Fathers' Subjective Birth Stress During Childbirth Predicts Depressive Symptoms at Six Months Postpartum

• In Event: Fathering in the Prenatal Period: Elucidating Paternal Experiences and Contributions During Pregnancy and Childbirth

Abstract

Introduction

Childbirth, an event that parents often describe as one of the most challenging and meaningful experiences of their lifetime, can range from easy and joyful, to painful, medically complex, and even life-threatening. Fathers may find themselves actively supporting their partners, “worrying in the wings” (Hughes et al., 2020), or feeling vulnerable and frightened (Johansson et al., 2015). For both partners, the childbirth experience has wide-ranging biopsychosocial impacts across the lifespan (Saxbe, 2017).

For many men, witnessing their partner’s childbirth marks their official entry into fatherhood. The transition to parenthood can be a time of vulnerability to mood disorders. Although postpartum depression has received most intensive study in mothers, new fathers also show heightened prevalence of depressive symptoms after the birth of a child (Lamb, 2010). However, childbirth stress has been particularly understudied as a potential predictor of perinatal depression in fathers, in large part because men in industrialized countries have only been encouraged to actively participate in childbirth in the last half-century (Leavitt, 2010). The current study uses longitudinal data from before, during, and after childbirth to elucidate the relationship between fathers’ childbirth experiences and subsequent postpartum depression risk.

Hypotheses

We hypothesized that a more subjectively stressful birth experience will increase fathers’ self-reported depressive symptoms at six months postpartum. We also planned to explore whether mode of delivery (vaginal vs c-section birth) predicted paternal postpartum depressive symptoms or moderated the relationship between birth stress and depressive symptoms.

Methods

The current study reports on 100 expectant fathers cohabitating with their child’s mother. Approximately 3 days after the birth, fathers completed the Birth Experiences Questionnaire (BEQ; Saxbe et al., 2018), a self-report questionnaire measuring childbirth stress, pain, fear, and violation of expectations. Information on delivery method and birth complications was abstracted from birth records. Fathers also completed the Beck Depression Inventory (BDI-II), both in pregnancy, and again at six months postpartum.

Results

Our hypothesis was largely supported, as shown in Table 1. Controlling for prenatal depressive symptoms and delivery method, subjective birth stress significantly predicted fathers’ postpartum depressive symptoms. This effect was not significant when delivery method was not included in the model, suggesting that vaginal vs c-section birth may affect the relationship between stress and subsequent paternal mental health. Delivery method was also not significant on its own as a predictor of subsequent paternal depression.

Conclusion

Our finding that subjective childbirth stress predicts postpartum depressive symptoms in fathers has clinical implications, highlighting the childbirth experience as a potential window of vulnerability for fathers at risk for depression. Involving fathers in birth preparation may not only benefit the couple relationship, but help reduce the risk of birth experiences that feel frightening and out-of-control. Following a difficult or stressful birth, both new mothers and fathers might benefit from additional mental health support.

Authors

• Elizabeth C Aviv, University of Southern California
  Presenting Author

• Emma Preston

• Pia Elizabeth Sellery, University of Colorado Boulder

• Darby E. Saxbe, University of Southern California