Working mechanisms of the self-compassion-based childbirth and parenting preparation program: A realist evaluation

The Self-Compassion-Based Childbirth and Parenting Preparation Program (SCPPP) for newly expecting couples is designed to activate self-compassion at challenging moments, induce calm, and enhance co-parenting motivation during the perinatal period. However, how the program affects participants' learning processes remains unknown. This study aimed to clarify the working mechanisms of the SCPPP.

Between 2022 and 2023, a total of 18 participants (9 couples) were recruited in Japan through obstetric checkups and snowball sampling. They attended 5-week prenatal and 1-day postnatal online programs, wherein they learned about self-compassion and discussed its use with their partners and group members. Their narratives, psychological measurements, and observational data obtained from the online sessions were qualitatively and quantitatively analyzed using a realist evaluation approach.

Five prenatal mechanisms were identified: (1) Acknowledge the comfort of learning in a group; (2) Start self-talk; (3) Slow down practices by recalling the safety guidelines; (4) Explore the meaning of learning self-compassion; and (5) Expand self-focused perspectives by listening to partner and group members. Additionally, four postnatal mechanisms were identified: (1) Recall one's trajectory; (2) Incorporate one's learning with the new life through time spent experiencing mutual support within the group; (3) Try to shift the viewpoint from a single-minded focus on childcare; and (4) Make meaning of one's learning experiences.

The findings suggest that the SCPPP may work under mechanisms that follow adult learning and attachment theories, and that these mechanisms may be essential in a self-compassion-based program for expecting couples transitioning to parenthood.

This study has been registered in the Japan Registry of Clinical Trials (jRCT1030220453).