436 B. Kerstis et al. marital satisfaction (25). In another study, men whose partners suffered from postpartum psychiatric disorders reported greater marital dissatisfaction, and women who perceived satisfying marital relations were less likely to exhibit mental health problems during and after pregnancy (42). The correlation between lower perceived discord and depressive symptoms was stronger for the fathers than for the mothers. One explanation for this might be that women often have larger social networks than men (43). The connection between a high perceived level of discord and depressive symptoms may partly be due to the fact that if the mother or father feels unhappy it is easy to blame the partner (44). There was a correlation between higher levels of discord among mothers and fathers for the items: Socializing with family and friends, Important decisions, and Household tasks and perceived and depressive symptoms. If a person feels down it might be easy to think that her/his spouse does not understand the issues they have. For mothers, there was a correlation between higher levels of discord for the items: Friends and Philosophy and depressive symptoms. One expla- nation for this could be that a mother with depressive symptoms requires support from the father and wants him to prioritize herself and their child, as opposed to their friends. A correlation existed between higher levels of dis- cord among fathers for the items: Recreational activ- ities, Time together, Leisure time interests and activities, and Decisions regarding career/personal and depressive symptoms. One could assume that some fathers feel that their spouses do not have enough time to spend with them. Another reason may be that the father misses time for himself after the childbirth. Some recent fathers do not have a clear idea of what it means to be a father and might need support to assume their new role (45). If we had investigated marital discord after several weeks/months, the parents might have given different responses. Limitations and strengths The present study has a number of limitations that must be acknowledged. Firstly, DCS and EPDS were not measured on the same occasion so we do not know if the depressive symptoms were present at the time the marital consensus was assessed and vice versa. Another limitation was that marital discord was assessed 1 week after childbirth, i.e. a period in life that includes an overwhelming experience for most couples. However, the reason for this decision was that we intended to create a baseline variable for comparison with the 3-month assessments. Another option would have been to measure marital discord during pregnancy, although this is a period in life when many couples experience other types of pro- blems (46). EPDS has only occasionally been validated on men (36), and, to our knowledge, there has been no validation on men in Sweden, which is a shortcoming. The present study’s EPDS cut-off of >9 increases the rate of false-positive postpartum depressions com- pared to a cut-off of >12. The latter gives few false- positives, but the sensitivity is far from adequate (47) and will miss a considerable number of cases (39). A cut-off of >9 is, however, recommended for routine examinations when the scale is used by primary care workers (27). Choosing the cut-off of >9, which has been used in other Swedish studies (48–50), also gives study groups large enough to compare the mothers’ and fathers’ DCS and EPDS scores. Another limitation of the present study was that the printing error in the baseline questionnaire, with about one out of four questionnaires missing the DAS questions, resulted in 96 couples not being possible to analyse, and they were thus removed from the data set. However, the missing question- naires were scattered across the ﬁeld meaning that couples with complete questionnaires could be found in all communities. The major strength of the present study was that both parents of the child were included which facili- tated a description and comparison of their DCS and EPDS scores with each other. However, we could not control whether the couples inﬂuenced each other when ﬁlling in the questionnaires, even though our intention was, and the instructions emphasized, that the parents should ﬁll in the questionnaires separately. Suggestions for clinical implications A recommendation that can be based on our results is that professionals in antenatal care, child health cen- tres, as well as family caregivers should be conscious that mothers and fathers may have different views on relationship consensus, and that perceived discord can be related to postpartum depressive symptoms. The results from the present study might help profes- sionals to make parents aware that they sometimes believe that their spouses are disagreeing with them, while, in reality, they are not. The professionals should also be aware of the high level of depressive symptoms in women and men who have recently become parents in order to minimize the harmful effects for the individual, the relationship, and the child. Further research is needed to examine per- ceived relationship discord and the development of depressive symptoms over a longer term.