Effects of motivational enhancement therapy on mother-infant attachment, breastfeeding self-efficacy, and cesarean delivery preference following a traumatic birth: a randomized controlled trial in southeast Iran.

INTRODUCTION

A traumatic birth experience can have profound and enduring negative consequences on both maternal and neonatal health and well-being. Although Maternal Empowerment Training (MET) has been applied in other maternal contexts, its specific efficacy on the combination of maternal-infant attachment, breastfeeding self-efficacy, and delivery preference among mothers experiencing a traumatic birth remains unclear. This study aimed to evaluate the effectiveness of MET on these outcomes in this population.

MATERIALS AND

METHODS

This randomized controlled trial was conducted in 2023 at Payambar-e Azam and Afzalipour hospitals in Kerman, Iran. Seventy mothers with a history of birth trauma were enrolled, with 35 participants assigned to the intervention group and 35 to the control group. Convenience sampling was used, and participants were randomly allocated using block randomization. Assessors were blinded to group allocation during data collection and analysis. Research tools included a demographic questionnaire, the Mother-to-Infant Bonding Scale (MIBS), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and a checklist assessing preference for cesarean delivery; all instruments are valid and reliable. Data were collected at baseline and two weeks after the last intervention session. The intervention group attended four sessions of Motivational Enhancement Therapy (one face-to-face and three online individual sessions), while the control group received routine postpartum care. Data were analyzed using SPSS-21.

RESULTS

After controlling for baseline differences using ANCOVA, the MET group showed a significant improvement in mother-infant attachment (lower MIBS score), a significant increase in breastfeeding self-efficacy, and a significant reduction in the preference for cesarean delivery compared to the control group (p < 0.0001 for all).

CONCLUSION

Given the effectiveness of MET, its application is recommended for mothers with traumatic birth experiences to improve breastfeeding self-efficacy and maternal-infant attachment, and to decrease preference for Ce-section.