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Studies show that a woman's dissatisfaction with her birth experience may affect her well‐being. This study aimed to examine: (1) the birth satisfaction in Croatian women and compare it with UK normative data; (2) the association of different dimensions of birth satisfaction with posttraumatic stress disorder (PTSD) and depressive symptoms. In a cross‐sectional online study, 603 postnatal Croatian women completed the Birth Satisfaction Scale‐Revised (subscales: Stress experienced during labour (SL), Women's personal attributes (WA), and Quality of care provision (QC)); City Birth Trauma Scale (subscales: Birth‐related symptoms and General symptoms); and Edinburgh Postnatal Depression Scale. Subscale and total scale scores were calculated. Path analysis tested the model of three aspects of birth satisfaction effect on PTSD dimensions and depressive symptoms. The average birth satisfaction score was significantly lower compared to the UK data on the total scale and all three subscale scores. Path analysis revealed that all three dimensions of birth satisfaction (SL, WA, and QC) had an effect on Birth‐related symptoms. However, only Women's personal attributes (i.e., feeling anxiety or being in control during childbirth) had an effect on General symptoms and depressive symptoms, as well. Different aspects of birth satisfaction are important for maternal mental health following childbirth.

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Objectives The metacognitive model of rumination and depression (Papageorgiou & Wells, 2003, Cognitive Therapy and Research, 27, 261) postulates that beliefs that perseverative negative thinking, i.e. rumination, will help solve problems contributing to rumination. However, this activates negative beliefs about the uncontrollability and social consequences of ruminations, which exacerbate depression. The metacognitive model has been well‐supported but with some inconsistencies in specific pathways. It has also not yet been tested for postpartum depression (PPD). Therefore, this study aimed to examine the relations between the metacognitive model of rumination and depression when applied to PPD symptoms and to compare it with the cognitive model of depression. Design This is a cross‐sectional study. Method Postpartum mothers (N = 603) participated in an online study in their first postpartum year. They completed the Edinburgh Postnatal Depression Scale (EPDS), Postnatal Negative Thoughts Questionnaire (PNTQ), Ruminative Responses Scale (RRS), Positive Beliefs about Rumination Scale (PBRS) and Negative Beliefs about Rumination Scale (NBRS). Results A path analysis revealed that the model had an excellent fit to the data. Specifically, positive beliefs about rumination predicted engagement in rumination that, in turn, predicted PPD, both directly and indirectly, through negative beliefs about uncontrollability and the social consequences of rumination. A cognitive model with ruminations as a partial mediator between negative postpartum thoughts and PPD symptoms also had a good fit. Conclusion The findings of this study contribute to the understanding of the cognitive and metacognitive mechanisms underlying postpartum depression, which might be similar to depression in general and have important implications for treatment strategies.

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The City Infant Faces Database (CIFD; Webb et al., 2018) is a database of 154 infant emotional expressions for use in experimental studies of infant facial communication, facial expression recognition, and parental sensitivity. The CIFD was validated only in a small sample from the general public and student midwives and nurses in the UK. This study, therefore, aimed to validate it in a larger sample of Croatian students and parents of 1-12 months old infants. Three-hundred and fifty students (Study 1), 422 mothers and 106 fathers (Study 2) were presented with images of Caucasian infant faces. The students rated images from the CIFD and Tromsø Infant Faces. They also completed questionnaires measuring empathy, alexithymia, and perceiving and expressing emotions. The parents rated the valence of facial expressions of images from the CIFD. The results were consistent with the initial validation in both the students and parents’ sample, except that agreement for negative images was lower for Croatian parents than in the UK study. Compared to the UK study, students rated images as more intense, clear, genuine, and reported stronger internal emotion. Furthermore, there was no difference in accuracy between mothers and fathers or between first-time parents and experienced parents. The CIFD is, therefore, a promising tool for research and should be further validated in other countries, focusing on its predictive validity.