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

## TL;DR

A positive childbirth experience is linked to better mother-infant bonding and breastfeeding confidence, but less strongly to lower postpartum depression.

## Contribution

This study explores the relationship between birth satisfaction and early postpartum outcomes in low-risk births, focusing on bonding, breastfeeding self-efficacy, and depressive symptoms.

## Key findings

- Positive birth experiences correlate with stronger mother-infant bonding and higher breastfeeding self-efficacy.
- Negative birth experiences are associated with higher postpartum depressive symptoms, especially anxiety and reduced enjoyment.
- Birth satisfaction weakly predicts postpartum depression, suggesting other factors are more influential.

## Abstract

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.

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.

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).

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.

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