Labour experience and postpartum stress and depression: a quantitative and qualitative examination

Abstract

Objectives: The purpose of this study was to examine the relationship between qualitatively and quantitatively assessed birth experiences and rates of post-birth distress and depressive symptoms three to four weeks postpartum. Both the rates of post-birth distress and depressive symptoms represented risk factors for subsequent mental health problems in the later postpartum period. Background: Childbirth is accompanied by various stress factors. However, little is known about the relationship between stressors occurring during birth (intrapartum) and the ways women cope with them and women’s development of depressive symptoms or acute stress reactions postpartum. Methods: One hundred and twenty-seven women from two longitudinal studies were interviewed 48–96 h after childbirth. Thirty birth interviews from both samples were additionally examined for qualitative themes related to women’s reported experience in connection with mental health adaptation (i.e. without symptoms (n = 10), symptoms of depression (n = 10) and acute stress reactions (n = 10)) at three to four weeks postpartum. Results: Women with depressive symptoms reported less intimate and helpful contact with their partners and baby during labour compared with women without symptoms or with acute stress reactions. Women with acute stress reactions had less confidence in themselves, and reported disorientation during the birth process, compared with women without symptoms or with depressive symptoms. Conclusions: Recognition of how women cope with intrapartum factors during labour could help to identify psychological distress shortly after delivery, and inform the introduction of timely and appropriate psychological support for affected women.

Keywords:

• Birth interview experience
• combined quantitative–qualitative approaches
• risk aspects
• postpartum depressive symptoms
• acute stress reactions

Acknowledgements

The study ‘Birth experience and psycho-physical adaptation postpartum’ was run as a cooperative project between the Department of Obstetrics and Gynaecology of the University Hospital, Basel, and the Clinic for Child and Adolescent Psychiatry of the University Hospital, Basel, Switzerland. We are grateful to the mothers who participated in the study. ‘Triadic family functioning, sesam-L’ was part of the National Centre of Competence in Research (NCCR) Swiss Etiological Study of Adjustment and Mental Health (sesam). This publication is the work of the authors and D. Bielinski-Blattmann and S. Gürber serve as guarantors for the paper. We thank Kristen Lavallee for her invaluable help in proofreading the manuscript. We are extremely grateful to all the families who took part in this study. Our further thanks go to the hospital staff for their help in recruiting the participants, and the whole sesam team, which includes interviewers, computer and laboratory technicians, research scientists, volunteers, managers, receptionists, and nurses.

Disclosure statement

No potential conflict of interest was reported by the authors.