Psychological growth after childbirth: an exploratory prospective study

Abstract

Introduction: It is important to elucidate the psychologically positive aspects of childbirth for mothers, and not only the negative aspects such as perinatal depression. This study aimed to examine psychological growth after childbirth and its related variables by focussing on five factors of posttraumatic growth: relating to others, new possibilities, personal strength, spiritual change and appreciation of life.

Methods: Pregnant women during mid-pregnancy were consecutively recruited at a women’s hospital in Japan and followed up 1 month after childbirth. Psychological growth was assessed by the Posttraumatic Growth Inventory.

Results: Among 177 participants, 117 (66.1%) completed follow-up assessments 1 month after childbirth. Multivariable regression analysis revealed that primipara, higher resilience and less fear at childbirth were associated with posttraumatic growth factors of relating to others and new possibilities. High resilience and less fear at childbirth were also associated with personal strength. On the other hand, being primiparous and high depressive symptoms were associated with greater appreciation of life. No variables were associated with spiritual change.

Discussion: These findings suggest that giving birth for the first time could be a highly challenging life event as well as an opportunity which leads to PTG, and that giving birth with low fear might lead to mothers’ psychological growth. On the other hand, appreciation of life might need attention as it might signify some sorts of coping response. These findings contribute to our understanding of the psychological changes experienced by mothers.

Keywords:

• Childbirth
• posttraumatic growth
• resilience

Acknowledgements

We thank Ms. Natsuki Konno, Miyuki Makino, Kasumi Araki and Yuuri Matsumura for careful recruitment and research coordination. We also thank Dr Yo Sano for specialist obstetric advice, Dr Hiroko Noguchi for training clinical research coordinators for this study, and Ms. Yumiko Kamoshida for administrative assistance. None of these acknowledged individuals report any financial or other conflicts of interest relative to the subject of this work.

Disclosure statement

KU reports no conflicts of interest.

Funding

This study was supported by a Grant-in-Aid for Young Scientists (A) from the Japan Society for the Promotion of Science [25702043], and the National Centre of Neurology and Psychiatry Japan [27-3]. DN has received research grants from the Japan Society for the Promotion of Science, the National Centre of Neurology and Psychiatry Japan, the Ministry of Health, Labour and Welfare and Japan Agency for Medical Research and Development, and lecture fees from Otsuka Pharmaceutical Co., Ltd., and a manuscript fee from Sumitomo Dainippon Pharma Co., Ltd.

Current knowledge on the subject

• Psychological growth can occur after childbirth, but there has been no previous study in Japanese women.

• The impact of resilience on psychological growth after childbirth is unknown.

• Significant stress might be required for psychological growth after childbirth.

What this study adds

• Women who experienced a first birth, reported greater resilience in pregnancy, and experienced less fear during childbirth had higher psychological growth a month after childbirth in Japan.

• Giving birth for the first time could be a highly challenging life event as well as an opportunity which leads to PTG, that giving birth with less fear might lead to mothers’ psychological growth for a first birth.

• However, expressing growth as “appreciation of life,” which means a greater appreciation for each day and for the value of life, might be a sign of distress.