Birth experience partially mediates link between prenatal mental health symptoms and postpartum bonding

Mother-infant bonding is crucial for child development. Prenatal mental health and subjective birth experience are both predictors of postpartum bonding. The purpose of this study was to investigate how prenatal depression, anxiety, and stress were related to bonding and whether these relationships were mediated by birth experience. This prospective cohort study included a diverse sample of 108 pregnant women (38% non-Hispanic White, 37% Black, 25% another race/ethnicity) in the Northeastern United States, approximately half of whom had a mental health condition. Participants completed assessments during pregnancy and 5-7 weeks postpartum, including self-report measures of depression, generalized anxiety, perceived stress, birth experience, and postpartum bonding. Mediation analyses were conducted to explore the relationships between prenatal mental health symptoms, birth experience, and postpartum bonding. Higher levels of prenatal stress and depression symptoms predicted poorer postpartum bonding. These relationships were partially mediated by subjective birth experience. Generalized anxiety symptoms during pregnancy were not related to bonding. Results highlight the key role of the birth experience for postpartum bonding. Mental health symptoms early in pregnancy may impact subjective birth experience and postpartum bonding, suggesting that early interventions have the potential to improve maternal well-being and mother-infant bonding.