# Associations between formal social support in early postpartum, parenting self-efficacy, and parent-infant bonding: A cross-sectional survey

## TL;DR

This study finds that informal support and reduced depressive symptoms are key to improving parental self-efficacy and bonding during the postpartum period.

## Contribution

The study provides new insights into how formal and informal support, along with depressive symptoms, affect parenting outcomes in early postpartum.

## Key findings

- Higher satisfaction with informal support was significantly linked to maternal self-efficacy.
- Depressive symptoms were consistently associated with lower parental self-efficacy and bonding.
- Non-exclusive breastfeeding was linked to higher maternal bonding difficulties.

## Abstract

Formal social support from healthcare professionals is critical in facilitating the transition to parenthood and may contribute to parental self-efficacy. However, its association with parent-infant bonding remains unclear, and evidence to guide clinical practice is scarce, especially during the postpartum hospital stay.

This study aimed to (a) explore associations between formal social support during the postpartum stay, parenting self-efficacy, and parent-infant bonding; and (b) investigate the role of depressive symptoms and other confounding factors.

A cross-sectional survey was conducted from April 2023 to August 2024 in five hospitals in French-speaking Switzerland.

420 first-time parents (298 mothers and 122 partners).

First-time mothers and co-parents completed a cross-sectional survey. Variables were measured using the Hospital Anxiety and Depression Scale, the Birth Satisfaction Scale-Revised, the FOCUS-Postpartum Scale, the Perinatal Infant Care Social Support Scale, the Parenting Expectations Survey, and the Mother-Infant Bonding Scale. Descriptive statistics, correlation analyses, and regression analyses were performed.

A total of 298 mothers and 122 partners answered the survey. Parents reported low satisfaction with the information received during the postpartum hospital stay. In bivariate analyses, formal social support was positively associated with maternal self-efficacy (rho = 0.18, p = 0.004) but not with partners’ self-efficacy (rho= -0.07, p = 0.45) or parent-infant bonding. After adjustment for confounding factors, the association between formal social support and maternal self-efficacy was no longer significant. In the maternal regression model, satisfaction with informal general support was significantly associated with maternal self-efficacy (β = 0.62, p = 0.002). Non-exclusive breastfeeding was associated with higher maternal bonding difficulties (β = 0.34, p = 0.008). Partners with a secondary education level reported lower parenting self-efficacy (β = -35.49, p = 0.005) and lower bonding quality (β = 0.7, p = 0.019) than those with an apprenticeship education. Depressive symptoms were negatively associated with parental self-efficacy (mothers β = -2.44, p = 0.015; partners β = -4.57, p < 0.001) and bonding (mothers β = 0.08, p < 0.001; partners β = 0.07, p = 0.002).

Higher satisfaction with informal support was linked to maternal self-efficacy, while depressive symptoms consistently undermined both parental self-efficacy and bonding for both parents. Together with parents’ low satisfaction with information received, these findings underscore the need for tailored support and the importance of clear and consistent communication from healthcare professionals for both mothers and partners.