Volume 31, Issue 3 (Summer 2025)
Intern Med Today 2025, 31(3): 0-0 |
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Afiat M, Babazadeh R, Amiri B, Foroughi P. Association of Subjective, Clinical, and Interpersonal-Supportive Childbirth Experiences with Postnatal Depressive Symptoms in Women: A Systematic Review. , Intern Med Today. 2025; 31 (3)
URL: http://imtj.gmu.ac.ir/article-1-4142-en.html
URL: http://imtj.gmu.ac.ir/article-1-4142-en.html
1- Associate Professor, Family and the youth of population Support Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Assistant Professor, Department of Midwifery, Nursing and Midwifery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Midwifery, Gon.C., Islamic Azad University, Gonanad, Iran; PhD Student in Reproductive Health, Department of --, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, University of Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
4- PhD Student in Reproductive Health, Department of --, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. & Student Research Committee, University of Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. ,foroghip@gmail.com
2- Assistant Professor, Department of Midwifery, Nursing and Midwifery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Midwifery, Gon.C., Islamic Azad University, Gonanad, Iran; PhD Student in Reproductive Health, Department of --, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, University of Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
4- PhD Student in Reproductive Health, Department of --, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. & Student Research Committee, University of Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. ,
Abstract: (28 Views)
Background and Objective: Postpartum depression (PPD) is one of the most common psychiatric disorders in the postpartum period, with a global prevalence of 10% to 20%, leading to adverse consequences for both maternal health and infant development. While existing evidence highlights the role of the childbirth process in postpartum mental health, the various dimensions of childbirth experience (including subjective, clinical, and supportive-relational aspects) and the independent impact of each on PPD require comprehensive synthesis. Therefore, this study aimed to systematically review literature investigating the association between subjective, clinical, and interpersonal childbirth-related experiences and symptoms of postpartum depression in women.
Methods: This systematic review was conducted based on the PRISMA guidelines. The Web of Science, PubMed, and Scopus databases were searched for articles published up to July 16, 2025, using MeSH terms and related keywords concerning childbirth experiences and postpartum depression, without time restrictions. Original English-language studies examining the association between childbirth experiences and PPD were included. Short communications, reviews, articles without full text, and secondary analyses were excluded. Screening of titles, abstracts, and full texts, along with data extraction, was performed by two independent researchers using a standard data extraction form, and discrepancies were resolved by a third researcher.
Results: A total of 21 original studies were included in the final analysis. Data synthesis revealed that the dimensions of childbirth experience can be categorized into three domains: 1) Subjective dimension: Negative birth experience, perceived trauma, and feelings of lack of control were the strongest predictors of PPD. 2) Clinical dimension: Emergency cesarean sections, instrumental deliveries, and unmanaged severe pain were associated with increased depression risk, although the mode of delivery was typically mediated by the mother’s negative appraisal. 3) Supportive-relational dimension: Receiving respectful maternity care and emotional support from healthcare providers showed a significant protective effect in reducing depressive symptoms.
Conclusion: A mother’s subjective perception of the childbirth process plays a more decisive role in the development of PPD than purely clinical factors. Incorporating standardized depression screening tools (such as the EPDS) alongside the assessment of childbirth experiences, promoting respectful maternity care, and providing continuous emotional support during labor are recommended to reduce the burden of postpartum depression.
Methods: This systematic review was conducted based on the PRISMA guidelines. The Web of Science, PubMed, and Scopus databases were searched for articles published up to July 16, 2025, using MeSH terms and related keywords concerning childbirth experiences and postpartum depression, without time restrictions. Original English-language studies examining the association between childbirth experiences and PPD were included. Short communications, reviews, articles without full text, and secondary analyses were excluded. Screening of titles, abstracts, and full texts, along with data extraction, was performed by two independent researchers using a standard data extraction form, and discrepancies were resolved by a third researcher.
Results: A total of 21 original studies were included in the final analysis. Data synthesis revealed that the dimensions of childbirth experience can be categorized into three domains: 1) Subjective dimension: Negative birth experience, perceived trauma, and feelings of lack of control were the strongest predictors of PPD. 2) Clinical dimension: Emergency cesarean sections, instrumental deliveries, and unmanaged severe pain were associated with increased depression risk, although the mode of delivery was typically mediated by the mother’s negative appraisal. 3) Supportive-relational dimension: Receiving respectful maternity care and emotional support from healthcare providers showed a significant protective effect in reducing depressive symptoms.
Conclusion: A mother’s subjective perception of the childbirth process plays a more decisive role in the development of PPD than purely clinical factors. Incorporating standardized depression screening tools (such as the EPDS) alongside the assessment of childbirth experiences, promoting respectful maternity care, and providing continuous emotional support during labor are recommended to reduce the burden of postpartum depression.
Keywords: Postpartum Depression, Parturition, Perception of Childbirth, Perinatal Care, Social Support, Risk Factors, Systematic Review
Type of Study: Review |
Subject:
Basic Medical Science
Received: 2024/12/15 | Accepted: 2025/03/20 | Published: 2025/05/30
Received: 2024/12/15 | Accepted: 2025/03/20 | Published: 2025/05/30
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