The Link Between the Birth Experience and Postnatal Depression


Postnatal depression is an area of concern in nursing as midwifes are usually the ones responsible for creating the best experience of delivery for future mothers. Despite the recent increase in interest regarding postnatal depression, a lot is yet to be uncovered in relation to the link between the birth experience and the postnatal feelings of anxiety and depression. This paper proposes a systematic review study to identify, examine, and assess the latest research surrounding post-partum depression, negative labor experiences, birth trauma, as well as post-traumatic stress disorder.


The concept of postnatal depression has only recently entered the public consciousness primarily due to the conversations centered around the experiences of womanhood and childbirth initiated by the feminist movement. Conversely, there is still a lack of understanding of what postpartum depression truly is and how it affects mothers and infants. According to the statistics cited by Bell and Andersson (2016), this type of depression occurs in the West at a much higher rate with a prevalence of 13-19%. Firstly, it is crucial to define postnatal depression and distinguish it from other conditions, which might appear similar at first sight. Postpartum depression can be defined as a series of prolonged depressive episodes characterized by mood swings, feelings of sadness and despair, suicidal thoughts, loss of emotional balance and energy. The Diagnostic and Statistical Manual of Mental Disorders and the Tenth Revision of the Classification of Disease are often utilized to diagnose postnatal depression. Thus, it is apparent postpartum depression is a real condition millions of women in the United States and the world struggle with.

In order to examine the issue of the link existing between postnatal depression and the experience of labor, it is exceptionally important to have a clear understanding of the term “postnatal depression.” While the commonly used phrase “baby blues” might not encompass the actual seriousness of postnatal depression, postpartum psychosis is an entirely different condition, which is often a lot more concerning and requires immediate mental health care assistance. Both of these phenomena are simply two extremes, with postnatal depression existing somewhere in the middle. A period of 2-3 weeks hatcheries by mood swings and feelings of sadness and suffering are referred to as “baby blues.” This fortnight of mental struggles can actually be scientifically explained as the shifts in mood occur as a result of hormonal shifts right after giving birth (Bell & Andersson, 2016). As for postnatal psychosis, it is much more of a rarity. It is a condition involving a patient getting out of touch with reality, which may lead to an increased risk of harm for the infant. Therefore, while all of the aforementioned conditions are primarily characterized by mood disturbances following childbirth, postnatal depression is a common, long-lasting condition, which may last for as long as a couple of months or even a year.

Postnatal depression has a range of risk factors, which have to be acknowledged as well. Bell and Andersson (2016) argue that “a history of psychopathology, depression or anxiety during pregnancy, poor social support, and stressful life events” are some of the primary risk factors to keep in mind (p. 113). Yet it becomes evident the actual childbirth experience and the trauma it might cause are not considered a crucial risk factor. The purpose of this study is to explore the association between the labor experience and postnatal depression. One of the primary questions the proposed study aims to answer is whether a negative birth experience is a reliable predictor of postnatal depression in women. While there are some studies confirming that more of birth is not associated with postpartum depression, there is still potential in exploring the impact of complications and traumatic labor experiences on the likelihood of a mother developing postnatal depression.

Another factor, which is crucial to discuss is the possible impact of postnatal depression both on the mother and the child. Negative consequences of postnatal depression might include the ones characterized by issues in regard to mother-infant interaction. Such issues might include attachment problems, the lack of mother-infant bonding, impaired child development, and so on. These developmental impairments may be “low empathy, bullying, irritability, negativity, difficulties in school, cognitive deficits” and various types of pathologies (Bell & Andersson, 2016, p. 113). Apart from the impact postnatal depression has on the child, it may create tension in intimate relationships by placing additional stress in partners and testing family bonds. All of these potential outcomes of a mother developing postnatal depression demonstrate the seriousness of the condition and the severity of its possible impact on the mother, the infant, as well as the family as a whole.

Apart from defining postnatal depression, it is integral to conceptualize the birth experience in order to move further in this in-depth discussion. While the experience of labor and delivery is deeply personal, there are some universal aspects to every individual experience. Bell and Andersson (2016) define the birth experience as “a complex psychological individual experience, with elements of universal physiological processes and life event significance” (p. 113). Furthermore, a positive birth experience is generally considered to be the one characterized by the mother’s own trust in herself and her ability to go through labor. However, in addition to this, in order for the experience to be truly positive for the mother, she has to feel comfortable in her surroundings, which is usually associated with a proper support system one should have during pregnancy and childbirth, in particular.

In the context of nursing, a positive experience could be facilitated through efficient pain relief, supportive care of high quality, respect for the mother’s dignity, as well as the efforts addressed at ensuring the mother makes informed decisions about the labor and delivery process. An important distinction to make is the fact that no matter how hard and challenging the birth might be, a woman will still perceive it as positive if she has a great support system and expert caregiving by health care providers, she chooses to assist her during childbirth.

The purpose of the proposed systematic review is to examine the aforementioned association between the childbirth experience and postnatal depression. It is worth clarifying that since the experience of labor cannot be assessed in any other way than subjective attitudes, the perceptions of such prenatal experiences will be the focus of this mini proposal.

Literature Review

The first article chosen for the literature review is a research report published in the peer-reviewed journal Midwifery in 2017. The article is called “Women’s experiences of living with postnatal PTSD” and written by Susan Peeler and her colleagues. The primary focus of the study was mental health concerns related to becoming a mother, particularly developing a post-traumatic stress disorder because of giving birth. The primary objective of the study was to examine how traumatic birth experiences affected women’s mental health and overall emotional well-being.

In order to do that, the authors conducted a qualitative analysis of the interviews with seven participants: women suffering from postnatal PTSD, all of whom were chosen from a NHS Trust. In regard to the findings, Peeler et al. (2017) argued that, based on the data collected, “complicating factors such as relationship difficulties and pre-existing health problems appeared to contribute to postnatal post-traumatic stress disorder” (p. 70). Moreover, the interviews provided the evidence to infer good relationships with midwives were crucial in facilitating a more positive birth experience for women. As for further implications for practice, the research suggested patients to go through mandatory personality testing prior to giving birth in order for midwives to be ware of potential traits such as alexithymia and be prepared to navigate the delivery of care with such patients.

The second article chosen for the literature review is the work of Bell and Andersson “The birth experience and women’s postnatal depression: A systematic review” published in Midwifery in 2016. The focus of the study was the link between the birth experience, postnatal depression, and developmental impairments in children as a result of the latter. Bell and Andersson (2016) define the purpose of their systematic review as identification and review of the recent, reliable research related to the association between labor experience and postpartum depression. In regard to methodology, the researchers employed an efficient search strategy with clearly defined criteria. It is worth mentioning that with the assistance of the Matrix Method and the integration of the PRISMA reporting method, the authors managed to narrow down the list of more than 1000 abstracts to just 112 studies.

The study concluded that a negative childbirth experience is an important contributor to postnatal depression. The results were supported by the fact that “eleven of the 15 studies meeting search criteria demonstrated a significant association between women’s postnatal birth experience and postnatal depression” (Bell & Andersson, 2016, p. 112). As for the implications for practice, the article specified that reducing the risk of postnatal depression would require the changes in healthcare policy and the systems of care delivery with more focus on supportive care.

As for the third article, the literature review includes the study conducted by Hall et al. in 2018. The purpose of the study was to examine the complexity at the center of women’s dynamic experiences of childbirth. The researchers employed the van Manen principles, using a phenomenological approach to design a qualitative study. Participants were rather diverse although all of them were from one geographic area: Atlanta, Georgia. In regard to the findings, Hall et al. (2017) concluded that comfort during childbirth was an essential risk-averting factor when it came to the shifts in mental and emotional well-being. As for implications for proactive, it became apparent just how crucial it truly was for clinicians to do everything in their power to accommodate the needs of women in labor. The goal was to balance out dynamic fluctuations of moods and emotions in order to ensure a positive outcome in regard to childbirth experience.

The fourth study out of the selection made for this literature review is the article in the Journal of Affective Disorders written by Nawa et al. (2019). Since multiple studies had linked maternal depression to impairments in infant development and growth, the authors of this particular study decided to examine the association between postnatal anxiety and child weight. Nawa et al. (2019) utilized “Generalized Estimating Equations to assess whether child BMI trajectories varied by the presence of maternal anxiety” (p. 136). It is important to note that the anxiety of participants was measured using the Crown-Crisp Experiential Index, while the depressive symptoms were assessed with the help of the Edinburgh Postnatal Depression Scale-7. The findings revealed maternal anxiety was associated with body mass index changes observed in children, although the opposite was true for maternal depression. In regard to implications, the study provided multiple invaluable insights as to why it was crucial to integrate anxiety-reducing strategies into the care of pregnant women throughout their pregnancy and during childbirth, in particular.

The last article chosen for the literature review is the Malaysian study conducted by Latif in 2018 and subsequently published in the Malaysian Journal of Medical Research. The main objective of the study was to provide in-death insights in regard to the prevalence of anxiety, depression, and stress in new mothers. Latif (2018) conducted a cross-sectional assessment of 130 participants who were all postpartum patients at a clinic in Kelantan. The researcher examined the data using the Chi-square tests, concluding that age was a significant determining factor when it came to postnatal anxiety and stress in women. As for the implications for future practice, the article urged the medical community to train nurses in accordance with the latest research surrounding postnatal depression and anxiety.

Sampling Methods, Methodology, and Data Analysis

Since the proposed study is a systematic review, it is important to determine how the articles for the subsequent analysis will be selected. There will be a set of selection criteria applied to all the studies. Only those thematically suitable, published within the last 10 years, and peer-reviewed will be assessed as part of the systematic review. The number of studies fitting all the criteria is expected to be around 15-20. In regard to methodology, the review will be guided by the Matrix method, with the PRISMA process expected to be utilized for the reporting part. The primary steps of the Matrix method are to identify the primary objective; to ensure there is a concise yet reliable paper trail documenting every single step of the screening and selection processes; to optimize the interrelation of review components; to summarize each study chosen for the review; to provide detailed conclusion for each study.

Since the proposed study is a systematic review, no complexities of data analytics are expected to be integrated. It is likely that most of the studies eligible for review will already be based on previously gathered data. Secondary analysis studies and studies with retrospective designs do not require any intricacies in the design of the analysis framework for the proposed study. PRISMA guidelines will be used to ensure the review is of the highest possible general quality.


In conclusion, the proposed study offers a systematic overview of the latest scholarly research surrounding postnatal depression with the goal of determining whether the birth experience is a contributing factor to postpartum anxiety, stress, and depression. In terms of the implications such a study might have for future practice, it is evident that any scholarly insights related to postnatal depression are exceptionally welcome in the medical community. The study could offer invaluable evidence-based recommendations as to how to ensure patients are treated to the best childbirth experience possible in an effort to reduce the risk of postnatal depression. In the long run, these findings could be helpful in decreasing the number of children suffering from developmental impairments.


Bell, A. F., & Anderson, E. (2016). The birth experience and women’s postnatal depression: A systematic review. Midwifery, 39(1), 112–123.

Hall, P. J., Foster, J. W., Yount, K. M., & Jennings, B. M. (2018). Keeping it together and falling apart: Women’s dynamic experience of birth. Midwifery, 58(1), 130–136.

Latif, R. A. (2018). Prevalence of depression, anxiety and stress among post-natal mothers having low birth weight (LBW) infants. Malaysian Journal of Medical Research, 2(2), 18–29.

Nawa, N., Black, M. M., Araya, R., Richiardi, L., & Surkan, P. J. (2019). Pre- and post-natal maternal anxiety and early childhood weight gain. Journal of Affective Disorders, 257(1), 136–142.

Peeler, S., Stedmon, J., Chung, M. C., & Skirton, H. (2018). Women’s experiences of living with postnatal PTSD. Midwifery, 56(1), 70–78.

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PsychologyWriting. 2023. "The Link Between the Birth Experience and Postnatal Depression." January 6, 2023.

1. PsychologyWriting. "The Link Between the Birth Experience and Postnatal Depression." January 6, 2023.


PsychologyWriting. "The Link Between the Birth Experience and Postnatal Depression." January 6, 2023.