MATERNAL WELLBEING: IMPACT OF PARENTING AND CHILD ABUSE

The present study examined impact of parenting and child abuse on maternal wellbeing. A sample size of 200 pregnant women was selected from the hospital settings by purposive sampling technique. Flourishing Scale, the Alabama Parenting Questionnaire Parent Form (APQ-P) and ISPCAN Child Abuse Screening Tool—Parent version (ICAST-P) were used. The results indicated that there is a significant negative relation and impact between maternal well-being and child abuse. The relationship of maternal wellbeing is significantly positive and predictable with involvement, positive parenting and inconsistent discipline. However, maternal wellbeing is significantly negatively associated and predicted with poor monitoring and corporate punishment. The interpretation of quantitative content analysis revealed parenting techniques mothers used as appropriate means to discipline their children.


INTRODUCTION
A women's physical, psychological, social, or emotional health before during, or after pregnancy is known as maternal well-being.Childbirth brings many variations and changes in women's life in the form of physical, psychological, and social changes.Maternal wellbeing is as much important for the mother as it is for the child because if maternal wellbeing is affected either physically or psychologically, then it brings intense outcomes for the child's wellbeing in the form of child abuse and maltreatment, and other risk behaviors (Awlahkar, 2020).Maternal well-being is highly linked with children and their behaviors in the future.One study in Canada was conducted on adolescent risk behaviors which revealed that mothers suffering from depression during childhood increase the chances of drug abuse, violence, and all other risk behaviors.It means that maternal wellbeing highly affects child well-being and their future (Wickham et al., 2014).Other than that it is also considered that parenting is the main reason behind a child's development of risk behaviors and being abusive.Those children who have no attachment to their parents, no involvement of parents, and limited affection and guidance, are more prone to be abusive and involved in risky behaviors and violence (Delvecchio et al., 2020).Child maltreatment or abuse is defined as violence on children that are intentionally or unintentionally implied on children either in the form of physical,or psychological by adults from society or parents.There are various forms of child abuse as physical abuse in which they maltreat the child, psychological abuse in which mental torture is used, and sexual abuse in which they experience assault (Fernandes, et al, 2021).Chang et al., (2008) conducted a study to understand the link or connection between parental psychological abuse and child abuse or maltreatment.The population for this study was mothers who have children of age 0-17 years and the sample size was 1149 specifically belonging to North (574) and South Carolina (575).Both partner psychological and child abuse were divided into further categories out of which only neglect was binary.
The results indicated that both partner psychological abuse and child abuse or maltreatment were strongly associated.It also highlighted the fact that partner psychological abuse was nothing new in families and with the review of previous research it was clear that women or mothers were two times more abusive towards their children either physically or psychologically.Yaman (2020) in this paper conducted a research on comparison of motherhood and child abuse or neglect.The sample size was 17 and the population was mothers out of which 8 were non-abusive and 9 were abusive from whom the data was collected through in-depth interviews using diversity sampling method.The scale used for this purpose was Adult-Adolescent Parenting Inventory and the method to collect data was semi-structured interviews.Only those mothers were included to participate having children of age range 6-11 years and those who have low socio-economic status and education.The results identified certain themes that are linked with child abuse and neglect as mother characteristics, parenting, relation, financial and work situations, family circumstances.Thus all these factors are majorly linked to motherhood which leads to child abuse and neglect.The research gap was that this paper highlighted that mothers are mostly involved in child abuse but it did not emphasize this in terms of fatherhood.Dickerson (2019) conducted a study on maternal psychological wellbeing and its impact on children and adolescents specifically in Peru.It also focuses on impact of maternal depression on health of children.The results highlighted that maternal depression has influence on children's wellbeing and also indicates that maternal wellbeing or life satisfaction is positively linked with better outcomes in children.The limitation of this paper was that the maternal depressive symptoms were not clinically diagnosed.Richter et al., (2018) conducted a study and the results indicated positive direct and indirect association and correlation among pro-social behavior and maternal wellbeing as well as parenting practices.Results also highlight the fact that maternal wellbeing enhances positive parenting which in return also enhances child wellbeing.The major limitation of this study was its cross-sectional kind of data.Also as the interview of children was taken at their homes providing them comfortable environment might bring the biases in results.
Researches showed that parenting stress and child abuse is positively linked, in other words which means that parenting affects child abuse.Child abuse is associated with maternal depression and in results indicated that mothers with psychological illnesses like depression are more likely to abuse their children and maltreat them.Which means that maternal well-being is linked with child abuse and if mothers' well-being is not good, it will lead to child abuse having a significant relation among them (Rodriguez et al.,1997;Çalgi, 2021).In Pakistan, there is not much literature available on this research topic which brings the gap in Pakistan's research study and that was one of the aim and objective of study to contribute and enhance its literature.The hypotheses of this study are 1) There will be a negative relation between maternal well-being and child abuse, 2) There will be a significant relation between maternal well-being and parenting, 3) There will be a significant relation between parenting and child abuse, 4) Child abuse and parenting will significantly impact maternal wellbeing.

METHODOLOGY
The study was conducted in two phases.Phase I comprised of translation of Alabama Parenting Questionnaire-Parent form and ICAST-Parent Form into urdu.Brislin (1986) devised forward and backward methods for translation.By following this standardized method of translation in Urdu, below is mentioned the steps involved in our translation of both APQ form and ICAST-C scales.In forward translation, the scales were translated from the English language to Urdu by parallel back translation.Two PhDs and three PhD Scholars from Department of Psychology translated the versions.After forward translation, in second step all the forwardly translated versions were combined and compared to measure the relevance of items by reviews from experts and this approach is known as committee approach.Here one PhD, one PhD scholar and one MPhil committee members reviewed and finalized Urdu version.Backward translation was done by two PhD scholars and one PhD of English department of forwardly translated version is arranged and compared to original as well as forward translated version to improve the consistency level of items by keeping the purpose of the scale intact.In the last step, both forward and back translations were judged by experts using committee approach to check whether the translated version complement the original version or not.In tryout phase 30 participants were approached and translated versions were found to be understandable and culturally relevant.In Phase II, the relationship between all the variables like maternal well-being, parenting and child abuse, was explored with cross-sectional correlational study design.For this purpose, a standardized questionnaire using 3 scales is used to correlate each variable with other.

Sample
The target Population for this study was pregnant women's who have at least one child of above 1-year age range.The sample size of target population was 200 pregnant women's and the data collected in government hospital settings.Non-probability sampling technique was utilized for the depiction and well representation of pregnant women from government hospital settings named as DHQ Hospital Jhelum, Rural Health Center Dina, District Jhelum and Sir Ganga Ram Hospital Lahore.The inclusion criteria for selection and participation in this study were: Pregnant women's who willingly participated want to share their experience, pregnant Women's who have at least 1 child above one year.The criteria for exclusion from this study were: Pregnant women's who are not willing to participate in study and Women's who are experiencing pregnancy for the first time with no child.The mean and standard deviation of age was (M=30.18,SD=4.99), husband age (M=33.24,SD=5.88), marriage duration (M=8.68,SD=3.65) and income (M=51660.00,SD=37668.00).

Instruments
The data relevant to this study was collected through 3 scales named Flourishing Scale, Alabama Parenting Questionnaire (APQ) Form and ICAST-P version 3 and one informed consent form and demographic form.Choudhry et al., (2018) translated the Urdu version of the Flourishing Scale which measures subjective well-being.The Alabama Parenting Questionnaire was developed by Paul Frick in 1991 which is a multi-informer assessment tool.It consists of 5 subscales or constructs to assess parenting behaviors which includes Parental Involvement, Positive Parenting, Poor Monitoring, Inconsistent Discipline and Corporal Punishment (Frick, Christian, & Wootton, 1999).ISPCAN Child Abuse Screening Tool Parent Version (ICAST-P) V3 consists of five subscales to measure physical and psychological violence, non-violent, sexual abuse and neglect.ICAST-P has good internal consistency.This scale consists of total 44 items relating to non-violent, psychological and physical discipline (Runyan, Dunne, Zolotor, Madrid, Jain, Gerbaka,... & Youssef, 2009).Though whole scale was translated into Urdu but because of cultural stigma with sexual abuse, its subscale was not used in the present study.

Procedure
After they granted the permission, pregnant women were approached and information on this study was disseminated among them.Also for those who have at least one child were further briefed about the purpose of this study, ensured about privacy that their personal information will be confidential and data will be used only for the purpose of research studies.After they orally agreed to participate, consent form was signed.They were instructed to fill the demographic form as well as all the statements of all 3 scales (Flourishing scale, APQ, and ICAST-P) mentioned in the questionnaire carefully and completed.200 questionnaires were completely responded even though 250 were administered but not completed due to lack of interest to complete many participants left questionnaires half-filled or missed some responses which can't be included in the study.

RESULTS
The current study inspected the relationship between maternal well-being and child abuse, maternal well-being and parenting, and parenting and child abuse..04***p< .001Table 4 shows the impact of abuse on well-being in pregnant women. Te R 2 value of .04revealed that the predictor value variable explained 4% variance in the outcome variable with F (1, 198) = 8.01, p < .001.The findings revealed that significant negative impact of child abuse on wellbeing..11***p < .001Table 5 shows the impact of Involvement on well-being in pregnant women. Te R 2 value of .11revealed that the predictor value variable explained 11% variance in the outcome variable with F (1,198) = 23.79,p < .001.The findings revealed that significant positive impact of involvement on wellbeing..08 .28***p < .001Table 6 shows the impact of Positive Parenting on well-being in pregnant women.The R 2 value of .08 revealed that the predictor value variable explained 8% variance in the outcome variable with F (1,198) = 16.72,p < .001.The findings revealed that significant positive impact of positive parenting on wellbeing..04***p < .001Table 7 shows the impact of Poor Monitoring on well-being in pregnant women. Te R 2 value of .04revealed that the predictor value variable explained 4% variance in the outcome variable with F (1,198) = 8.35, p < .001.The findings revealed that significant negative impact of poor monitoring on wellbeing.8 shows the impact of Inconsistent Discipline on well-being in pregnant women.The R 2 value of .02revealed that the predictor value variable explained 2% variance in the outcome variable with F (1,198) = 4.21, p < .001.The findings revealed that significant positive impact of inconsistent discipline on wellbeing.9 shows the impact of Corporate Punishment on well-being in pregnant women.The R 2 value of .04revealed that the predictor value variable explained 4% variance in the outcome variable with F (1,198) = 7.52, p < .001.The findings revealed that significant negative impact of corporate punishment on wellbeing.

DISCUSSION
Various studies have inspected the link between mother-child in developed countries as well as in developing countries that what is the impact of maternal well-being on child health but revealed that it is scanty in developing countries (Thomas et al., 2020).The main objective of conducting the whole study was to inquire or investigate the relationships among maternal wellbeing, parenting and child abuse in Pakistan.The first hypothesis of this study was that there is a significant correlation between maternal wellbeing and child abuse.This association between variables was assessed and evaluated by correlation analysis that indicated well-being has a significant but weak negative correlation with physical abuse (r=-.19**,p<.01), psychological abuse (r=-.14*,p<.05) and neglect (r=-.16*,p<.05) which means that maternal well-being and child abuse (physical as well as psychological, neglect) have significant weak negative correlation.The impact of child abuse on maternal wellbeing is F (1, 198) = 8.01, p < .001which explains 4% variance.Previous researches and literature also supports this hypothesis of significant relation between maternal well-being and child abuse (Harding & Nakamura 2020).One other study also supports hypothesis as their research shows that maternal depression increases child abuse risk and significantly linked (Conron et al., 2009).
The second hypothesis of the study was that there is significant relation between maternal well-being and parenting.The correlation analysis indicates that Well-being has weak positive correlation with Involvement (r=.33**, p<.05), Positive parenting (r=.28***, p<.05) and Inconsistent Discipline (r=.14*, p<.05), weak negative correlation with Poor Monitoring (r=-.20**,p<.05),Corporate Punishment (r=-.19**,p<.05).This shows that with improved maternal well-being, positive parenting will occur in result and vice versa.This correlation value indicates positive significant correlation but weak.The R 2 value of .11showed that 11% variance with F (1,198) = 23.79,p < .00,revealed significant positive impact of involvement on wellbeing.The R 2 value of .08 revealed 8% variance with F (1,198) = 16.72,p < .001for significant positive impact of positive parenting on wellbeing.The R 2 value of .04revealed 4% variance with F (1,198) = 8.35, p < .001for significant negative impact of poor monitoring on wellbeing.The R 2 value of .02revealed 2% variance with F (1,198) = 4.21, p < .001for significant positive impact of inconsistent discipline on wellbeing.The R 2 value of .04revealed 4% variance with F (1,198) = 7.52, p < .001for significant negative impact of corporate punishment on wellbeing.Literature review of previous researches support this relation as one study concluded that affected maternal well-being results in poor parenting, in other words good maternal well-being specifically mental well-being results in positive parenting providing that there is a significant relation between both of them (Hickey et al., 2019).
The third hypothesis of this study was that there is significant relation between parenting and child abuse.The correlational analysis indicates that there is significant moderate but negative correlation between parenting and abuse as with physical (r=-43***, p<.05) and psychological (r=-.41***,p<.05) and weak with neglect (r=-.32***,p<.05).This means that there is negative moderate correlation between parenting and child abuse as positive parenting increases, the child abuse will decrease and vice versa.Previous literature and studies on this relation provides evidence on statistical significant relation between both parenting and child abuse (Lo et al., 2019).Other research study indicated in its results that parenting stress is correlated with child abuse which supports this hypothesis as affected maternal wellbeing lead to increase in child abuse (Rodriguez et al., 1997).The findings of research clearly proved that there is a strong association between parenting and child abuse or maltreatment.Schafer et al., (2013) conducted a study on to impact of maltreatment on children in terms of general evaluations from parents.The sample size was 348 divided between men and women and out of all respondents who were recognized as non-white, black were 201, Native American were 22, Asian were 22, 80 were others and the remaining 23 were multiracial identified.The results indicated that abused or maltreated respondents assessed abusing parents less approvingly as compared to nonabusing parents but there are some discrepancies in their relations.

Conclusion
Al in all, the present study explored the relationships among maternal well-being, parenting and child abuse by collecting data from pregnant women having one child at least.The results concluded that there is a negative correlation and impact between maternal well-being and child abuse.There is a significant relation and impact between parenting and child abuse, and significant relation between maternal well-being and parenting as well.Thus, implications pointed out towards carrying intervention studies for effective parenting, reduced child abuse to enhance maternal wellbeing.

Table 3 .
Quantitative Content Analysis for Open-Ended Question.

Table 3
illustrates the quantitative content analysis.78 mothers responded that they discipline their child with love and politeness, 26 preferred that scolding, 49 highlighted that they punish and beat them, 17 mothers threat them with father's name, 23 of them prefer providing good environment and 7 of them stated that the use of rewards work best to discipline them.78 mothers discipline their child with love and politeness and that works best.

Table 4 .
Regression Coefficients Of Child Abuse On Well-Being

Table 5 .
Regression Coefficient Of Involvement On Well-Being

Table 6 .
Regression Coefficient Of Positive Parenting On Well-Being

Table 7 .
Regression Coefficient Of Poor Monitoring On Well-Being

Table 8 .
Regression Coefficient Of Inconsistent Discipline On Well-Being

Table 9 .
Regression Coefficient Of Corporate Punishment On Well-Being