Effect of childbirth experience on the development of early postpartum depression in mothers admitted to postnatal wards at a Tertiary care hospital in Galle, Sri Lanka: A descriptive cross-sectional study

Background : The maternal experience of childbirth has a significant effect on the mother-child relationship and can even lead to the development of postpartum depression (PPD). Early onset PPD is defined as depression which has an onset within four weeks after giving birth to a child. The study aimed to explore the link between childbirth experiences and the development of early PPD in mothers admitted to postnatal wards at a tertiary care center in Sri Lanka. Methods : A descriptive cross-sectional study was conducted among 420 postnatal mothers during the first 72 hours following childbirth, admitted to the German-Sri Lanka Friendship Hospital for Women, Galle employing systematic random sampling. PPD symptoms and childbirth experience were assessed with validated Sinhala versions of the Edinburgh Postnatal Depression Scale and the Childbirth Experience Questionnaire, respectively. Data was analyzed with Chi-square and Pearson correlation. Results : The mean age ± SD of the sample was 29.8 ± 5.438 years, 54.5% were primiparous, and 45.2% had normal vaginal deliveries. A negative childbirth experience was present among 6.9% postpartum mothers, and 11.7% had symptoms of early PPD. A significant weak positive correlation was observed between negative childbirth experience and early PPD symptoms (r=0.245, p<0.001). The presence of antenatal complications (p=0.004), antenatal hospital admissions (p=0.010), and absence of spousal support (p=0.010) were significantly associated with a negative childbirth experience. The development of breastfeeding problems was observed as a secondary outcome (p<0.001) of a negative childbirth experience. Conclusions : The prevalence of negative childbirth experiences and the presence of early PPD symptoms in mothers were found to be low but significant. Training the staff in maternity hospitals to care for patients with empathy during the perinatal period, while providing better social support for pregnant women is recommended to ensure a positive childbirth experience.