Marital Satisfaction in Postpartum Women: The Role of Personality, Body Image Satisfaction, Anxiety, and Sexual Function

Background:

The postpartum period is considered a vulnerable and stressful period for many women due to various hormonal, physical, and psychosocial changes, such as adapting to parental rules, changes in body and self-image, loss of autonomy, breastfeeding, and taking care of the baby

Objective:

This study aimed to test a conceptual model considering the interrelated role of anxiety, body image satisfaction, sexual function, type of personality, income, and education on women’s marital satisfaction. Also it also aimed to test the mediating role of sexual function and anxiety.

Methods:

In this cross-sectional study, 447 lactating women were recruited from January to April 2019. Women answered some questionnaires including a socio-demographic checklist, female sexual function index (FSFI), Body Self-Relation Questionnaire (BSRQ), the Enrich Marital Satisfaction, and the NEO Personality Inventory (NEO PI-R). Data were analyzed using the descriptive test, and Path analysis was done with LISREL software.

Results:

Results show that sexual function (β= 0.44), anxiety (β= -0.26), and educational level (β= 0.47) are the main predictors of marital satisfaction (dependent variable). Sexual function and anxiety were two main mediators; variables, such as anxiety (β= -0.35), body image satisfaction (β= 0.19), and extraversion personality (β= 0.19) (independent variables), with an effect through sexual function, can impress marital satisfaction indirectly.

Conclusion:

Identifying relationships between anxiety, educational level, sexual function, anxiety, body image, and personality with the quality of life of postpartum women highlights the importance of designing interventions to improve marital satisfaction. Given these relationships, it is recommended that health professionals educate women about body changes during postpartum and find ways to improve mothers' marital satisfaction.

Relationship Satisfaction, Attachment, and Perinatal Depression in Women of Color: A Quantitative Investigation

The purpose of this study was to examine the relationships among relationship satisfaction, perceived attachment injury, and perinatal depression for Women of Color (WOC) who have given birth within the last 12 months. In addition, this study aimed to examine the impact of relationship satisfaction and romantic attachment quality on these mothers' attachments to their newborns. The sample consisted of 120 WOC with perinatal depression. Linear regression and hierarchical multiple regression were used for data analysis. The results indicated that (a) lower relationship satisfaction is predicted with higher severity of perinatal depression, (b) attachment insecurity predicts the severity of perinatal depression, and (c) relationship dissatisfaction, attachment insecurity, and a disrupted attachment bond between mothers and their newborns are predictive of perinatal depression. The results of this study have significant implications for couple and family therapists addressing the needs of pregnant and postpartum WOC. Ultimately, fostering healthy couple relationships during these critical times can play a crucial role in enhancing maternal mental health and overall family wellbeing.

A Blended Cognitive-Behavioral Intervention for the Treatment of Postpartum Depression: Study Protocol for a Randomized Controlled Trial

Despite the existence of effective treatment for postpartum depression, few women seek professional help, indicating the need for a new and innovative format of treatment that can overcome help-seeking barriers. This article presents the study protocol for a blended cognitive–behavioral intervention for the treatment of postpartum depression, by integrating face-to-face sessions with a web-based program (Be a Mom) into one treatment protocol. This study will be a two-arm, noninferiority randomized controlled trial comparing blended intervention to usual treatment for postpartum depression provided in healthcare centers. Portuguese postpartum adult women diagnosed with postpartum depression (according to the DSM-5 diagnostic criteria for major depressive disorder) will be recruited during routine care appointments in local healthcare centers and will be eligible to participate. Measures will be completed at baseline, postintervention, and at three- and six-month follow-ups. The primary outcome will be depressive symptoms. Secondary outcomes will include anxiety symptoms, fatigue, quality of life, marital satisfaction, maternal self-efficacy, and mother–child bonding. Cost-effectiveness analysis and mediator and moderator analysis will be conducted. This study will provide insight into the efficacy and cost-effectiveness of a blended psychological intervention in the Portuguese context and increase the empirically validated treatment options for postpartum depression.

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom's efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.

Improving help-seeking for postnatal depression and anxiety: a cluster randomised controlled trial of motivational interviewing

Low uptake of treatment by women with symptoms of postnatal depression and anxiety is consistently reported. This study examined whether a brief motivational interviewing (MI) intervention delivered by Maternal and Child Health Nurses (MCHNs) during routine emotional health assessments improves help-seeking following childbirth. In this parallel two-group cluster randomised controlled trial, MCHNs delivered a MI intervention ('PRIMER', n = 20) or Routine Care (n = 20) at women's (n = 541) postnatal consultations. The primary outcome was help-seeking over the 12 months post-birth. Other outcomes were emotional distress measured by the Edinburgh Postnatal Depression Scale, Beck Depression Inventory-Revised and Depression Anxiety Stress Scales, and barriers to help-seeking obtained by self-report via a checklist of potential barriers that was presented to women to select from if applicable. 27.4% of the sample experienced emotional distress over the 12 months post-birth. When comparing women who experienced emotional distress with those who did not, odds of seeking help were 4.0 times higher for the MI condition than Routine Care (p = .004). Of the women who sought help from a psychologist, 47.6% in the MI condition attended 6 + sessions versus 20.0% in Routine Care (numbers too small for reliable significance test). There was a non-significant trend of lower depression, anxiety and stress in the MI condition. Three risk factors for postnatal depression predicted help-seeking: antenatal anxiety (OR = 2.8, p = .002), depression history (OR = 2.5, p = .002) and self-esteem (OR = 0.7, p = .04). Common barriers to seeking help were thinking that one would or should be able to manage without help (endorsed by 11.1%). Treatment uptake for postnatal distress can be increased with MI. Training MCHNs in MI was feasible and valued. Given the devastating effects of depression, further research is needed to ascertain whether MI can improve mental health outcomes. Australian New Zealand Clinical Trials Registry (ACTRN12611000635965), 22 June 2011.

Postpartum depression: risks, protective factors, and the couple's relationship

This study examined pregnancy risk for developing, and protective factors for preventing, Postpartum Depression (PPD). The object of this study was to (a) examine previously identified pregnancy stressors to learn which stressors put women more at risk for PPD and (b) to identify possible buffers for women who are at risk for developing PPD. A secondary data set was used for two analyses. Women were invited to participate in the study while still in the hospital, within 24-48 hours after delivery of a singleton, term (≥37 weeks) live-born infant. The data were collected in four large urban hospitals in Utah from 2005-2007. A total of 1,568 women participated in the study. Women who report experiencing less stress in their couple relationship are less likely to report PPD symptoms even when they have a personal history of depression and or PPD. The results of these analyses illustrate that a couple's relationship, depending on the stress level experienced in the relationship, can be both a risk and protective factor for pregnant women.

When the bough breaks: rethinking treatment strategies for perinatal depression

Awareness of depression among OB-GYN physicians has increased with the result that more than 13% of pregnant women in the United States receive prescriptions for antidepressant medications. But the safety and effectiveness of these compounds has been exaggerated while the effectiveness of psychotherapy has been overlooked and distorted and various medical guidelines for treatment of perinatal depression have been downplayed or ignored. This article addresses the common fears and misconceptions surrounding treatment of depression during pregnancy and after childbirth. The effectiveness of strategic cognitive-behavioral therapy enhanced with hypnosis offers excellent results without the risks associated with these medications. Targets for focused intervention are identified and discussed.

Prevalence and characteristics of postpartum depression symptomatology among Canadian women: a cross-sectional study

Background

This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS) among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment.

Methods

An analysis based on 6,421 Canadian women, who had a live birth between 2005 and 2006 and were part of the Maternity Experience Survey (MES), was performed. PPDS was measured based on the Edinburgh Postnatal Depression Scale. Various factors that assessed socio-economic status, demographic factors, and maternal characteristics were considered for the multinomial regression model.

Results

The national prevalence of minor/major and major PPDS was found to be 8.46% and 8.69% respectively. A mother's stress level during pregnancy, the availability of support after pregnancy, and a prior diagnosis of depression were the characteristics that had the strongest significant association with the development of PPDS.

Conclusions

A significant number of Canadian women experience symptoms of postpartum depression. Findings from this study may be useful to increase both the attainment of treatment and the rate at which it can be obtained among new mothers. Interventions should target those with the greatest risk of experiencing PPDS, specifically immigrant and adolescent mothers.