Introduction

Olson believes that the extent of marital satisfaction in each of the lifecycle stages is different. Schlesinger presents three curves for this concept, including a linear decline after the honeymoon period, a curved trend during which the family is devoid of children with increased independence as the most important event, and finally a U-shaped curve associated with a peak in the early years, a decline during the birth of children, and eventually a rise as the children leave the family (3-5).

In a study performed by Shakerian in Iran, 63.2% of the healthy women had problems in their marital relationships (6). In another study carried out by Attari, 49.9% of the participants reported to have a moderate level of satisfaction with their marital relationships (7). In a study conducted in Tehran, Saadat Mousavi found that one fourth of women with higher education level and one third of women with diploma had unpleasant and very unpleasant marital status and needed a serious couple therapy (8).

One of the most important stages of lifecycle that is relatively difficult and complex is transition from marriage to parenthood. The adaptation to the new member of the family is accompanied by the incidence of a number
of changes across all aspects of marital relationship (9-11). The process of “transition to parenthood” initiates from the period before pregnancy. In other words, it begins from the days when the couple predict parenthood and imagine themselves in this role. This period is considered to usually consist of nine phases, including: 1) decision to become pregnant, 2) physical measures for pregnancy (non-use of contraceptives), 3) pregnancy, 4) birth, 5) the first 6 weeks post-delivery, 6) 6 weeks to 6 months post-delivery, 7) 6-12 months post-delivery, 8) 12-18 months of child’s age, and 9) 18-24 months of child’s age (12).

The birth of the first child is usually predicted as a time for happiness and excitement. However, the very issue of “transition to parenthood” can be associated with fatigue and confusion about the changes in roles and relations (13-6). When transitioning to the parental stage, changes in sexual relationships cause altered emotional intimacy, which is absolutely important (17). Factors, such as reduced sleep, neonate’s dire need to the parents, and increased maternal involvement with the newborn, cause further problems in this regard (18-20).

Both mother and father should specify their responsibilities and initiate the process of establishing a relationship with the newborn (13, 21). In a couple of studies performed by Doss B. et al. (2009) and Lawrence et al. (2008), the couples with children reported a lower level of sexual satisfaction and less time for common activities, compared to those without children (22, 23).

Various factors, including income status, children’ health, sexual satisfaction, childbirth, and employment status, affect the couple’s relationship in marital life (24, 25). It sounds that with the entrance of women to high-income jobs, the division of housekeeping duties and balance in couple contribution have been converted to important subjects for the perception of justice (26-28). Employed mothers should match their occupational responsibilities with the familial ones. However, this may result in conflicts, diminished occupational satisfaction, and poor performance in serving the maternal and spousal roles.

Multiple studies have investigated the relationship between marital satisfaction and division of housekeeping or parenthood duties among employed women and housewives. However, to the best of our knowledge, there is no study examining this relationship during the transition to parenthood period, which is a turning point in couple’s relationship. Transition to parenthood period and marital satisfaction are issues of fundamental importance among employed women and housewives, which eventually contribute to strengthening the family system. With this background in mind, the current study was conducted with the aim of determining the relationship between the transition difficulty to parenthood and marital satisfaction among employed women and housewives.

Materials and Methods

This correlational study was conducted on 120 housewives and employed mothers referring to the healthcare centers of Mashhad, Iran, in 2014 for neonatal health monitoring. The study population was selected using a three-stage clustering technique. In this regard, in the first stage, the five healthcare centers in Mashhad were considered as classes. In the second stage, the healthcare centers and bases covered by each of the five centers were chosen through the table of random numbers.
Finally, in the third stage, the research unit
was selected through convenience sampling technique.

To this end, first, the healthcare centers and bases covered by each of the healthcare centers 1, 2, 3, 4, 5, and Samen were listed. Then, the population covered by each of the healthcare classes was determined, and its percentage to the total population covered by the healthcare centers was calculated. Thereafter, the share of each class in the entire sample size was calculated. Subsequently, the number of the required healthcare centers as cluster was calculated using the table of random numbers. Finally, the number of the required couples from each of the healthcare centers was determined, whereby 14 healthcare centers were specified. The sample size was determined by performing a preliminary study based on which the final sample size was estimated using a correlation formula. The participants were divided into two groups of housewife and employed based on their occupational status.

The inclusion criteria were: 1) literacy, 2) no history of any psychological diseases (i.e., nervous system diseases, psychiatric medication consumption, history of hospitalization in a psychiatric hospital, and being under the supervision of a psychiatrist or a psychologist consultant), 3) no history of any incurable physical diseases (e.g., cancer, AIDS, chemotherapy, amputation, spinal cord injury, paralysis, blindness, hearing loss, and speech impairment), 4) drug abuse, 5) use of psychotropic drugs or alcohol, and 6) being in the first marriage.

On the other hand, the participants who did not live with their parents or spouse were excluded from the study. In addition, the incidence of a traumatic event in the past three months and incomplete questionnaires by at most 5% were among other exclusion criteria. Furthermore, the inclusion criteria for the children were: 1) child’s age range of 6 weeks to 6 months in couples with one child and regarding the couples with two children, the first child’s age of < 8 years and the second child’s age range of 6 weeks to 6 months, 2) healthy status (i.e., lack of cardiovascular, pulmonary, and renal diseases, hypertension, diabetes, seizure, mental or physical retardation, and genetic diseases), 3) singleton birth, and 4) biological child.

The research instruments included Transition (to Parenthood) Difficulty Scale (TDS; Steffensmeier, 1982; Twiss, 1989), ENRICH Marital Inventory (29), and demographic form. The modified TDS measures the degree of “difficulty of transitioning” experienced by new parents. This instrument contains 38 items with four dimensions, namely parental responsibilities and limitations, parental satisfaction and gratification, marital intimacy and stability, and personal commitment (30). The TDS is rated on a 5-point Likert scale with the score ranges of 50-109, 110-179, and 180-250 suggesting low, moderate, and high levels of difficulty in transitioning to parenthood, respectively (10).

This scale is a standard and valid instrument, which has been used abroad in different studies (30-32). Since this instrument had not been used in Iran before, its reliability and validity were estimated in the present study. To this end, the translated version of the scale was distributed among the faculty members of nursing and midwifery, as well as the professors of English department to determine its content validity. In the next stage, the corrective comments were applied in the instrument.

The TDS has been used in a study performed by Zelkowitz and Milet (1997) reporting a reliability range of 0.75-82 for its four subscales (30). In addition, Muller et al. reported the Cronbach’s alpha coefficient of 0.81 and 0.65-0.82 for the entire instrument and its subscales, respectively (31). In the current study, the reliability of this scale was confirmed by obtaining a Cronbach’s alpha coefficient of 0.79. Furthermore, this value was estimated as 0.78, 0.74, 0.81, and 0.70 for dimensions one, two, three, and four, respectively. The ENRICH Marital Inventory is a reliable and valid instrument, the reliability of which was calculated as 0.75 through Cronbach’s alpha in this study.

After acquiring the confirmation of the Ethics Committee of the University and an introduction letter from the Faculty of Nursing and Midwifery, the researcher referred to the family health units of the selected healthcare centers every morning during the working hours. The participants were provided with the necessary explanations about the research objectives. Furthermore, they were informed about anonymity and confidentiality terms. Subsequently, the subjects who were willing to participate in the study and meeting the inclusion criteria completed the written informed consent form, and then filled out the other questionnaires. The duration required for completing the questionnaires was around 30 min. The sampling lasted for 4 months, more specifically from March 2013 to June 2014.

The data were analyzed in SPSS software (version 16). First, the normality of the variables was determined using the Kolmogorov-Smirnov test. In the next step, independent t-test, Mann-Whitney U test, as well as Pearson and Spearman correlation tests were utilized. A confidence interval of 95% and significance level of 0.05 were considered for all tests.

Results

According to the results, the mean age of the participants was 30.49±5.28 years (age range: of 16-43 years). Regarding the education status, 7 (5.8%), 6 (5%), 32 (26.7%), and 75 (62.5%) participants had primary, middle school, high school, and academic education levels, respectively. To investigate the homogeneity of the demographic variables among the employed and housewife groups, first, the normality of the variables was checked, and then proper statistical tests were run (Table 1). Given the lack of any relationship between the demographic and main variables, t-test, and Mann-Whitney U test were used to compare the two groups.

Table 2 presents the extent of the difficulty of transition to parenthood among the employed women and housewives. Table 3 tabulates the data regarding the level of marital satisfaction among housewives and employed women.

Considering the normality of transition difficulty to parenthood in the two groups, the data were subjected to t-test. Accordingly, a significant difference was observed between the employed women and housewives regarding the extent of transition difficulty to parenthood (P=0.009). In this regard, transition to parenthood was more difficult for employed women than for the housewives. The mean scores of difficulty in transitioning to parenthood were 1.40±22.87 and 1.50±18.36 in the housewife and employed groups, respectively. However, the results of the Chi-square test revealed no significant difference between the two groups in terms of marital satisfaction (P=0.71).

Among the housewives, there was an inverse significant relationship between the extent of difficulty in transitioning to parenthood and marital satisfaction level (r=-0.60, P<0.05). In other words, as the difficulty of transition to parenthood increased, the extent of marital satisfaction decreased (Figure 1). A significant relationship was observed between transition difficulty to parenthood and the level of marital satisfaction among the employed women
(r=-0.43, P<0.05) (Figure 2).

There was a significant relationship between the difficulty of transition to parenthood and marital satisfaction among women and their spouses. Furthermore, the marital satisfaction of women was inversely associated with all dimensions of transition difficulty to parenthood, including the parental responsibilities and limitations, parental satisfaction and gratification, marital intimacy and stability, and personal commitment. This suggests that as the difficulty increased across the dimensions of transition to parenthood, the women’s marital satisfaction declined (Table 4).

The results of the Pearson correlation coefficient indicated no significant relationship between transition difficulty to parenthood and the variables of age, level of education, household income, duration of marital life, and desired pregnancy among housewives (P>0.05). However, the marital satisfaction was significantly associated with household income in this group (r=0.36, P=0.004). Accordingly, as the income enhanced, the extent of marital satisfaction increased. (Table 5).

Regarding the employed group, transition