Exploring the relationship between obstetric violence, postpartum depression, and breastfeeding through structural equation modelling: evidence from 2015 Pelotas birth cohort
Year: 2025
Type: article
Abstract: BACKGROUND: Obstetric violence is a gender-based violence against women perpetrated by health professionals during pregnancy and childbirth and presents negative consequences for women and newborns. Our objective was to evaluate the effect of obstetric violence on breastfeeding and the role of postpartum depression as a mediator. METHODS: We analysed data from 4275 women and their newborns enrolled in the Pelotas 2015 Birth Cohort by type of delivery (vaginal and c-section). We performed structural equation modelling. The exposure to obstetric violence during childbirth was a latent variable, and the outcome was the duration of breastfeeding. We evaluate postpartum depression as a possible mediator of that relationship. RESULTS: Women who suffered obstetric violence presented a higher probability of interrupting breastfeeding earlier than those who did not. This effect was observed only among women who had vaginal delivery (-0.224; p value: 0.017). We did not find an effect of obstetric violence on breastfeeding among women who had c-section deliveries. The effect of postpartum depression as a mediator on the relationship between obstetric violence and breastfeeding was not demonstrated. The total effect (direct + indirect effect) among women who had vaginal delivery was - 0.223, p value: 0.016. The total effect for the c-section group did not attain statistical significance. CONCLUSIONS: The occurrence of obstetric violence decreases the duration of breastfeeding among women who have vaginal births. We were unable to demonstrate the same effect among the c-section group. We did not identify postpartum depression as a mediator of the association studied. This is the first study to evaluate the role of postpartum depression as a mediator of the association between obstetric violence and breastfeeding and the second to evaluate this relationship. Further studies must be conducted to better understand this subject.
Source: BMC Public Health
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
Funders: Wellcome Trust, Universidade Federal de Pelotas, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, Associação Brasileira de Saúde Coletiva
Awards: G3818105930, G4748797464, G5787551899, A lifecourse approach for understanding levels, trends, determinants and consequences of physical activity, and to inform interventions and policy for global action., A lifecourse approach for understanding levels, trends, determinants and consequences of physical activity, and to inform interventions and policy for global action.
OpenAlex ID: W4413270788