Predictors of mothers' postpartum body dissatisfaction based on demographic and fertility factors

Experiential avoidance, thought suppression, meta-cognition, and body-checking among women during pregnancy and postpartum: Buffering effect of self-compassion

OBJECTIVE

The present study attempted to explore the psychological experiences of experiential avoidance, thought suppression, meta-cognition, self-compassion and body-checking during two stages of maternity (pregnancy and postpartum) among women embracing maternity for the first time.

METHODS

The study used a cross sectional correlational design and enrolled 306 women participants who were in their third trimester of pregnancy or of postpartum (pregnant = 154 [50.3%]; postpartum = 152 [49.7%]) with ages ranging between 20 and 35 years (M = 26.62; SD = 2.19). The data was collected using the Brief Experiential Avoidance Questionnaire (BEAQ); Thought Control Questionnaire (TCQ); Metacognitions Questionnaire (MCQ); Self-Compassion Scale (SCS), and Body-checking Questionnaire (BCQ). Data was subjected to statistical analysis using SPSS version 21.

RESULTS

A significant positive association was observed between experiential avoidance, thought suppression, meta-cognition, and body-checking while self-compassion showed reverse association with these variables. The body-checking outcome was significantly negatively predicted by self-compassionate attitude and positively by thought suppression in both groups (i.e., pregnant and postpartum). The experiential avoidance positively predicted body-checking among women in post-partum group only. Moreover, a mediating association of experiential avoidance and a moderating effect of self-compassion (self-kindness and common humanity) and meta-cognition (positive beliefs about worry and need to control thought) were also observed to moderate between thought suppression and body-checking outcomes.

CONCLUSION

The study concluded that experiential avoidance and thought suppression contribute in developing body-checking behaviors among women who are pregnant or at postpartum stage of maternity. In addition, self-compassion and meta-cognition moderate this association with self-compassion playing potential buffer.

The body image experiences of breastfeeding mothers in the UK: A qualitative exploration

Despite the well-documented benefits of breastfeeding, the UK has one of the lowest breastfeeding rates in the world. One of the areas that has been identified as impacting on a woman's experience of breastfeeding is body image. The aim of this study was to explore the body image experiences of breastfeeding mothers in the UK. Eighteen female participants were interviewed about their thoughts and feelings around their body image, specifically in relation to their breastfeeding. Three themes were developed following thematic analysis of the data: Breastfeeding as a functional tool, Body confidence and breastfeeding in public and Not feeling like the real me: a loss of identity. Implications of the findings are discussed, with suggestions for health promotion and ideas for encouraging a more positive body image in pregnant and breastfeeding women, with the hope of improving breastfeeding rates and experiences.

Psychometric evaluation of the Chinese version of the fear of pregnancy scale: a translation and validation study

Introduction

Many women experience fear toward pregnancy, which can impact their desire to have children and the national birth rate. Thus, assessing women's fear of pregnancy is of great importance. However, there is currently no specialized tool for assessing women's fear of pregnancy in China. The purpose of this study is to translate the Fear of Pregnancy Scale into Chinese and test its reliability and validity among women of childbearing age.

Methods

Using convenience sampling combined with a snowballing method, a cross-sectional survey was conducted on 886 women of childbearing age in two cities in China. The translation was strictly carried out according to the Brislin model. Item analysis, validity analysis, and reliability analysis were employed for psychometric assessment.

Results

The Chinese version of the Fear of Pregnancy Scale comprises 28 items. Exploratory factor analysis extracted four factors with a cumulative variance contribution rate of 72.578%. Confirmatory factor analysis showed: NFI = 0.956, CFI = 0.986, GFI = 0.927, IFI = 0.986, TLI = 0.985, RMSEA = 0.032, and χ2/df = 1.444. The scale's Cronbach's α coefficient is 0.957, split-half reliability is 0.840, and test-retest reliability is 0.932.

Conclusion

The Chinese version of the Fear of Pregnancy Scale possesses robust psychometric properties and can assess the degree of pregnancy fear among Chinese women of childbearing age. It provides a reference for formulating relevant policies in the prenatal care service system and implementing targeted intervention measures.

A prospective study on body image disturbances during pregnancy and postpartum: the role of cognitive reappraisal

Background

During pregnancy, body size rapidly modifies over a relatively short period. Literature emphasizes the need to identify the factors that influence body image during peripartum as the extent of women's adaptation to these changes has significant repercussions on both mother's and newborn's health. Emotion regulation strategies (i.e., expressive suppression and cognitive reappraisal) were linked to body image in the general and clinical population, but no studies were conducted in the peripartum. The present study aims to investigate the longitudinal impact of prepartum body image disturbances on postpartum body image disturbances and to evaluate the mediational role of emotional regulation strategies.

Methods

A total of 133 pregnant women completed a three-phase longitudinal study. Women answered online questionnaires during the second (T1) and the third (T2) trimesters of pregnancy, and at about 6 months postpartum (T3).

Results

Findings indicated that body image disturbances at T1 were a significant predictor of body image disturbances in the postpartum (1 year after the first assessment). Moreover, cognitive reappraisal measured at T2 partially mediated this relationship: body image disturbances in the second trimester of pregnancy were linked to less use of cognitive reappraisal in the third trimester of pregnancy, and this, in turn, was associated with worse body image disturbances at 6 months after birth.

Conclusion

Findings of this longitudinal study highlight the importance of assessing body image disturbances during pregnancy to early identify women at risk, and suggest cognitive reappraisal as a possible target intervention.

Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum

PURPOSE

Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity.

METHODS

In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake.

RESULTS

Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy.

DISCUSSION

The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies.

LEVEL OF EVIDENCE

Level I-Evidence obtained from: systematic reviews and meta-analyses.

Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study

Antenatal depression may be distinct from postpartum depression in terms of prevalence, severity of symptoms, comorbidities, prognosis, and risk factors. Although risk factors for perinatal depression have been identified, it is unclear whether there are differences in the onset of perinatal depression (PND). This study explored the characteristics of women requiring mental health support during pregnancy or postpartum. A sample of 170 women (58% in pregnancy; 42% postpartum) who contacted the SOS-MAMMA outpatient clinic was recruited. Clinical data sheets and self-report questionnaires (EPDS, LTE-Q, BIG FIVE; ECR; BSQ; STICSA) were administered, hypothesizing possible risk factors, such as personality traits, stressful life events, body dissatisfaction, attachment style, and anxiety. Hierarchical regression models were carried out in the pregnancy (F_10;36 = 8.075, p < 0.001, adjR2 = 0.877) and postpartum groups (F_10;38 = 3.082, p < 0.05, adjR2 = 0.809). Recent stressful life events and conscientiousness were associated with depression in both the pregnant (29.3%, 25.5% of variance) and postpartum groups (23.8%, 20.7% of variance). In pregnant women, "openness" (11.6%), body dissatisfaction (10.2%), and anxiety (7.1%) symptoms were predictive of depression. In the postpartum group, "neuroticism" (13.8%) and insecure romantic attachment dimensions (13.4%; 9.2%) were the strongest predictors. Perinatal psychological interventions should consider the differences between mothers with depression during pregnancy and postpartum.

Does the postpartum body image of primiparous women giving vaginal delivery affect their sexual functions and depression and fatigue levels?

The body image-related problems can negatively affect women's lives in many ways. The study was aimed at investigating the effects of postpartum body image on sexual functions, and fatigue and depression levels of primiparous women who gave birth vaginally. This cross-sectional study was conducted with 133 women who presented to the obstetrics and gynecology clinics of a state hospital in Turkey between June 2021 and December 2021. At the end of the study, a moderate relationship was determined between the women's body image and their depression (r = 0.500; p < 0.001) and fatigue (r = 0.666; p < 0.001) levels, and a weak relationship between their body image and sexual functions (r = -0.372; p < 0.001). According to the backward regression model used in the study, the women's fatigue and education levels accounted for their body image by 45.7%.

The relationship between body dissatisfaction and postpartum depressive symptoms: A cross-sectional study

BACKGROUND

Women are least satisfied with their bodies during the postpartum period. There is a potential correlation between body dissatisfaction and depressive symptoms post delivery.The aim of this study was to explore the relationship of appearance and body areas satisfaction with depressive symptoms and examine the risk factors of depressive symptoms at 4-6 weeks postpartum.

METHODS

A total of 330 postpartum women participated in the study. Body dissatisfaction was measured using the Appearance Evaluation (AE) scale and Body Areas Satisfaction Scale (BASS), while depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), 4-6 weeks postpartum.

RESULTS

The prevalence of postpartum depressive symptoms among postpartum women was 40 % while 12.1 % of the women had thoughts of self-harm. Those with depressive symptoms or thoughts of self-harm had lower AE and BASS scores. Body dissatisfaction was significantly associated with factors such as postpartum weight retention of >5 kgs, no exercise, lower education level, and cesarean delivery. The three body areas that women were most dissatisfied with were weight, mid-torso, and lower torso. Education level, delivery method, and BASS score significantly predicted postpartum depressive symptoms.

LIMITATIONS

The selection bias might have occurred if those with depressive symptoms neglected routine postpartum care visits due to emotional distress.

CONCLUSIONS

The results indicate an association between body dissatisfaction and depressive symptoms at 4-6 weeks postpartum. Awareness of this relationship and focus on these risk factors will help healthcare providers plan peripartum programs to decrease the likelihood of postpartum depressive symptoms.

Do Changes in Body Shape Due to Pregnancy Lead to Cosmetic Surgery? A Cross-Sectional Study

OBJECTIVE

Pregnants and puerperas show different perceptions of their body image and appearance, so authors investigated their perceptions related to pregnancy and puerperium, evaluating their views on cosmetic surgery, by a cross-sectional study.

MATERIALS AND METHODS

5-item questionnaires were administrated to women at first pregnancy and puerperas. Patients were submitted also to Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Body Image Inventory (BII) analysis, indicating the level of anxiety, depression and body dissatisfaction for somatic changes during pregnancy and after childbirth.

RESULTS

186 healthy women, aged between 25-35 years, equally divided in pregnancy and puerperium, were compared in terms of body image, with no significant difference between groups. Analyzing the item "cosmetic surgery is required after all pregnancies", there was a significant difference in puerperas and the item "cosmetic surgery is necessary for postpartum" was the principal. The comparison of BII, BDI, BAI values between pregnants and puerperas showed a significant difference between groups (p<0.00), with higher scores in postpartum patients.

CONCLUSION

Body shape and physical dissatisfaction during pregnancy is linked with increased risk of depression in pregnancy and puerperium, pushing women to opt for cosmetic surgery, especially in puerperium.

Confirmatory factor analysis and psychometric properties of the Persian version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS) in women with polycystic ovary syndrome

PURPOSE

Body image is a multidimensional and complex psychological construct. Since the Multidimensional Body Self-Relation Questionnaire-Appearance Scale (MBSRQ-AS) is a questionnaire that measures body image as a multidimensional construct. This study aimed to translate and evaluate the psychometric properties of the Persian version of MBSRQ-AS.

METHODS

This methodological study was conducted on 251 women with polycystic ovary syndrome referring to polyclinics of hospitals that were covered by Iran University of Medical Sciences, with age ranging from 18 to 46 years old (M = 27.35; SD = 6.32). The mean body mass index (BMI) was 25.59 kg/m² (SD = 4.9). A forward-backward translation procedure was applied. Then face and content validity was inducted.

RESULTS

Face and content validity of the Persian MBSRQ-AS was established. Confirmatory factor analyses showed good fit indices for the five-factor structure (appearance evaluation, appearance orientation, body areas satisfaction, overweight preoccupation, and self-classified weight). The internal consistency (Cronbach's alpha ranged from 0.71 to 0.85) and test-retest reliability by calculating the intraclass correlation coefficient ranged from 0.75 to 0.91 was adequate.

CONCLUSION

This study confirms the factor structure of the MBSRQ-AS. The Persian version of MBSRQ-AS has acceptable psychometric properties.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Cosmetic outcomes of skin closure with tissue adhesive or staples in repeated cesarean section: A randomized controlled trial

OBJECTIVE

To compare scar quality associated with metal staples or tissue adhesive for closure of the skin incision at repeat cesarean delivery (CD).

STUDY DESIGN

Single-center Randomized Controlled Trial (ClinicalTrial.gov ID: NCT04302597), including women undergoing repeat CD using metal staples or 2- octylcyanoacrylate for closure of the skin incision. Patients were randomized to have skin closure following CD with either staples or tissue adhesive. Scar quality was evaluated 2 and 6 months postoperatively using the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale (POSAS), and a visual analog scale.

RESULTS

Of the 66 patients who were recruited, 55 successfully completed the study. The duration of surgery was comparable in both groups. A partial wound dehiscence occurred in one patient who had tissue adhesive closure. No difference in subjective and objective scar cosmesis rating was found between tissue adhesive and staples groups at either 2 months or 6 months.

CONCLUSIONS

In women undergoing CD, stapled wounds and those closed with tissue adhesive result in equivalent cosmetic appearance of the scar.

Connections Between Perceived Social Support and the Body Image in the Group of Women With Diastasis Recti Abdominis

Background: The psychological features of the body image and the role of perceived social support for women with diastasis recti abdominis (DRAM) is significant for the treatment of this group of patients, but it is difficult to identify research on this topic. We aimed to search for similarities and differences between postpartum women with DRAM in terms of their psychological features of the body image and perceived social support from the partner, family and friends. Methods: Three hundred forty-five Polish women with DRAM were asked to fill the The Multidimensional Body-Self Relations Questionnaire (MBSRQ), The Multidimensional Scale of Perceived Social Support (MSPSS) and The Drawing Self-Assessment Sheet. Data analysis included the stepwise regression analysis and k-cluster analysis. Results: We identified several predictors in the group of women with DRAM. Social support of partner, family, and friends are the predictors of self-assessment of general body appearance. Social support of family is a predictor of self-assessment of the health of the body. Social support of friends is a predictor of self-esteem of weight and fear of gaining weight. Moreover, three clusters of women with DRAM were found. Type 1-women with DRAM with one child and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight, and fear of weight gain, and low level of social support; Type 2-women with DRAM with three or more children and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight and fear of weight gain, and high level of social support; and Type 3-women with DRAM with two children and high self-esteem for the general appearance of the body, high level of self-esteem for health of the body, low self-esteem of weight and fear of weight gain, and high levels of social support. Conclusions: Social support is a predictor of body image in women with DRAM, but there are other factors that influence body acceptance more in this group of women. Furthermore the three clusters featured in the study may help in treating women with DRAM.