out-
comes and parenting efficacy. In particular, we ask two ques-
tions: (a) What is the relationship between prenatal expecta-
tions of parenting efficacy and PPD? and (b) What are the
mental health consequences for first-time mothers and fathers
when prenatal expectations of parenting efficacy are unmet
following the birth of the child?
Based on previous literature concerning the relationship be-
tween parenting efficacy and distress (Biehle and Mickelson
2011b), we expect that prenatal parenting efficacy will be neg-
atively associated with depression in the postpartum periods for
both mothers and fathers. Also consistent with existing litera-
ture (Harwood et al. 2007), we expect that unmet parenting
efficacy expectations (i.e., the difference between expectations
prior to birth and perceived efficacy after birth) will be associ-
ated with higher levels of PPD. Given the literature we
discussed, we argue that gender is an important consideration
for researchers interested in exploring experiences during the
transition to parenthood. Although we do not necessarily ex-
pect parenting efficacy—or unmet efficacy expectations—to be
more consequential for men than for women, prior research
also indicates differences in both efficacy and expectations
for men that may be particularly consequential for understand-
ing PPD among first-time fathers. Previous studies examining
these processes have done so with either mothers or fathers,
making it difficult to compare the relationships across gender.
Thus, in our study we examine the relationship between par-
enting efficacy expectations and PPD separately for mothers
and fathers in an attempt to determine whether and to what
extent there are gender differences in parenting efficacy expec-
tations, efficacy experiences, and PPD.
Our proposed path model also considers three potentially
important covariates. First, because experiencing depressive
symptoms during pregnancy is a significant risk factor for the
development of PPD (Katon et al. 2014), we include baseline
levels of depression. Second, we include co-parent parenting
efficacy because studies have demonstrated that an individ-
ual’s parenting efficacy is a significant predictor of the parent-
ing efficacy of the co-parent (Biehle and Mickelson 2011a).
Third, given the high correlation between anxiety and PPD
and the established relationship between anxiety and this
Sex Roles (2017) 76:290–305
particular transition (Sockol et al. 2014), we include anxiety
during pregnancy. Figure 1 illustrates our proposed path
model.
Method
Participants and Procedure
The data for our study are observations from the Baby
Transitions in Marital Exchanges (Baby T.I.M.E.) study.
Participants in the Baby T.I.M.E. study were recruited from
online pregnancy message boards and birthing classes in a
suburban, Midwestern community in the United States. In
order to be considered eligible to participate in this study,
participants were required to be heterosexual, primiparous
couples who were married or cohabitating with their partner,
experiencing a low-risk pregnancy, employed at the time of
the baseline interview period, and were fluent in English.
Couples agreed to take part in a year-long, longitudinal study
in which they would be interviewed at four time points. The
interviews occurred during the third trimester of pregnancy
(between 24 and 32 weeks of pregnancy), 1-month postpar-
tum, 4-months postpartum, and 9-months postpartum.
Baseline data collection began in January 2008 and 9-month
postpartum interviews began in December 2008. Interviews
were conducted with online questionnaires, with a second
portion of the survey completed within 24 hours of the online
survey via telephone with trained interviewers. Interviews
were completed independent of the participant’s co-parent
(i.e., one’s spouse or partner), and efforts were made for both
parents to complete their respective interviews during the
same day (Biehle and Mickelson 2011a).
Our study focuses on three waves of the Baby T.I.M.E. data:
the third trimester of pregnancy (hereafter referred to as
Bpregnancy^), 1 month following the birth of the child, and
4 months following the birth of the child. One hundred and
four couples (208 individuals) completed the pregnancy inter-
views. Only cases with valid responses at 4-months postpar-
tum (i.e., respondents who remained in the study for all three
waves of data collection) were considered in our project,
resulting in a final sample size of 150 individuals (75 mothers,
75 fathers). Logistic regression analyses (not reported) indicat-
ed that distress (i.e., depression or anxiety during pregnancy),
parenting efficacy during pregnancy, and demographic back-
ground did not significantly predict attrition from the study.
Descriptive statistics for our study (by gender) can be
found in Table 1. With respect to the full sample, the ages of
respondents ranged from 19 to 46 years, with an average age
of 28.94 years. These analyses also show our sample is highly
educated. Specifically, over 70 % of respondents reported
attaining a bachelor’s or advanced degree. Our sample also
has an average household income that exceeds the national
Sex Roles (2017) 76:290–305 295

Fig. 1 Proposed path model for Parenting

the relationship between Depression
Efficacy
parenting efficacy expectations during Pregnancy
Expectations
and postpartum depression

Co-Parent Depression
Parenting during
Efficacy Postpartum

Change in
Anxiety during
Parenting
Pregnancy
Efficacy

average; over 70 % of respondents reported a household in- Over 88 % of the sample reported a race category of White,
come of at least $60,000. Over 90 % of the sample reported non-Hispanic. As illustrated by Table 1, significance tests in-
being married at the time of the first observation. The average dicate that differences exist between mothers and fathers with
length spent in a relationship with one’s co-parent is 3.4 years. respect only to age (p = .002).

Table 1 Descriptive statistics for

the demographic variables Mothers (n = 75) Fathers (n = 75)

Valid Percent or Valid Percent or

M (SD) Range M (SD) Range

Age (in years) 28.01a(3.16) 19–37 29.87 (3.96) 23–46

Race
White (Non-Hispanic) 89.3 % 88.0 %
African American 1.3 % 2.7 %
Hispanic 1.3 % 1.3 %
Asian 4.0 % 2.7 %
Other 4.0 % 5.3 %
Education
High School 6.7 % 12.0 %
Some College 14.7 % 25.3 %
College 60.0 % 40.0 %
Advanced Degree 18.7 % 22.7 %
Household Income
Less than $20,000 4.1 % 4.1 %
$20,000–40,000 8.2 % 8.2 %
$40,000–60,000 15.1 % 15.1 %
$60,000–80,000 34.2 % 34.2 %
$80,000–100,000 15.1 % 15.1 %
$100,000–120,000 11.0 % 11.0 %
More than $120,000 12.3 % 12.3 %
Marital Status
Married 94.7 % 94.7 %
Cohabitating 5.3 % 5.3 %
Relationship Length (in years) 3.42 (2.01) 0–12 3.39 (2.04) 0–12
a
Difference between mothers and fathers is significant, p < .01
296
Measures
Parenting Efficacy
Parenting efficacy was assessed at pregnancy, 1-month, and 4-
months postpartum with an adapted version of Self-Efficacy for
Parenting Tasks (SEPTI-TS) (Coleman and Karraker 2003),
which has been found to have good content validity (Črnčec
et al. 2010). This instrument was modified to 14 questions,
which reflected activities required to care for infants. During
pregnancy, participants were asked how they expected to be
when becoming a parent. During postpartum, participants were
asked how they were as a parent. Items included: BI will/have
difficulty determining what is and is not safe for my baby to
do^ and BI will be/am successful in getting my baby to eat on a
fairly regular schedule.^ Potential responses ranged from 1
(disagree strongly) to 6 (agree strongly). Appropriate items
were reverse coded, and a sum score of the items was created
with higher numbers indicating higher parenting efficacy. The
scale demonstrated adequate internal consistency for both
women and men at all waves of data collection (mothers:
αs = .70 during pregnancy, .68 at 1-month, and .64 at 4-
months; fathers; αs = .65 during pregnancy, .78 at 1-month,
and .71 at 4-months). Although the alphas for this scale were
only moderate, the alpha levels obtained were similar to what
Coleman and Karraker (2003) found for the domains of parent-
ing efficacy with the original construction of the measure.
Change in Parenting Efficacy
To assess the extent to which efficacy expectations are Bmet,^
we construct two change in parenting efficacy variables,
assessed as the difference between prenatal efficacy expecta-
tions and perceived efficacy (a) at 1-month and (b) at 4-
months postpartum. These difference scores were calculated
by subtracting pregnancy parenting efficacy sum scores
(reflecting prenatal efficacy expectations) from parenting effi-
cacy sum scores at 1-month and 4-months postpartum
(reflecting perceived efficacy at 1-month and 4-months post-
partum). A positive score indicates that a respondent’s parent-
ing efficacy experiences were more positive than (or
exceeded) prenatal expectations, a score of zero indicates that
a respondent’s parenting efficacy experiences matched prena-
tal expectations, and a negative score indicates that a respon-
dent’s postpartum parenting efficacy experiences were more
negative than (or fell short of) prenatal expectations. We ex-
pect that falling short of one’s expectations (i.e., a negative
score) will be associated with higher PPD.
Postpartum Depression
Postpartum depression is measured with a shortened version
of the Postpartum Depression Screening Scale (Beck and
Sex Roles (2017) 76:290–305
Gable 2000) administered at both postpartum interview ses-
sions. Following previous research on this topic, we use the
term PPD to refer to symptoms of depression specifically re-
lated to parenthood and baby care and not to a formal diagno-
sis of PPD. Participants were asked to report how they felt
during the past 7 days on 11 items assessing their postpartum
mood state. Example items included BI got anxious over even
the littlest things that concerned my baby,^ BI felt like I was
not the parent I wanted to be,^ and BI had trouble sleeping
even when the baby was asleep.^ Responses ranged from 1
(strongly disagree) to 5 (strongly agree), with higher scores
indicating greater incidence of postpartum depression. A total
PPD score was created for both mothers and fathers by sum-
ming the scores from the individual items.
The scale demonstrated high internal consistency at both
postpartum waves of data collection (mothers: αs = .81 at 1-
month and .83 at 4-months; fathers: αs = .86 at 1-month and
.83 at 4-months). In addition to these psychometric properties,
this measure is ideal for the purposes of our research because it
is specific to depression in the postpartum period, in contrast
to generalized distress. For example, the items on the PDSS
are designed to capture the experiences of mothers within the
new role of motherhood (Beck and Gable 2000). Moreover,
the PDSS scale is a more accurate assessment of PPD in com-
parison to generalized depression measures because general-
ized measures often include symptoms, such as fatigue, that
are considered to be normal physiological reactions in the
postpartum period (Beck and Gable 2000).
Control Variables
We include baseline depression, co-parent parenting efficacy,
and baseline anxiety as control variables. Baseline depression
was assessed with the Center for Epidemiologic Studies-
Depression Inventory (CES-D), which is a well-validated
and reliable measure (Radloff 1977). Participants answered
20 questions assessing their mood over the past week.
Example items included: BHow often have you felt depressed
in the past 7 days?^ and BHow often did you feel that your life
was hopeless over the past 7 days.^ Responses ranged from 0
[none/rarely (<1 day)] to 3 [most (5–7 days)], and a total
depression score was created by summing scores from the
individual items. The scale demonstrated adequate internal
consistency for both mothers (α = .87) and fathers (α = .88)
at the pregnancy wave of data collection.
Co-parent parenting efficacy was measured with the co-
parent’s SEPTI-TS score at 1-month and 4-months postpar-
tum. Baseline anxiety was assessed using the Symptom
Checklist-90-R (SCL-90-R) anxiety subscale (Derogatis
1994). Participants answered 10 items assessing their anxiety
over the past week. Example items included: BHow often have
you felt nervous or shaky?^ and BHow often have you felt so
restless you couldn’t sit still?^ Responses ranged from 0
Sex Roles (2017) 76:290–305
[none/rarely (<1 day)] to 3 [most (5–7 days)], and a total
anxiety score was created by summing scores across the indi-
vidual items. The scale demonstrated adequate internal con-
sistency during the pregnancy wave of data collection (α = .83
for mothers; α = .79 for fathers).
Prior research has also shown that such demographic vari-
ables as age (Carlson 2011), socioeconomic status (Beck 2001;
Segre et al. 2007), relationship status (Biehle and Mickelson
2011b), and relationship length (Krieg 2007) are associated with
the major study variables. Thus, age (in years), education (coded
as some high school, high school, some college, college educa-
tion, and advanced degree), household income (ranging from
less than $20,000 per year to more than $120,001 per year),
relationship status (categorized as married or cohabitating), and
relationship length (coded as years living with one’s co-parent)
were explored as potential statistical controls for our study.
Results
Table 2 illustrates the descriptive statistics for the main study
variables. One-way ANOVA results indicate that a number of
significant differences exist between mothers and fathers on
these variables. In terms of parenting efficacy, mothers’ mean
scores for the three waves of analysis were significantly higher
than fathers’ mean parenting efficacy scores at 4-months post-
partum (p = .014).
With respect to change in parenting efficacy between preg-
nancy and postpartum, we find that in general, parenting ex-
pectations of efficacy are unmet at the 1-month postpartum
interview. The parenting efficacy experiences at 1-month post-
partum for both mothers and fathers were more negative than
what was expected during pregnancy. However, by 4-months
postpartum, parenting expectations of efficacy were exceeded
by the full sample. In other words, the parenting efficacy ex-
periences at 4-months postpartum were more positive than
expected during pregnancy for both mothers and fathers.
This difference in mean scores on the change in efficacy var-
iable at 4-months postpartum is almost significantly different
for mothers and fathers (p = .051). Further, mothers reported
significantly higher depression scores relative to fathers dur-
ing pregnancy (p = .001), 1-month postpartum (p = .001), and
4-months postpartum (p = .007).
When comparing scores among mothers and among fathers
across waves, several significant differences also emerged.
For mothers, parenting efficacy scores at 4-months postpar-
tum were significantly higher than their parenting efficacy
expectations as measured during pregnancy and their parent-
ing efficacy scores at 1-month postpartum. Fathers reported a
significant decrease in parenting efficacy scores at 1-month
postpartum relative to their parenting efficacy expectations
as measured during pregnancy; by 4-months postpartum, fa-
thers’ efficacy scores had increased to a level comparable to
297
their parenting efficacy expectations. For both mothers and
fathers, PPD scores were significantly lower at 4-months post-
partum in comparison to their depression scores at 1-month
postpartum. Bivariate correlations for these study variables
can be found in Table 3.
Parenting Efficacy Expectations and PPD
To test the extent to which changes in efficacy (or unmet
expectations) explain differences in PPD for new mothers
and fathers, we utilized structural equation modeling (SEM)
(AMOS; Arbuckle 2012). SEM analyses were estimated sep-
arately for mothers and for fathers to examine the unique
processes by which new mothers and fathers experience the
transition to parenthood. Although our sample size is some-
what small, researchers have demonstrated that SEM models
are suitable with smaller samples (e.g., 50–100) if the model is
not overly complex and the variables demonstrate good reli-
ability (Bearden et al. 1982; Bollen 1990; Iacobucci 2010), as
is the case in our research.
Initial analyses revealed that our demographic control vari-
ables were not significantly related to the dependent outcome in
our sample and that only education was significantly related to
a variable of interest (parenting efficacy). Thus, our SEM
models included education as a Bfree-to-float^ control variable,
along with our independent variable (change in parenting effi-
cacy) and parenting efficacy expectations, anxiety during preg-
nancy, co-parent parenting efficacy, and depression during
pregnancy as controls. Co-parent depression was also explored
as a potential control variable; analyses indicated co-parent
depression did not significantly predict PPD for mothers or
for fathers at either 1-month or 4-months postpartum.
Although this finding is not consistent with some research in
this area regarding the significance of maternal PPD as a pre-
dictor of paternal PPD (Goodman 2004b), it is consistent with
recent research that shows the relationship between paternal
and maternal depression to be indirect in nature (Don and
Mickelson 2012). Further, analysis indicated that the inclusion
of this variable did not significantly improve overall model fit.
Thus, to preserve degrees of freedom, we did not include co-
parent depression in the final models. Correlations in our
models included parenting efficacy expectations with change
in parenting efficacy, co-parent parenting efficacy with change
in parenting efficacy, co-parent parenting efficacy with parent-
ing efficacy expectations, and depression with anxiety during
pregnancy. Using the modification indices values as a guide,
we added and eliminated structural pathways as needed.
Efficacy Expectations and PPD in Mothers
The first set of SEM models examines the relationship be-
tween parenting efficacy and PPD at 1-month postpartum
for mothers. These analyses focus on differences between
298 Sex Roles (2017) 76:290–305

Table 2 Descriptive statistics for

the main study variables Mothers (n = 75) Fathers (n = 75) Range

M (SD) M (SD) Potential Actual

Parenting Efficacy
During pregnancy 71.61 (6.16) 71.11 (5.24) 14–84 55–82
1-month postpartum 71.37 (6.31) 69.49a (7.10) 14–84 50–84
4-months postpartum 73.80ab (5.32) 71.41b (6.43) 14–84 51–82
Depression
During pregnancy 11.80 (8.04) 7.96 (6.17) 0–60 0–38
1-month postpartum 24.72 (8.03) 20.83 (6.40) 11–55 11–46
4-months postpartum 21.33b (7.33) 18.47b (5.41) 11–55 11–40
Co-Parent Parenting Efficacy
1-month postpartum 69.49 (7.10) 71.37 (6.31) 14–84 50–84
4-months postpartum 71.41 (6.43) 73.8 (5.32) 14–84 51–82
Anxiety During Pregnancy
Change in parenting efficacy 5.33 (4.10) 3.71 (3.80) 0–30 0–23
1-month postpartum -.24 (6.19) −1.61 (6.17) −17 to 20
4-months postpartum 2.19b (5.46) .31b(6.22) −18 to 16

Depression during pregnancy was assessed with the Center for Epidemiologic – Depression Inventory; depression
at 1-month and 4-months postpartum was assessed with the Postpartum Depression Screening
Scale. Bolded font denotes a significant difference ( p ≤ .05) between mothers and fathers. Superscripts denote
a significant difference (p ≤ .05) among mothers and fathers across waves
a b
mean score significantly different from pregnancy, mean score significantly different from 1-month
postpartum

prenatal expectations of parenting efficacy and perceived par-
enting efficacy shortly after birth. Overall, the trimmed model
fits the data well: χ 2 = 9.391 (df = 11, n = 75, p = .586),
CFI = 1.00, RMSEA = .000. With respect to the fit of the final
trimmed model, the χ2 statistic is not significant, the CFI value
(1.00) is greater than .90, and the model’s RMSEA value
(.000) is below .08.
Results from the trimmed model indicate that, consistent
with our expectations, prenatal expectations of parenting effi-
cacy is a significant predictor of PPD at 1-month postpartum
(β = −.335, p = .006). With respect to whether unmet expecta-
tions between pregnancy and 1-month postpartum predict
PPD, our results indicate that as scores for the change in par-
enting efficacy variable increase (i.e., postpartum experiences

Table 3 Bivariate correlations of the main study variables for mothers (n = 75) and fathers ( n = 75)

1 2 3 4 5 6 7 8 9 10 11

Efficacy pregnancy —— .54** .45** -.23* -.38** -.22 -.36** -.31** .35** .43** -.22
Efficacy 1-month .51** —— .57** .70** .14 -.26* -.44** -.31** .19 .23* -.21
Efficacy 4-months .56** .67** —— .28* .66** -.32** -.43** -.40** .09 .22 -.26*
Change in efficacy 1-month -.48** .52** .13 —— .48** -.11 -.20 -.10 -.07 -.10 -.05
Change in efficacy 4-months -.59** .08 .35** .67** —— -.14 -.14 -.16 -.20 -.14 -.08
Depression pregnancy -.18 -.21 -.28* -.03 -.06 —— .48** .54** -.09 -.13 .70**
Depression 1-month -.23* -.40** -.33** -.18 -.06 .35** —— .61** -.18 -.17 .39**
Depression 4-months -.32** -.33** -.37** -.02 .00 .57** .64** —— -.15 -.16 .46**
Co-parent efficacy 1-month .29* .19 .23* -.09 -.10 -.11 -.10 -.15 —— .67** -.16
Co-parent efficacy 4-months .32** .09 .22 -.22 -.15 -.03 -.05 -.10 .57** —— -.07
Anxiety pregnancy -.12 -.19 -.30* -.08 -.15 .69** .38** .40** -.05 -.07 ——

Correlations for fathers are above the diagonal; for mothers, below the diagonal
*p < .05. ** p < .01
Sex Roles (2017) 76:290–305 299

exceed prenatal expectations), there is a decrease in scores for
PPD (β = −.318, p = .007). In other words, this finding sug-
gests that negative parenting efficacy experiences at 1-month
postpartum were associated with higher reported levels of
PPD for mothers.
Our second set of SEM models examines the relationship
between parenting efficacy expectations and PPD for mothers
at 4 months following the birth of the child. Overall, the final
trimmed model fit the data well: χ2 = 13.438 (df = 10, n = 75,
p = .200), CFI = .973, RMSEA = .068. Results from the final
model indicate that prenatal expectations of parenting efficacy
remains a significant predictor of PPD at 4-months postpartum
for mothers (β = −.324, p = .01). With respect to the change in
parenting efficacy between pregnancy and 4-months postpar-
tum, our results indicate that this variable did not predict PPD
(β = −.162, p = .183) for the mothers in our sample. The results
from the 1-month and 4-months postpartum SEM estimations
for mothers are summarized in Fig. 2.
Efficacy Expectations and PPD in Fathers
Our third set of SEM models examines the relationship be-
tween prenatal expectations of parenting efficacy and PPD for
fathers at 1 month following the birth of the child. The final
trimmed model fits the data well: χ2 = 7.513 (df = 6, n = 75,
p = .276), CFI = .983, RMSEA = .058. Results from this final
model indicate that prenatal expectations of parenting efficacy
is a significant predictor of 1-month PPD for fathers
(β = −.322, p = .003). In terms of whether the change in par-
enting efficacy between pregnancy and 1-month postpartum
predicts PPD, as scores for the change in parenting efficacy
variable increase, scores for 1-month PPD decrease for fathers
(β = −.248, p = .014). This finding suggests that the greater the
degree of unmet expectations between pregnancy and 1-
month postpartum, the higher the levels of 1-month postpar-
tum PPD for the fathers in our sample.
Our fourth set of SEM models examines the relationship
between prenatal expectations of parenting efficacy and PPD
for fathers at 4-months postpartum. The final trimmed model
fits the data well: χ 2 = 9.852 (df = 6, n = 75, p = .131),
CFI = .964, RMSEA = .093. Pathway estimates from the final
model estimation indicate that prenatal parenting efficacy ex-
pectations remains a significant predictor of PPD at 4-months
postpartum for fathers (β = −.280, p = .019). With respect to
the change in parenting efficacy between pregnancy and 4-
months postpartum, our results indicate that as scores for the
change in parenting efficacy variable increase, scores for 4-
months postpartum PPD decrease for fathers (β = −.213,
p = .048). This finding suggests that among fathers, increases
in negative parenting efficacy experiences at 4-months post-
partum relative to prenatal efficacy expectations were associ-
ated with higher levels of PPD. Figure 3 shows the results
from the 1-month and 4-months postpartum SEM estimations
for fathers.
Discussion
Our paper had three aims. Our first aim was to examine the
relationship between parenting efficacy and PPD across the
transition to parenthood. Whereas previous studies have ex-
amined this relationship at different phases of the transition to
parenthood, we extend this work to examine both prenatal
efficacy expectations and postpartum efficacy experiences.

Fig. 2 Standardized estimates for

the final trimmed model for Education
-.33**
mothers at 1-month and 4-months
postpartum (n = 75). Estimates for (-.33** )
4-months postpartum are denoted Parenting
with parentheses. For ease of Depression during
Efficacy
presentation, a non-significant Pregnancy
Expectations
-.34**
covariance between change in
(-.32**)
parenting efficacy and education .30** .11
-.45***
at 4-months postpartum is not (.52***)
included in the figure. Asterisks (-.59***) (.28*)
indicate significant paths.
Co-Parent .69***
*p < .05. ** p < .01. ***p < .001 -.00 (-.01 ) Depression during
Parenting (.69***)
Postpartum
Efficacy

-.0 9 .25

(-.15 ) (-.01)
(-.16)
Change in -.32**
Anxiety during
Parenting
Pregnancy
Efficacy
300 Sex Roles (2017) 76:290–305

Our second aim was to examine the extent to which chang-
es in efficacy, focusing on a comparison of expectations
and experiences, further explain differences in PPD. This
relationship has been examined to some extent in previous
research; however, much of this research has taken place
outside of the United States. To examine these questions
throughout the transition to parenthood, we used three
waves of data collected during pregnancy as well as 1-
month and 4-months following the birth of the child.
Finally, we sought to extend research on paternal PPD, as
well as maternal PPD, by examining these processes con-
currently for first-time fathers and mothers.
Our results indicate that parenting efficacy expectations
in the prenatal period are negatively associated with de-
pression for the mothers and for the fathers in our sample
at both 1-month and 4-months postpartum. In other words,
respondents with high levels of expected parenting effica-
cy during pregnancy reported lower levels of depression
during the postpartum period than their less efficacious
peers. Based on previous research concerning the influence
of efficacy expectations (Bandura 1977), we also anticipat-
ed that unmet expectations between the prenatal and post-
partum period would be associated with higher levels of
depression. Our findings indicate that not meeting expec-
tations of parenting efficacy is indeed related to depression
for mothers at 1-month postpartum and for fathers at both
1-month and 4-months postpartum. Specifically, mothers
whose parenting efficacy experiences were more negative
than their prenatal expectations of parenting efficacy re-
ported higher levels of PPD at 1-month postpartum.
However, this effect dissipates for mothers by 4-months
postpartum. For fathers, we similarly found that unmet
expectations resulted in higher levels of depression at 1-
month postpartum. Unlike mothers, this relationship
persisted at 4-months postpartum. In the following sec-
tions, we discuss these findings in greater detail in the
context of differences (and similarities) in these processes
for women and men.
Parenting Efficacy and Postpartum Depression
Our first goal was to establish whether there was a relationship
between parenting efficacy and PPD for men and for women.
Based on previous theory and research, we expected that par-
enting efficacy during pregnancy would be negatively associ-
ated with depression in the postpartum periods for both
mothers and fathers. Based on our results, we see that parent-
ing efficacy expectations were negatively associated with de-
pression for the mothers and the fathers in this sample at both
1-month and 4-months postpartum. In other words, the higher
the levels of expected parenting efficacy during pregnancy, the
lower the levels of depression reported during the postpartum
period. Importantly, our results also show that the relationship
between parenting efficacy expectations and PPD does not
vary by gender. Although there is a slight decrease in the
association between efficacy expectations and PPD at 4-
months postpartum for fathers, for the most part the process
seems to be operating similarly for men and women. With the
comparison between expectations and experiences in mind,
we turn to our next research question.
Changes in Efficacy and Depression
Our second goal in our research was to examine the relation-
ship between changes in efficacy over the transition period.
Building on Harwood et al. (2007), we anticipated that unmet
expectations between the prenatal and postpartum period
would be associated with higher levels of depression. Our
findings indicate that the failure to meet parenting efficacy
expectations was indeed related to depression for mothers at
1-month-postpartum and for fathers at both 1-month and 4-
months postpartum. Specifically, mothers whose parenting

Fig. 3 Standardized estimates for Parenting Depression

the final trimmed model for Efficacy during
fathers at 1-month and 4-months Expectations
-.32**
Pregnancy
postpartum (n = 75). Estimates for (-.28* )
4-months postpartum are denoted .35** .35*
-.23*
with parentheses. Asterisks (.37**)
indicate significant paths. (-.38**) (.43***)
*p < .05. ** p < .01. ***p < .001
Co-Parent Depression .70***
-.06 (-.02 )
Parenting during (.70***)
Efficacy Postpartum

-.0 7 .07

(-.14 ) (-.14)
(-.21*)
Change in -.25*
Anxiety during
Parenting
Pregnancy
Efficacy
Sex Roles (2017) 76:290–305
efficacy experiences were more negative than their prenatal
expectations of parenting efficacy reported higher levels of
PPD at 1-month. However, this effect dissipated for mothers
by 4-months postpartum. For fathers, we similarly found that
unmet expectations resulted in higher levels of depression at
1-month postpartum, but unlike mothers, this pattern persisted
at 4-months postpartum. Thus, we do find gender variation in
the relationship between prenatal expectations and postpartum
experiences. We suggest this may be due to differences in
gender-role socialization and preparation for the parenting
role.
Previous research finds that women tend to be more accu-
rate in their efficacy expectations relative to their male coun-
terparts (Biehle and Mickelson 2011a). Consistent with previ-
ous research, we speculate that this finding is related to the
differences in the source and amount of education and prepa-
ration for men and women during pregnancy (Hudson et al.
2001). Where women may be more likely to be told what to
expect in terms of their parenting abilities through formal and
informal networks, men may receive less socialization expe-
riences regarding the parental role (Schoppe-Sullivan et al.
2014). Therefore, first-time mothers may also be more pre-
pared for setbacks that are considered typical in the months
following birth. Additionally, the norms surrounding expecta-
tions of fathers are generally less structured than those for
mothers (Curtis et al. 1997), which may make it somewhat
more difficult to seek or receive family support or develop
one’s sense of what they believe they will accomplish as a
parent. As a result, men may be less realistic about their ex-
pectations (Biehle and Mickelson 2011a) as well as less able
to adjust them in the face of incongruent experiences. Overall,
understanding the extent to which expectations are actually
met (or not met) helps us better articulate the connection be-
tween efficacy as a resource and psychological well-being.
Studies that have examined factors that predict efficacy for
new parents (Biehle and Mickelson 2011a), as well as the
relationship between maternal and paternal PPD (Don and
Mickelson 2012), have indicated that gender plays a role in
the formation of efficacy expectations. By examining both
mothers and fathers, we were able to show some similarities
and differences that emerge during this critical period of tran-
sition. Moreover, by using longitudinal data, we are able to
assess efficacy expectations prior to birth, thereby allowing us
to better understand the impact of the transition on expecta-
tions relative to perceptions of efficacy after birth. In other
words, using a prospective design put us in a better position
to examine change (or difference) in parenting efficacy and
mental health. Researchers have highlighted the need for clar-
ification regarding the causal relationships between parenting
efficacy beliefs and PPD (Jones and Prinz 2005). We believe
that our study provides a step toward this goal. That said, it is
important to note that our particular research design does not
allow us to rule out the possibility of reverse causality.
301
Limitations and Future Research Directions
Although our research adds to the literature on parenting effi-
cacy and well-being, it also has limitations. First, there are
limitations to the generalizability of our findings given the
homogeneous nature of the sample. Participants in the Baby
T.I.M.E. study were recruited from birthing classes and online
pregnancy message boards, which may have impacted selec-
tion into the study. For example, most respondents in our
sample were White, upper middle-class, college educated in-
dividuals. Given the higher levels of income and education in
our sample, it is more likely that these parents have had op-
portunities and resources to help them prepare for the birth of a
child. As such, their expectations may be somewhat higher
than those of parents who lack such resources. At the same
time, their perceptions postpartum may be skewed based on
social comparisons and feedback from friends and family after
the birth. In addition to elevated expectations, it is possible
that high-resource parents are relatively more accurate in their
expectations of the transition to parenthood. Indeed, previous
research by Belsky (1985) found that prenatal expectations of
well-educated parents generally matched reported postpartum
experiences. Thus, although our data provided us with a
unique opportunity to examine these issues from pregnancy
to 4-months postpartum, future research should seek to extend
this work with more diverse samples.
Second, although our focus in our study was to isolate the
relationship between parenting efficacy and mental health, it is
important to recognize that there are additional factors to con-
sider both with respect to parenting expectations and the tran-
sition to parenthood more generally. For example, researchers
suggest self-esteem (Gerdes et al. 2007; Leerkes and
Crockenberg 2002) and social support from other parents
and from family (Bost et al. 2002; Wells et al. 1999) influence
both the expectations that one has prior to the birth of the baby
and perceptions of how one is doing after the birth. In addition
to variation in self-perceptions of first-time mothers and fa-
thers, the impact of perceptions of infant temperament on
parenting efficacy is also an important consideration during
this transition (Porter and Hsu 2003; Teti and Gelfand 1991).
We speculate that these factors, along with others, may help
explain the observed gender differences in levels of parenting
efficacy expectations, efficacy experiences, and PPD in our
study. As we discussed, mothers reported a substantial in-
crease in parenting efficacy at 4-month postpartum relative
to their parenting efficacy expectations and their parenting
efficacy scores at 1-month postpartum, yet they also report
higher levels of depression than fathers at 4-months postpar-
tum. It stands to reason that there is gender variation in factors
that predict both efficacy expectations and mental health out-
comes during this important transition. This finding is consis-
tent with previous work that suggests the predictors of efficacy
are unique for mothers and fathers (Biehle and Mickelson
302
2011a; Leerkes and Burney 2007), as well as with literature
suggesting that women are more likely to report higher levels
of depression than do men for reasons not examined here
(Hyde et al. 2008). Thus, whereas our focus in our study
was to isolate the relative effect of parenting efficacy expec-
tations on PPD for men and women during the transition to
parenthood, we acknowledge that other factors should be con-
sidered when assessing gender differences in PPD and parent-
ing efficacy more broadly. Future studies might also examine
mental health outcomes more common among men, such as
externalizing behaviors (Aneshensel et al. 1991; Horwitz
2002; Rosenfield et al. 2005; Simon and Barrett 2010), to
determine whether and to what extent gender differences
emerge in the relationships among parenting efficacy expec-
tations, efficacy experiences, and additional forms of distress.
Third, we examined the relationships between parenting
efficacy expectations and PPD for women and men separately
in order to examine the unique processes by which mothers
and fathers experience the transition to parenthood. However,
researchers have also drawn attention to the importance of
considering the family dynamics that operate during this tran-
sitional period (Kamp Dush et al. 2014). For example, prior
investigations have shown that maternal mental health signif-
icantly influences paternal mental health (Goodman 2004b),
and couple-level analyses have indicated that couples experi-
ence similar changes in depression during the pregnancy and
postpartum periods (Don and Mickelson 2012; Salmela-Aro
et al. 2006). With respect to parenting efficacy, previous re-
search suggests that personal and co-parent predictors of par-
enting efficacy can change throughout the transition to parent-
hood (Biehle and Mickelson 2011a). Thus, we believe an
important next step is for researchers to explore the relational
and familial dynamics that operate within couples as they
experience this transition.
Finally, it will be important for future research to examine
the transition to parenthood in the context of other social roles.
Numerous studies point to the impact of parenthood on em-
ployment (Barclay and Lupton 1999) and marriages (Kamp
Dush et al. 2014; Lawrence et al. 2008; Page and Wilhelm
2007), with martial satisfaction particularly impacted for cou-
ples of higher SES standing (Twenge et al. 2003). Moreover,
expectations in these other social roles may impact this impor-
tant period of transition, which might further explain gender
variation in the forming of expectations about parenting and
parental efficacy. Research shows, for instance, that men and
women have different trajectories as they combine work and
family roles (Milkie and Peltola 1999). These differences may
be further exaggerated during the transition to parenthood,
where women minimize the importance of their work roles
and men often do the opposite (Cowan et al. 1985; Knoester
and Eggebeen 2006). Such differences are likely to produce
variation in the experience of role overload or role strain that
may ultimately impact perceived efficacy in the parent role.
Sex Roles (2017) 76:290–305
As such, it is also important to understand the dynamic and
interactive nature of these important social roles when contex-
tualizing the mental health consequences of this transition.
Practice Implications
Our findings add to a growing body of literature that examines
the social psychological mechanisms that may be predictive of
PPD during the transition to parenthood—particularly for
first-time parents (Biehle and Mickelson 2011a, b; Harwood
et al. 2007). Given a shift in PPD literature from focusing
primarily on hormonal factors to additional sources of social
stress, such as stressful life events and a previous history of
depression (O’Hara et al. 1991), we suggest it is important to
identify factors that may contribute to the development of
PPD for both men and women. Parenting efficacy is one such
factor. Moreover, a better understanding of how expectations
about social roles influence mental health during the transition
period (e.g., becoming married, beginning a new job, becom-
ing a parent for the first time) may have implications for pol-
icies aimed at reducing stressors associated with such transi-
tions. In the case of parenthood, parents may seek and receive
counseling and educational opportunities in order to become
better prepared for the realities associated with this major life
event. Such information may result in higher levels of efficacy
coupled with more realistic expectations.
Conclusions
Our study examines the role of parenting efficacy in
explaining PPD. Specifically, our findings indicate that for
both mothers and fathers, having parenting efficacy experi-
ences that were more negative than their prenatal expectations
of parenting efficacy was associated with higher levels of PPD
at 1-month postpartum. The effect persists for fathers 4 months
following the birth of the child. Given the pervasive and de-
bilitating nature of postpartum depression and related disor-
ders, and the long-term and short-term consequences for par-
ents and their children, continued investigation aimed at iden-
tifying the correlates of these disorders is warranted. Our pro-
ject provides clarification concerning how a key social psy-
chological factor, parenting efficacy, relates to the mental
health adjustment of new mothers and new fathers.
Compliance with Ethical Standards
Disclosure of potential conflicts of interest There are no known po-
tential conflicts of interest.
Research involving Human Participants As a secondary data analy-
sis, this research was reviewed and approved by our institution’s
Institutional Review Board as Level I/Exempt research.
Sex Roles (2017) 76:290–305
Informed Consent As a secondary data analysis, this research was
reviewed and approved by our institution’s Institutional Review Board
as Level I/Exempt research.
Funding sources No external funding sources were used to fund this
research.
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