Perception of mother-infant bonding and depressive symptoms after delivery: The contribution of caregiving, perception of parental self-efficacy, and marital relationship satisfaction

Childbirth is often associated with feelings of joy and excitement, but at a significant rate it may entail also negative feelings and adjustment difficulties for the mother. The multiple changes of this period were found to increase the vulnerability of woman after childbirth for developing symptoms of various mental disorders. Postpartum depression (PPD) is a phenomenon that may develop following childbirth. Its incidence is between 10%-15% and it is defined as a major or minor episode of depression expected to occur at approximately four weeks postpartum.

The effects of maternal depression on mother-infant bond has been extensively studied following the understanding that depressive symptoms have long-lasting negative effects on the mother-infant bond, the quality of infant care and his cognitive and mental development.

This study examines the phenomena of PPD through the prism of attachment theory which maintains that humans have patterns of attachment that develop from infancy and remain with them throughout life. The study focused on the maternal caregiving dispositions and perception of maternal self-efficacy. The caregiving system are parallel to the attachment system of the infant and their goal is to ensure protection and support while the infant is in distress. The caregiving system drives a person to relieve suffering and to promote the wellbeing of others. Parenting self-efficacy is defined as the belief the ability to perform the parenting role successfully.

The aim of this study is to evaluate the unique contribution of the maternal caregiving system and maternal self-efficacy to the development of depressive symptoms and mother-infant bond among women six months postpartum, and whether marital satisfaction moderates these correlations.

Method: 182 women in a relationship during the period of six months postpartum have participated in this study. The participants filled on-line self-reporting questionnaires which measure the caregiving system (CSF), maternal self- efficacy (KPCS), depressive symptoms (EPDS), mother-infant bond (PBQ), martial satisfaction (RAS) and general background.

Results: 21 women (11.60%) were found to be suffering from postpartum depression. The first study hypothesis that there is a correlation between the maternal caregiving system and the mother-infant bond was partially confirmed. There was an association between anxious caregiving, but not avoidant caregiving, with mother-infant bond. The second hypothesis that there is a correlation between the maternal caregiving system and post-partum depressive symptoms was confirmed. The third hypothesis that there is an association between maternal self-efficacy and mother-infant bond was confirmed. The fourth hypothesis that there is a correlation between maternal self-efficacy and depressive symptoms was confirmed. The fifth hypothesis that the marital satisfaction will moderate the correlation between the maternal caregiving system and maternal self-efficacy to depressive symptoms and mother-infant bond, was partially confirmed. Only the correlation between anxious caregiving and mother infant-bond was moderated.

In addition, it was found that marital satisfaction partially mediates the correlation between avoidant caregiving and postpartum depressive symptoms. Following indications arising from the regression model, additional mediation models were examined. It was found that maternal self-efficacy fully mediated the correlation between anxious caregiving to depressive symptoms and mother-infant bond.

The study contribution: this study adds to the current knowledge regarding risk factors for developing depressive symptoms postpartum. In addition, the study enables a better understanding regarding the contribution of the characteristics of the caregiving dispositions to the emergence of both depressive symptoms and mother-infant bond in the six months postpartum. The outcomes of this study may assist the identification of women in high risk for developing postpartum depressive symptoms or a pathological bond with their infant. Early recognition may enable the development of intervention methods in the period prior to childbirth or in the early postpartum period.