Association between postpartum post-traumatic stress disorder, maternal functioning, and self-efficacy in women after cesarean section

Lili Ma, Jiaqi Lu, Mei Chan Chong, Wan Ling, Mengling Wu

Abstract

Childbirth, particularly cesarean delivery, can trigger postpartum post-traumatic stress disorder (PTSD), impairing maternal functioning and self-efficacy. Although self-efficacy is crucial for patient outcomes, its mediating role between postpartum PTSD and maternal functioning remains unclear. This study addressed these gaps by investigating the association between postpartum PTSD and maternal functioning, with a specific focus on exploring the mediating role of self-efficacy. Data were collected during a 42-day postpartum follow-up of 307 women post-cesarean section using the Barkin Index of Maternal Functioning, General Self Efficacy Scale, and Post-Traumatic Stress Disorder Checklist-Civilian version. Non-parametric tests and Spearman rank correlation were analyzed using SPSS 26.0 and the mediating effect using SmartPLS 4. Median scores for maternal functioning, self-efficacy, and postpartum PTSD were 70.00 (60.00, 77.00), 24.00 (22.00, 26.00), and 26.00 (23.00, 32.00), respectively. Spearman's correlation analysis revealed a significant positive correlation between maternal functioning and self-efficacy (r = 0.532, p < 0.01), and a negative correlation between maternal functioning and postpartum PTSD (r = -0.301, p < 0.01). We conclude that self efficacy fully mediated the association between postpartum PTSD and maternal functioning. Therefore, enhancing self-efficacy and addressing postpartum PTSD are crucial for improving maternal functioning in post-cesarean women.

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