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

AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. REGISTRATION: This study has been registered in the Japan Registry of Clinical Trials (jRCT1030220453).