Disrespectful Maternity Care and Postpartum Depression at 2 Months: A Population-Based Study

Abstract

Objective: To assess the association between maternity care experienced as disrespectful and postpartum depression (PPD) symptoms 2 months after childbirth. Design: Nationwide, population-based, cross-sectional study from the 2021 Enquête Nationale Périnatale (ENP) survey. Setting: All maternity units in metropolitan France. Population: Women who gave birth during 1 week in March 2021 and completed the 2-month follow-up questionnaire. Methods: The experience of disrespectful maternity care was retrospectively assessed at follow-up. The association with 2-month PPD symptoms was estimated using Poisson regression with robust variance, adjusted for confounders and weighted to account for attrition. Main Outcome Measures: Two-month PPD symptoms, defined as an Edinburgh Postnatal Depression Scale score ≥ 13. Results: Among the 7189 women analysed, 24.9% (95% confidence interval [CI], 23.8–26.0) reported experiencing disrespectful maternity care, and the prevalence of 2-month PPD symptoms was 16.6% (95% CI, 15.7–17.6). After adjustment, women reporting disrespectful maternity care were more likely to have 2-month PPD symptoms (adjusted relative risk [aRR] 1.37; 95% CI 1.20–1.56). Conclusions: One-quarter of women reported experiencing disrespectful maternity care. After adjustment for most of the known vulnerability factors, this experience was associated with a higher prevalence of PPD symptoms at 2 months. Improving respectful maternity care may be a modifiable factor in reducing PPD, whose incidence and consequences are concerning.