Postpartum depression and maternal attachment beyond two years postpartum: The role of maternal self-efficacy

Evidence has found that a distressing childbirth increases the risk of developing depression in the postpartum. High maternal self-efficacy has been found to protect against the development of postpartum depression (PPD), which negatively effects attachment quality. However little is known about the long-term effects of distress and depression upon maternal attachment quality beyond two years postpartum. This study examines the relationships between measures of previous distress, current depressive symptomatology, maternal self efficacy, and their effect upon maternal attachment quality beyond two years postpartum. A 30 minute telephone survey was conducted with 54 women who had been screened for distress in a previous study after giving birth two years prior in Queensland. Mean age at childbirth was 30.2 years (SD = 5.5 years), and 68.5% were previously classified as distressed. Participants’ infants’ mean age was 28.9 months (SD = 2.33 months, 53.7% male). Depression scores indicated that 7 participants, all previously depressed, currently had depression. Results imply that previous distress significantly increased the risk of depression at two years postpartum, and significantly decreased maternal attachment quality. Current depression was found to negatively affect maternal attachment quality. Maternal self-efficacy significantly positively correlated with maternal attachment quality. Maternal self-efficacy was found to moderate, rather than mediate, the relationship between current depression and maternal self-efficacy. In conclusion, results indicate that distress during childbirth increases the risk of depression at two years postpartum. Postpartum distress and current depression negatively affect maternal attachment quality at two years postpartum, which is much later than previous research has found. Maternal self-efficacy appears to buffer the negative effect of depression upon maternal attachment quality. Limitations, clinical implications and recommendations for future research are discussed