Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health.

Previous research suggests that a negative birth experience is associated with symptoms of postpartum depression and anxiety in mothers and partners. However, this has mostly been investigated within the first year postpartum and research on the long-term effects is lacking. Additionally, the role of relationship satisfaction and the interdependence between parents have not been considered so far. Couples (N = 1992) completed questionnaires on their birth experience, relationship satisfaction, and symptoms of depression and anxiety at two months, 14 months, and two years after birth, respectively. Actor-Partner Interdependence Mediation Models indicated no partner effects, but several significant actor and indirect effects. A more positive birth experience was associated with higher relationship satisfaction and less depression and anxiety symptoms for both parents. Higher relationship satisfaction was in turn associated with less depression (mothers and partners) and anxiety symptoms (mothers). The association between birth experience and depression symptoms was partially mediated by relationship satisfaction for mothers and partners, while the association between birth experience and anxiety symptoms was partially mediated by relationship satisfaction only for mothers. Due to the highly educated, very healthy sample with low levels of depression and anxiety as well as high relationship satisfaction, results cannot be generalized to less privileged parents. Moreover, all effects were very small. Results highlight the importance of a positive birth experience for parents' relationship satisfaction and mental health. Negative birth experiences need to be avoided to prevent a negative impact on the whole family.

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Declaration of competing interest Susan Ayers receives funding for research from the National Institute of Health Research (NIHR 17/105/16; NIHR 133727; NIHR 128068) and Barts Charity (G-002188). All other authors have no interests to declare.