Maternal mental health over the course of 4 years following childbirth: The contribution of birth circumstances and psycho-social factors

Abstract

The aim of this study is to identify mothers at risk for poorer maternal mental health (MMH) 1 month post-partum and to determine changes in MMH over 4 years in relation to birth circumstances (singleton/twins, full-term/pre-term infant/s, first/non-first child), internal resources (adult attachment styles), and external resources (marital quality and maternal grandmother's support) at 1 month post-partum. The mediating effects of external resources were also investigated. Questionnaires were completed between 2001 and 2012 by 561 Israeli mothers. Shortly after birth, mothers at risk for poorer MMH were those who gave birth prematurely or were characterized by insecure attachment styles, lower marital quality, younger age, or a higher level of education. The mothers with a good prognosis for improvement in MMH were those who had given birth prematurely or were younger, more highly educated, or multiparous. Women with insecure attachment or lower marital quality reported lower MMH one month after delivery that did not improve over time, and the MMH of older or less educated mothers deteriorated over time. Marital quality mitigated or exacerbated the effects of birth circumstances and insecure attachment style on MMH shortly after giving birth. Findings suggested that early interventions may be important to help identify women at risk.

Perinatal Mental Health Support and Early Childhood Home Visitation During COVID-19

“…Wade et al (2012) found that that while not all fatigued mothers experience depression, those who experience a comorbidity of both report higher parenting stress, lower parenting efficacy, poor satisfaction, and high parental hostility. Women who give birth prematurely, had insecure attachment styles, perceived poorer marital quality, were younger, or had fewer years of schooling have been identified as having higher risk for poor mental health the early post-partum period (Porat-Zyman et al, 2018).…”

Mothers’ Experiences of Emotional Connection During COVID-19 in the United States: A Thematic Analysis

“…The effectiveness of these interactive, supportive connections—or other emotion-focused or problem-focused coping strategies—then determines outcomes associated with the stress, such as overall physical and mental health (Lazarus & Folkman, 1984). Studies of mothering experiences during times of stress have drawn on stress and coping theory to understand how parents have utilized their resources, such as social support, to cope (Baor & Soskolne, 2012; Porat-Zyman et al, 2018). Having a high level of social support may buffer mothers from the negative sequelae associated with a stressor, such as through promoting more resilient mental health outcomes (Gariépy et al, 2016; Wang et al, 2018).…”

Twin pregnancy and severe maternal mental illness: a Canadian population-based cohort study

“…Evidence regarding the impact of maternal age on perinatal mental illness has been conflicting, with certain large reviews and meta-analyses failing to show a relationship, and conflicting results reported depending on the specific mental health outcomes and time-periods being assessed 19,94 . Young maternal age (<19) is a strong risk factor for poor perinatal mental health with up to 50% of adolescents experiencing postpartum depression, and young age has been identified as a risk factor for chronic mental illness beyond the first postpartum year and for severe outcomes such as psychiatric hospitalization and intentional self-injury 67,69,70,82,83,88,[94][95][96] .…”

“…Risk factors for perinatal mental illness include unemployment, low income, lower educational attainment, recent immigration, poor marital quality, and single parenting 17,19,95,[104][105][106] . Aspects related to a mother's personality traits, including neuroticism, attachment anxiety and avoidance, and a more difficult child's temperament have also been demonstrated to be associated with risk of postpartum mental illness amongst mothers of multiples and singletons 14,19,94,98,105 . Socioeconomic vulnerability has been shown to be associated with a lack of improvement or worsening mental health outcomes over time 67,69,70,94,98 .…”

“…Factors related to neonatal complications including low birthweight, prematurity, and breastfeeding difficulties have all been demonstrated to be risk factors for postpartum mental illness, including depression and post-traumatic stress 19,[88][89][90]94 . Prematurity has been demonstrated to be a risk factor for poor maternal mental health outcomes amongst singleton pregnancies and to an even greater extent in multifetal pregnancies 94,114 .…”