Fear of childbirth, birth satisfaction, and postpartum depression in relation to mother-infant bonding in postpartum women

Abstract

Background This study aimed toexamine the relationships between fear of childbirth, birth satisfaction, postpartum depression, and mother-infant bonding. Methods The population of this cross-sectional study consisted of postpartum women who had given birth vaginally. A power analysis was conducted using G*Power (version 3.1.9.7) to determine the required sample size. The a priori power analysis, based on a multiple linear regression model (f & sup2; = 0.15, alpha = 0.05, power = 0.80), indicated that at least 346 participants were needed. The study was completed with 520 postpartum women who met the inclusion criteria. Data were collected online between June 18 and August 30, 2025, from postpartum women residing in T & uuml;rkiye using a snowball sampling method via Microsoft Forms. The following instruments were used for data collection: the Introductory Information Form, the Mother-to-Infant Bonding Scale (MIBS), the Wijma Birth Experience Scale Version B (WBES-B), the Birth Satisfaction Scale-Revised Form (BSS-RF), and the Edinburgh Postpartum Depression Scale (EPDS). Results The mean scores were 13.77 +/- 3.83 for MIBS, 111.57 +/- 12.14 for WBES-B, 21.83 +/- 3.11 for BSS-RF, and 12.84 +/- 4.45 for EPDS. A moderate negative correlation was found between WBES-B and MIBS (r = - 0.501, p < 0.001). A weak positive correlation was observed between MIBS and BSS-RF (r = 0.145, p < 0.01). Notably, EPDS showed a weak but statistically significant positive correlation with MIBS (r = 0.232, p < 0.001), indicating that higher levels of depressive symptoms were associated with poorer mother-infant bonding. In the multivariable analysis, WBES-B remained negatively associated with MIBS (B = - 0.145, p < 0.001), a finding that should be interpreted cautiously given the scoring direction of the MIBS. EPDS was also positively associated with MIBS (B = 0.152, p < 0.001). The association between BSS-RF and MIBS was of borderline statistical significance (p = 0.076). Conclusion Postpartum women demonstrated moderate levels of mother-infant bonding and birth satisfaction, along with elevated levels of fear of childbirth and a notable risk of postpartum depression. Higher levels of depressive symptoms were consistently associated with poorer mother-infant bonding in both bivariate and multivariable analyses. The relationship between fear of childbirth and bonding appeared complex and should be interpreted with caution, particularly in light of the scoring direction of the MIBS and the early postpartum context.