The transition to parenthood has been studied from different cultures and from different perspectives. Our extensive search via the Health Systems Evidence (HSE) found that particular emphasis on social contexts and how the impact of parenthood on well-being depends on marital status, gender, race/ethnicity, and socioeconomic status have been studied [1-4] Marital satisfaction across the transition to parenthood [5,6] its effect on the first-time parents’ postpartum changes in employment, child care, and housework responsibilities [6,7] Gender-role attitudes and behavior across the transition to parenthood [8] leep disruption and decline in marital satisfaction across the transition to parenthood [9]. Depressive symptoms and psychosocial stress across the transition to parenthood [10] Parental self-efficacy and stress-related growth in the transition parenthood [11]. The previous work has failed to consider the cultural effect on the experience of the transition to parenthood.

In the Middle Eastern countries, culture can have a major impact on life experiences such as the experience of the transition to parenthood. In most Asian countries, being a parent is a strongly sanctioned social value and a highly desired personal role [12]. As noted by Martins et al. (2014), motherhood and fatherhood are socially and culturally constructed [13]. Traditionally, the purpose of marriage is to produce children and carry on the family name [14]. Given the absence of studies on how culture influences the transition to parenthood from different cultures, particularly Arabic societies, the current study will add a new understanding of the influence of culture on the new parent’s experience of the transition to parenthood.

In Jordan, both child bearing and child rearing has long been viewed as a natural practice as old as humanity. Most Jordanian parents would argue that numbers of generations have been reared successfully using “old grandmother recipes” given down from parents to children. However, as Jordan undergoes dramatic societal modernization, cultural traditions are breaking down and family forms are fast changing; hence, it is no longer possible to learn all that one needs to know about parenting through modelling and experience. With extensive urbanization and the family nuclearization, today’s Jordanian parents can no longer rely on the traditional extended social network for support and help. Because all the available studies around parenting and the transition to parenthood are mostly from western cultures, it is not easy to apply the research findings in some Arabic cultures such as Jordan. This study, conducted with Jordanian parents and their support providers, is important and pioneering for both new parents in Jordan and health care providers and counsellors in considering the sensitivity of this life transition and acknowledging new parents need for professional support as much as their need for traditional assistance.

As mentioned, very little is known about the cultural effect on the experience of the transition to parenthood. Culture can have a major impact on the transition to parenthood and can make it a very stressful experience, with a significant negative impact on marital life. This spurred us to explore and understand the cultural influence on the transition to parenthood for new parents after the birth of their first child. This understanding will help families, nurses and care providers to plan proper interventions to enhance a positive experience of parenthood.

The aim of this study was to describe the cultural influence on the experiences of the transition to parenthood after the birth of the couple’s first baby. We asked the following research question: How does Jordan’s culture influence new parents’ experience during their transition to parenthood?

Design

A descriptive qualitative research design is required to answer this research question in the most appropriate way.

Sample

Forty participants (15 young men, 15 young women, five older men and 5 older women) were recruited for this study. The inclusion criteria for participants were that they had to be married couples that lived together and have a new baby by normal vaginal delivery aged 6 weeks are more .There were no specific criteria for the older generation; we interviewed those one who gave their consent to participate in the study.

Ethical consideration

The research proposal was approved by the University Ethics Committee and the Research Ethics Committee of the Ministry of Health in Jordan. Subsequent liaisons with the Health Directorate in the Irbid Governorate facilitated access to the Maternal and Child Care Health centers to recruit the study sample.

To ensure anonymity no private data which identified the participants would be used in the study publications. The participants were assigned with a number attached to the relevant interview record, transcription and field note. Couples were allocated the same number.

Data collection

Forty unstructured, in-depth interviews were conducted with participants who met the research criteria. All interviews were conducted by me (the primary investigator) at the home of the participants if they so choose’. The questions were open-ended, providing participants the opportunity to explain their views, feelings or experiences. For example parents were asked, “Can you tell me about your experience of the transition to parenthood?” “How does culture influence your whole experience?” Both questions produced very rich data. Follow up questions also encouraged detailed and spontaneous answers which could be probed in depth.

Analysis

Thematic analysis was used in our research to examine themes within data. In an inductive approach, the data was read and re-read in order to become familiar with what the data entails, paying specific attention to patterns that occur. The initial themes codes were generated by documenting where and how patterns occur. This happened through data reduction where I collapsed data into labels in order to create categories for more efficient analysis. I combined codes into overarching themes that accurately depict the data. I looked at how the themes support the data and the overarching theoretical perspective. Whenever the analysis seemed incomplete, I went back to the data and found what is missing. Then I defined what each theme is, which aspects of data are being captured, and what is interesting about the themes. While writing the final report, I decided on themes that made meaningful contributions to answering our research question.

Trustworthiness

Credibility was accomplished by taking a full description back to a randomly selected ten participants to see if it reflects their perception. The anonymised data was analyzed and reviewed by me and a faculty colleague who has experience with such research. I showed my analysis and conclusion to another colleague for the development of both the design and analysis of the study [15]. I conducted a pre-exercise interview with three participants who met the criteria. Truthful representations of the reality of the participant’s data are presented, and the participants are described accurately, with the aim of attaining trustworthiness [16]. Furthermore, I confirm that the research findings are the result of the research and not our assumptions and preconceptions. The issue of conformability focuses on the characteristics of data being dependable. According to Holloway and Wheeler (2002:255), inquiry audit can be used to trace the data to their sources [17]. In this way, our path of arriving at the constructs, themes and their interpretation can be followed. In this study I audited the whole research process. The transferability of this study was insured because I provided a full description about the setting, the participants as well as the method of data collection.

Demographic data

Forty participants (fifteen husbands and fifteen wives and ten older fathers and mothers) gave their consent to participate in my research. The age of wives ranged 19-27 years old, however husbands were 20-39 years old. Older participants were aged between (55-75) years old. All young participants were educated, 6 women to secondary level, 9 to university level (BSc). While 14 of the men were university graduates, with only one having left education after secondary school. Most women (10) were housewives, 4 school teachers, and 1 nurse. All men were employed; 1 dentist, 2 nurses, 1 school teacher, 2 engineers, 5 in private sector, and 4 in the royal army.

This research study aimed to identify and describe the importance of cultural values and beliefs in shaping the experiences of new parents in relation to marriage, birth and family life. Within Jordanian society, culture underpins traditional customs, values and beliefs which directly influence the way that women and their husbands respond to the family, marriage, and to having a baby. ‘Culture’ was described by the participants as influencing all aspects of their lives; providing their rules of living, guiding them in bringing up their children and preparing them for parenthood, and importantly, deciding their future roles as ‘wife’ and ‘husband’ or ‘mother’ and ‘father’.

This study produced four sub-themes in relation to the major theme of the influence of culture on the transition to parenthood; family loyalty, virginity, respect of gender roles, and arranged marriages.

Family loyalty: Young parents who participated in this study felt overwhelmed by the cultural ‘norms’; specifically that the elder generation should be respected and followed by the younger generation because of their experience and wisdom (Hikma). Participants acknowledged that their elders’ decisions are expected to be respected and followed by all family members.

“…we have to respect and follow our parents’ rules; they have to be respected for their ‘Hikma’… their long experience is highly respected and appreciated by all…fathers are the head of the family…”.

While this participant (a young man) felt overwhelmed by the expectation to remain loyal to his parents, he also felt that such loyalty impacted upon the decisions he took in life. This immediately creates an area of tension in his life. Young women traditionally move in with their in-laws (this was true of 8 mothers interviewed for this study), and report feeling under particular pressure to demonstrate respect and loyalty to their husbands and in-laws. Respect for in-laws can even be seen as a way of showing ‘real love’ to the husband. For example, one young mother observed:

“…My mother keeps on reminding me to respect my husband and his family… my husband told me that if I really love him, I have to respect his parents…” (Young woman).

The most important way for a young woman to show her family loyalty and respect is by guarding her chastity and virginity according to cultural traditions. Although the Quran places equal emphasis on the importance of virginity for both men and women, the participants in this study considered that the virginity of women was particularly important.

Virginity

Virginity is often set as a female ideal which intimates how portions of the Jordanian people mean idealize women, especially regarding physical self-control, and moral behavior. The older people interviewed in this study asserted that honour is maintained through a woman’s sexual purity.

“… Keeping family honour is very important and it is everyone’s responsibility, we guard our children especially a girl to keep her virginity… not to have any relationship with boys and not be alone with them… modesty is critical for all…” (Older man).

Family reputation and the reputation of children are interconnected. The requirement to preserve a good reputation had an influence on these participants in terms of the preparations they took towards parenthood. From the interviews, it emerged that a girl’s virginity is not solely her own; rather it belongs to her family and her community. One of the elder generation interviewed, stressed that the girl’s bad behavior reflects on the extended family and brings shame on them. She asserted that the shame brought on a family can last for generations and influences family connections in the community. This participant claimed that honor killings still take place to maintain family honor:

“… A girl’s behaviour will affect the whole family reputation for generations… if a girl had sex before marriage she will be killed by one of the family members to wash the shame off the family…” (Older woman).

In the interest of preserving reputation, older men put strong restrictions against the interactions of their daughters with men and none were socially approved of or accepted [18,19]. Interactions between women and men were strictly curtailed amongst this sample and most of the young women (n=9) entered marriage without having ever spoken to a male stranger alone. To preserve the reputation of women for virginity, chastity and honour, family members made it clear that it is not only sexual modesty that is important, but that young women should not be seen to even have social relationships with boys. Moreover, many Muslims share similar beliefs about the importance of female virginity as a social status, a spiritual symbol, and ‘a metaphorical symbol of continual renewal and promise’. A woman’s chastity is thus linked to the honour of the family and the loss of one implies the loss of the other.

The elder generation advocated more modesty for women than for men because of the influence of traditional ‘culture’ on their life styles. They contended that family honor and shame are intertwined with religion and tribal culture. These participants agreed that honour for Muslim women is about modesty, fidelity and devotion to responsibilities.

“…Islam forbids sex before marriage, it is forbidden ‘haram’… it is one of the never forgiven faults… female chastity is an unquestionable must …” (older woman).

Knowledge relating to sexuality and reproduction was limited amongst this sample. Most of the new mothers in the sample entered marriage with very little knowledge about sexuality or reproduction.

Some degree of disparity was observed between the views of young and older people in the sample with regards to the preparation for marriage. New mothers expressed frustration with the limitations they faced with regards to their mobility and interaction with men. Furthermore, young girls expressed anger towards the Jordanian culture for maintaining a widely accepted connection between virginity, reputation and interactions with men. These participants protested that direct contact with men does not impact severely upon family reputations. Nonetheless, maintaining family reputation was identified as important by participants representing both generations.

Young mothers demonstrated a degree of understanding regarding the importance of virginity and family reputation. These participants emphasized how their elders had impressed upon them that they must preserve family honour by not associating with men. Such participants observed that, although they understand the cultural beliefs around their chastity and reputation, they believe that this should not equate to the need to remain indoors under supervision.

The commitment to ‘cultural paradigms’ regarding virginity was also identified amongst male participants. One young male participant observed that he would refuse to marry a girl who would agree to have a sexual relationship with him. This participant argued that women partake in sex before marriage is morally corrupt. The finding confirms the strength of such beliefs in Jordanian culture.

“When a man is looking to marry a very good wife… he will always look for one who has never had unauthorised contact with a man… no-one will marry a girl who has been in a (sexual) relationship with him before marriage… you know…ammm… I believe if a girl had a relationship with one, sure she can have another relationship with another … ‘it is our culture’…” (Young man).

This finding suggests that women suffer more than men from the subject of ‘Virginity’ and its interconnection with reputation. The dilemma here is that there is a clear gender bias in this situation. For some men, mixing with girls is acceptable but when they want to choose a wife, they will avoid the same girls who mix with men.

Young women face the dilemma of either accepting such strict restrictions placed on them by their families or later facing the rejection of these men who will refuse to marry them in future. The mothers interviewed were consequently wary of interacting with men for fear of inviting questions about their morality and virginity. This in turn had an effect on their confidence and made them feel fragile and frightened or ‘mathoura’ (to worry and panic).

“…I have never ever been in an unauthorized relationship with a man … I know it is against cultural rules …” (Young woman).

“Behaviors count and the eyes are on you... you feel fragile, you become worried and ‘mathoura’.” (Young woman).

Implications for the transition to parenthood: Modernization has begun to influence the behavior of men and women with increased interaction between the sexes at university and in work place are mixed. This change has confused and frustrated many young people. Young adults remain reluctant to accept the restrictions placed on them. Cultural restrictions make young girls feel vulnerable and their selfconfidence is thus compromised together with their preparedness for future marital and parental roles. Young women within this sample observed that this interfered with their preparedness for relationships.

“... however the university is mixed, I never been in contact with any of the male students there... I believe this is not how it is supposed to be... ‘It even affects my self-confidence ...”(Young woman).

Respect of gender roles: The findings have identified a generational clash in terms of interpretations of gender roles. The older generation interviewed for this study expressed strong views about appropriate gender roles for men and women in the family, along traditional lines. Young participants call this division of gender roles into question and believed that these roles can be reshaped to fit with the development of cultures.

Older participants saw the role of a woman to be ‘a good wife and mother’. They believe these roles are achieved when women learn to manage the household including cooking, cleaning and helping the husband. Males are expected to be ‘good husbands and fathers’ and to work and make money.

“…Since she was a little girl I prepared her to be a very good wife, I taught her how to cook since she was 15 years old… I think… amm … she knows that she is the one who must help her husband… she must be a very good support for him…you know men go to work and expect to come home to find their food ready and the house is clean ... it is her job to do the house stuff… this is how she was reared …” (older woman).

My research found that Jordanian children are raised in such a way to prepare them for future roles as husbands and wives, and fathers and mothers. Females are prepared to be Homemaker or ‘ banna’ and sons are prepared as the breadwinners, or ‘Janna’.

“We have to prepare our children to be good husbands and wives and parents; … good mothers are ‘banna’ and good fathers are ‘janna’” (older mother).

Older participants believed that mothering skills and ‘mothering feelings’ come by nature “fitrah”. These participants believed that females are born to be wives and mothers, and this is their main responsibility. According to these participants, mothering skills develop gradually in young girls:

“I believe mothering skills comes with “fitrah”. If you watch little children playing, you will notice the difference between boys and girls ways of playing. Girls always prefer to play with dolls, feeding and changing nappies… They act as little mothers for these dolls …” (older woman).

Young women said that it was not enough to know how to clean and cook in order to manage the new experience of marriage, pregnancy and a new baby. They argued that the demands after marriage require preparation beyond a basic knowledge of how to run a household. Young fathers said that the role of contemporary fathers is different now and they wanted to play roles in a different way than their fathers:

“Everyone knows how to do shopping and buy stuff, but that does not mean that they will be a good husband or a good father, parenthood is different and needs different preparation... fathers’ roles are different than before... modern fathers are expected to share the experience of bringing up the baby with his wife...” (Young man).

New parents are facing the dilemma of what is expected of them and what they are really experiencing and are willing to do. They talked about feeling unprepared for marriage, pregnancy, birth and going home after birth.

Arranged marriages: In Jordanian culture, arranged marriages are common and considered as uniting two families, not just two individuals. Older participants in my research explained that they were concerned about the welfare of the couple and the new baby, and they give this as their reason for becoming so involved in the decision to marry:

“When your daughter or son got married, the whole family got involved… it is not just them, it is both their families… both families become as one family… We have shared concerns which is always about them and their new baby… both of us wanted to help as much as we can” (older mother).

Older participants advocated arranged marriages to ensure stronger and happier marriages. These participants considered it their responsibility to take all the important factors into account, including financial considerations, personal suitability, and family cohesion in order to make the marriage result in a strong life-long partnership. The families of young people were charged with negotiating marriage terms more so than the couple themselves.

“Personally I think that the way we arranged his marriage is great if it is done with great care and concern for the two getting married and their happiness financially and personally. We spent a very long time deciding who he should marry and our decisions were based on a wide array of things...we decided on his cousin… they didn’t know each other before” (older man).

In decisions about marriage, almost all young participants in this sample felt compelled to follow the advice of their parents with regards to choosing their partner. Young participants felt that they had no choice but to agree to an arranged marriage, so all participants were in arranged marriages.

Globalization and modernization engender young people to favor the modern way of choosing partners but within certain cultural limitations. Young people in this study did not mind marrying at a certain age but they wanted to have a say in choosing their intimate partner. A young man explained his own experience when he showed interest in a particular girl and he asked his mother to go and see her. This participant said that parental approval was important to the extent that the marriage would not happen without it. He commented if his parents did not agree with his choice, the marriage would not be possible.

“my wife was a student at my university… I asked my mother to go and propose marriage for her family, my parents opinion was very important, or I would not have been able to marry her, … if my parents did not agree with my choice, this marriage would not be possible”(young man).

Another young man expresses some doubts about the quality of the relationship in an arranged marriage.

“…arranged marriage might work out very well, better than both spouses ever expected but sometimes it’s hard when the newly married couple has to cope with a life in common and don’t really feel love for each other…”(young man).

Of all the fifteen couples, only one experienced a more modern arranged marriage in which they were introduced to each other and allowed some time alone to talk (30 minutes). Both, husband and wife agreed that they felt better because they had chosen their partner.

“…his parents came to our house to ask for my hand for marriage…I was allowed to sit with him alone for 30 minutes…the next day I gave them my decision…” (Young woman).

Implication for the transition to parenthood: Young participants explained that, in the first days of marriage they experienced mixed emotions, ranging from being happy and excited to being mixed up and confused. Women entered marriage with anxiety, tension and fear. Newly wedded couples were expected to be happy while the experience of these couples was found to be slightly different. Furthermore, couples who were living with their in-laws (n=9) lacked privacy and this made the first few days of marriage even more stressful. Women identified with feelings of loneliness and isolation:

“…I am living with my in-laws in the same house… the first few days after my marriage I was… ammm alone and isolated…you feel like you are not one of the family, there nothing shared between me and them… you know a feeling like...emmm a stranger…” (Young woman).

For mothers in such situations, immediate pregnancy was perceived as an important way to become integrated into a new family. One mother explained how her status was increased after giving birth to her first baby:

“… if you want to be one of this family then you have to have your baby as soon as possible.…it is expected to happen…then you will be involved…” (Young woman).

Most of the young participants in my research decided to have their first child immediately after marriage despite the fact that they were not prepared for the experience. While Jordanian culture is supposed to prepare people very thoroughly for family life, in fact, participants in this study claimed to be “unprepared for marriage and parenthood”. However older participants suggested these new parents were in fact prepared to build a strong relationship as husband and wife or father and mother.

Modernization and globalization have influenced the transition to parenthood in Jordan underlining the need for new ways of preparing new parents for marriage. The findings of this research study suggest that preparing people for marriage should include information about sexuality, childbirth and inter-spousal communication. Such information should however remain culturally sensitive to avoid the loss of the value of some cultural traditions. The education that new parents receive (particularly young mothers) is important if women are to be empowered during pregnancy, birth and the period following the birth of their baby. Women cannot make educated decisions in the absence of information. An effective, comprehensive programmed to educate and increase knowledge of sexuality, contraception and reproductive health amongst Jordanian schools (and all girl schools in particular) is essential in a globalized society. Education can empower women to decisions with regards to their marriage, pregnancy and planning their family. The care managers, specifically nurses and midwives, can work with young people, help them to make lifestyle changes, and provide the necessary information and advice to promote patient empowerment, enhance self-management skill, and achieve better compliance with care recommendatios [20] The gap between the level of knowledge that young people have about sexual relationships, family planning, pregnancy and birth, adds to the stresses of married life and made Jordanian young people in this sample frustrated and unhappy. Young participants reported that this lack of knowledge made the experience of parenthood difficult in terms of adjusting to their new roles as partners and parents. Parents are not ignorant about parenthood in Jordan; rather they are hostages to the nature of the systems of support which are available to them in Jordanian culture. In addition, society forbids them to discuss issues of sexuality. Because of the strong social and religious value placed on virginity, unmarried women risk criticism from community and health workers if they try to obtain information about contraception and sexuality. These women are torn between cultural expectations and their own agendas with regards to their future roles. This finding corresponds with the findings of a small qualitative study of Jordanian young people aged 10-24 years which found that most young people equate reproductive health with maternal health care and believe that health centers are exclusively for mothers and babies [21]. Jordanian young people are frustrated with their culture and blame, primarily, their own parents and their culture for not educating them about parenthood and sex. They also identify the fact that they are forbidden from accessing information as problematic.

Some young Jordanian girls are surprised by their first experience of sex due to the lack of knowledge they have been exposed to about marital relationships. Moreover, in terms of this study, parents believed that this lack of knowledge contributes to couples entering marriage apprehensively and anxiously, instead of with happiness and excitement. DeJong and El-khoury argue that the lack of accurate information about sex and reproduction reflects a wider Arabic public policy of reluctance to provide sex education in schools. Although sex education is increasingly included in Arabic school curricula, teachers are often too embarrassed to talk about the issues and cover issues of sexuality when teaching biology or anatomy to students [22].

This study found that young parents overall were frustrated with the lack of knowledge they have, which made them struggle during their transition to parenthood. They felt terribly unprepared for the whole experience of married life, birth and family life. In part, this lack of preparation was a result of traditional norms which discourage conversations about taboo topics such as sexuality, or meetings between members of opposite sexes. Overall this contradiction meant that the young parents’ experience in the early weeks of their child’s life was often an experience of tension between traditional practices on the one hand, and the more modern practices that they had been exposed to on the other.

Jordanian new parents are experiencing a clash between tradition and modern practices due to the cultural change. Globalization, the media, education and access to the internet made young people open to view, discuss, and compare their experiences with those of other young people in other countries. However, older participants tend to be still very loyal to their traditional cultural beliefs. This difference between the younger generation’s wish for a modern experience of married life and the older generation’s loyalty to their cultural customs around marriage and pregnancy caused a generational clash that contributed to the way that young people experienced the transition to parenthood. The new parents feel caught between contradictory demands: on the one hand, their relatively ‘modern’ expectations of involvement and control over their own reproductive decisions experiences – and on the other hand, their experiences of being controlled–both by the traditional pressures from their families, and by the dominance of medical procedures and decision-making.

• Convincing young people to speak about their real experience (private family issues) of their transition to parenthood was a big challenge in doing this study.

• The small size required for the nature of the qualitative research can affect the generalisability of the findings.

• As a qualitative research, the research quality is heavily dependent on the individual skills of the researcher and more easily influenced by the researcher’s personal biases and idiosyncrasies.

• Rigor was more difficult to maintain, assess, and demonstrate related to the research approach.

• The volume of data made analysis and interpretation time consuming.

• It is sometimes not as well understood and accepted as quantitative research within the scientific community.

• The researcher’s presence during data gathering, which was often unavoidable in qualitative research, could affect the participant’s responses.

• Findings were difficult and time consuming to characterize in a visual way.

“This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.”