Maternal Depression and Mother-to-Infant Bonding: The Association of Delivery Mode, General Health and Stress Markers

Abstract

Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breastfeeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P < 0.001)). EPDS scores were also associated with MIBS scores (P < 0.001)). However, there was no significant relationship between salivary stress marker levels and other questionnaire scores. MIBS scores of the vaginal delivery group (1.3 ± 1.7) were significantly better than those of the planned cesarean section group (2.1 ± 2.8). Multiple regression analysis revealed that maternal age and cesarean section were significantly associated with MIBS and EPDS scores (P < 0.01). Conclusion: Maternal general health is associated with maternal psychological health.These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.

The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM

“…At 14 months postpartum, no category of the MOD had a direct effect on parent-infant-bonding among fathers. Apparently, these findings are contradictory to previous research, finding either no association between the MOD and mother-infant-bonding [ 26 – 29 ] or indeed weaker mother-infant-bonding in mothers giving birth by CS compared to spontaneous VD [ 30 , 31 ]. An explanation to our findings might be compensatory behaviors that parents, whose baby was delivered via unplanned CS, engage in to mitigate potential negative impacts for the infant.…”

“…For instance, a prospective study contrasting CS and vaginal delivery showed that women who had an unplanned CS reported weaker bonding [ 30 ]. Similarly, Ishii et al [ 31 ] found that women who had a vaginal delivery reported stronger mother-infant-bonding than women who underwent a planned CS. Also, a qualitative study interviewing women who had an unplanned CS reported an interruption of the initial bond between mother and infant and a feeling of disconnectedness due to the separation after childbirth [ 32 ].…”

Charité Caesarean Birth Improves Birth Experience in Planned and Unplanned Caesarean Sections While Maintaining Maternal and Neonatal Safety: A Prospective Cohort Study

“…Therefore, parents often involuntarily miss out on having a natural birth experience to promote the safety of mother and child. Studies indicate that CD can negatively impact short-term and long-term birth satisfaction, bonding, and breast feeding [4][5][6][7][8][9]. Investigations of the association between delivery mode and postpartum maternal mental health have yielded contradictory results [10,11].…”

The Role of Oxytocin and Vasopressin in Attachment

“…The ability to form or express social bonds also can be disrupted by events that alter the oxytocin and vasopressin systems. Data from animal models and human epidemiology suggest that routine medical interventions (for example, oxytocin [Pitocin] use to induce labor, opioid medications that block the oxytocin system, or caesarean sections that alter exposure to endogenous oxytocin) have lasting consequences for the offspring and/or mother (Hayes, Balaban, Smith, Perry-Jenkins, & Powers, 2010;Kroll-Desrosiers et al, 2017;Song et al, 2017). Our ongo-ing animal research suggests that such exposures could have epigenetic efects on the oxytocin systems, including changes in DNA methylation.…”