Birth experience and early postpartum outcomes: A cross-sectional study of mother–infant bonding, breastfeeding self-efficacy, and depressive symptoms

INTRODUCTION Childbirth is a transformative experience with lasting psychological and emotional effects. Evidence shows that birth experience influences maternal outcomes such as breastfeeding self-efficacy, mother-infant bonding, and postpartum depression, yet these associations in low-risk births remain insufficiently explored. This study examined how birth satisfaction relates to early postpartum maternal well-being.

METHODS A cross-sectional study was conducted in Lithuania among 218 women who experienced low-risk deliveries. Data collection occurred between September 2022 and July 2024. The present analysis is based on data collected at 6-8 weeks postpartum. Standardized instruments were used to assess birth satisfaction (BSS-R), breastfeeding self-efficacy (BSES-SF), mother-infant bonding (MIBS), and postpartum depressive symptoms (EPDS). Mann-Whitney U tests and linear regression models were applied, with p<0.05 considered statistically significant.

RESULTS A positive birth experience was associated with stronger mother-infant bonding (less resentment, disappointment, and aggression; all p≤0.003) and higher protective emotions (p=0.025). These women also reported higher breastfeeding self-efficacy, including confidence in milk intake, latch, and managing difficulties (all p≤0.012). Negative experiences were linked to higher postpartum depressive symptoms (EPDS p=0.014), particularly anxiety and reduced enjoyment (both p≤0.008). Birth satisfaction predicted breastfeeding self-efficacy (R2=0.34; β=0.34, p<0.001, 95% CI: 0.63-1.39) and bonding (R2=0.30; β= -0.30, p<0.001, 95% CI: -0.16 - -0.07) but only weakly predicted postpartum depression (R2=0.09).

CONCLUSIONS A positive birth experience is associated with stronger mother-infant bonding and higher breastfeeding self-efficacy. Although linked to fewer depressive symptoms, its predictive value for postpartum depression was limited, indicating the importance of additional psychosocial determinants.

ABBREVIATIONS BSS-R: Birth Satisfaction Scale-Revised, BSES-SF: Breastfeeding Self-Efficacy Scale-Short Form, MIBS: Mother-Infant Bonding Scale, EPDS: Edinburgh Postnatal Depression Scale.