Differential patterns of postpartum depression following vaginal and caesarean births: The moderating role of emotional support.

BACKGROUND

Peripartum depression significantly impacts maternal well-being and mother-infant outcomes. Mode of birth may influence the risk of peripartum depression; however, evidence for this association remains inconsistent. Moreover, the roles of specific social support dimensions remain unclear.

OBJECTIVE

To examine longitudinal changes in depressive symptoms from late pregnancy to 6 months postpartum among primiparous women stratified by mode of birth (vaginal or caesarean), and to evaluate whether emotional, instrumental, and informational support moderate the association between mode of birth and depressive symptoms.

METHODS

In this longitudinal study conducted in Taiwan, 235 primiparous women were recruited in the third trimester and followed up at 2, 4, and 6 months postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Social support was assessed using a multidimensional support scale. Generalised estimating equations were used to evaluate interactions between mode of birth and each support dimension in relation to depressive outcomes.

RESULTS

The overall time effects on depressive symptoms were not significant. The vaginal birth group exhibited a downward trend in depressive symptoms, whereas the caesarean group showed increased odds of having depressive symptoms at 2 and 6 months postpartum compared with pregnancy. Emotional support significantly moderated the association between mode of birth and depressive symptoms. Higher emotional and informational support were independently associated with a lower prevalence of depressive symptoms; the association with emotional support was stronger in the caesarean group. Instrumental and informational support showed no significant moderating effects.

CONCLUSIONS

Emotional support was associated with a lower prevalence of depressive symptoms, with a stronger association after caesarean birth. Postpartum care strategies that strengthen emotional support may help reduce the risk of peripartum depression.