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The midwife needs to be open and accessible for a possible conversation in which she can reassure the mother-to-be that no abuse is taking place and that everything is normal. Above all, she must be respectful. In such moments, it is even better to have someone beside the pregnant woman who knows of her abuse and whom she fully trusts.

This person can reassure her that what she is experiencing are reawakened feelings pertaining to her abuse; that the abuse is no longer happening and that it is safe. This double recognition and distinction between the past and the present is extremely important for the mother-to-be [ 46 , 29 , 47 ]. The woman can react in various ways. She can freeze, become rigid, apathetic, her breathing or facial expressions can change and she can even exhibit signs of panic. Women who are aware of their abuse and are consciously prepared for these feelings will be able to more easily control the situation.

Furthermore, such women will be able to discern that their feelings do not originate in the here and now, but have only been reawakened - it is safe [ 29 , 48 ]. It is much more difficult when a woman is not aware of her abuse. This is because the psyche and body experience are precisely what the woman has suppressed and unprocessed fear, shame, anxiety, panic, despair, disgust powerlessness, anger, etc. Clinical practices have shown that many victims of sexual abuse freeze during the abuse itself a subconscious defence mechanism that helps them survive the difficult events.

This is why many victims feel that experiencing the consequences e. In situations that are subconsciously reminiscent of their past experiences, the flashbacks awaken what they were not allowed to feel during the abuse itself due to apathy and dissociation. This often happens to victims who experience severe pain during their abuse. Consequently, such women may experience dissociation during childbirth. Here, their minds may wonder and they may not feel the pain. They are subconsciously fighting the pain.

This can prolong and hinder the course of childbirth. Women in therapy often say that, when dissociation occurs, what helps them the most is someone calling them by their name. In the above described case, the epidural analgesia helped because the physical pain the labour pain , which was reminiscent of the pains during her abuse, triggered dissociation.

In other cases, the epidural may cause dissociation or a panic attack. This is because the pregnant woman may feel that she is not in control of her body or that she is, in a way, tied, captured and cannot escape. As a result, she may experience feelings similar to those she experienced during the sexual abuse when her body froze. Dissociation is strongly associated with the feeling of not being safe: This made me feel safer.

But when contracting and dilating began, I started pushing and crying out for my mother In my mind, I tried to escape to a safe place I was exhausted from the touches Physical sensations , such as the stretching of the pelvis, tensions in the body, etc. This impact is stronger and greater if the abuse she suffered involved painful penetrations or rape.

General anaesthesia, especially the feeling of losing control over her body, can also arouse fear in a woman with a history of sexual abuse. Flashbacks can also be triggered by the position of the body , for example lying in bed. A woman who has been sexually abused night after night before sleep, while having to lie on her back in her bed, can experience bad and unpleasant feelings in this position [ 47 ].

In therapy, it transcribed that the above mentioned woman had, during her childhood, been sexually abused by her stepfather man. This man had a beard similar to the doctor and would come into her room in the dark. Most often, the medical personnel is not even aware that they have the power to re-traumatize a woman who has been sexually abused. At the same time, with kindness and professionalism, they can help her experience the delivery as something beautiful. Sometimes a sentence is enough to calm a woman down or, quite the opposite, enough for everything to fall to pieces.

Most abused women undergoing therapy report that they find it immensely difficult to tell their midwives or doctors that they have been sexually abused. This is because they are too afraid that the personnel might then look at them funnily or treat them differently. Furthermore, it is likely that some of them have never told anyone about their experience, not even their partner.

Many women say that it would be most helpful if, during pregnancy, they had a person perhaps a doula, a chosen midwife, a determined partner, etc. This person would then be present at delivery. For a mother with a history of sexual abuse, it can be highly reassuring to have someone beside her who knows how she is feeling and understands her reactions to situations which reawaken painful memories. When the abuse took place, there was nobody there to protect the girl and provide safety; to speak for her and draw the line or just reassure her that everything would be fine.

This is why such a positive experience can be very healing for the victim. The child is born. Even before giving birth, some mothers are afraid and worry about whether they will be competent mothers, whether they will feel the child, whether they will know how to protect it from dangers, etc. In this section, we explore the studies and clinical experiences relating to sexual abused mothers and their child during breastfeeding, caring for the child and in their attachment to the child.

Furthermore, how they raise their children and how sexual abuse can manifest in subsequent generations. The first contact after birth is most commonly related to breastfeeding. If a sexually abused mother feels an aversion to breastfeeding; perhaps this reawakens feelings relating to abuse and reminds her body that someone has been disrespectful to it, then she needs to be given as much support as possible and not be pressured to breastfeed at any cost.

Even though her body is completely ready to breastfeed, this does not necessarily mean that her psyche is. This is why emotional contra-indicators need to be taken into account [ 30 ]. Accounts of clinical experiences have shown that this often happens to women whose breasts were groped during abuse. Nudity reminds them of how it felt to be exposed and unprotected during abuse. Other mothers still limit the breastfeeding to daytime.

Impact of Maternal Stress, Depression & Anxiety on Fetal Neurobehavioral Development

At night they only bottle-feed the baby with pumped milk. This happens during breastfeeding in particular. During breastfeeding, the mother tenderly gives the baby all of her attention. With this, the mother establishes contact through feeding and changing her child, putting it to sleep and cuddling it. A partner who is jealous of this most likely demands attention, exclusively for himself. He may oppress the mother, even when she wants to get up in the middle of the night to comfort and calm the crying baby. Even worse, he may demand that she be sexually available to him, perhaps even before her check-up six weeks after the birth and before she is psychically ready.

Women in abusive relationships much more often have an unplanned pregnancy a few months after the birth [ 49 ]. Many other studies [ 18 , 50 , 51 , 44 ] report that CSA survivors are less content in intimate partner relationships.

Overall, there is more discord and violence. Furthermore, there is a higher probability of divorce. In such a distressful situation, if the mother is lonely and has nobody to support her, she can lose her milk. Furthermore, in order to have some peace from her partner or her awakened feelings, she may decide not to breastfeed anymore. It is extremely important that her environment and medical personnel the visiting nurse, paediatrician, gynaecologist, etc.

This reaction to breastfeeding does not make her a bad mother. If she were to breastfeed, the extreme anxiety she would experience would harm her relationship with her child - far more than not breastfeeding. However, if the mother has an experience of sexual abuse, it is even harder for her to trust her body and intuition. If she experienced her body already failing her during childbirth, she is even more afraid to trust herself afterwards. She is not sure that she is right about what the child needs when it cries, cannot sleep or refuses to breastfeed.

This is precisely why feelings of shame, guilt and anxiety frequently manifest in a sexually abused mother. All of these feelings are even more present if the woman grew up in a family living in utter chaos or in which everything was wrong and there was no safety. If this was the case, she may develop an intense need to do everything right as a mother.

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Endeavouring to raise her child differently can lead to extremes — to perfectionism. Such a mother will probably be very critical of how other parents raise their children. She will see herself as different, often stigmatized as a little girl, she already felt different and stigmatized due to abuse [ 49 ]. The results of a study [ 52 ] that measured the parenting characteristics of female survivors of childhood sexual abuse have highlighted some prominent traits: Mothers with a permissive parenting style may avoid invoking parental authority because of their own negative experiences as victims of adult power [ 53 ].

Consequently, they have less confidence in setting appropriate boundaries [ 54 ]. Moreover, because they are emotionally more wounded due to the sexual abuse, they have less energy to enforce discipline or appropriate behaviour of their children. They can be easily manipulated by crying children, presumably due to an over-identification with their children's unhappiness [ 55 ]. Contrary to this, using physical violence and other harsh parenting methods are likely indicate that the parent is repeating what they were subject to as children. Thus, they subconsciously preserve contact with their parents, albeit in a negative sense, and transmit the patterns of violence [ 46 ].

They claim that the maternal history of sexual abuse involving intercourse is related to the increased chances of physical abuse, sexual abuse or neglect in the second generation. Additionally, children of abused mothers are often parental, taking care of the emotional needs of their mothers who are, in a way, emotionally dependent on them no healthy boundaries.

Compared to their peers, these children look much more grown up.

Psychological and psychophysiological considerations regarding the maternal-fetal relationship

However, in the long term, their own development can suffer [ 57 ]. Clinical experiences show that mothers often treat their children as confidants and friends. This is particularly the case if they do not get along with their partner. Mothers reporting a history of incest were more likely to interact with their sons in a subtly seductive manner, considered to be indicative of generational boundary dissolution [ 58 ].

In general, children of sexually abused mothers show a more helpful, protective, managing and controlling behaviours towards family members. On the other hand, children of non-abused mothers show significantly more trusting, deferring, relying and submitting behaviours [ 59 ]. Grocke, Smith and Graham [ 60 ] have found that, compared to children of non-abused mothers, children of CSA survivors are more prone to interpreting ambiguous pictures of children and strangers as negative or frightening. They also believe that sexually abused mothers teach their children about the male and female sexual development and contraception-related topics in more detail.

Such mothers find this increased communication essential. This is because they presume that it will protect their children from a experiencing a similar sexual abuse. On the contrary, Douglas [ 61 ] reports that mothers with a history of sexual abuse are more anxious in child care, requiring intimate contact such as changing, bathing and putting to bed.

1. Introduction

Women who are aware of having been sexually abused may often fear that they will themselves abuse their child. The fact that the mother is afraid is a sort of safeguard and it is, therefore, quite unlikely that she would sexually abuse her child. However, there can be situations in which she feels aroused. For example, during the changing, bathing or breastfeeding of her child. Her body tells her that what is happening is not natural, that it is perverted. Particularly, this can happen if she, herself, has been sexually abused on the changing table.

In this case, she may not even have the images in her explicit memory, that is, she cannot recall the event of the abuse. It suffices that her body remembers it, that the abuse is recorded in the organ memory - in implicit memory. If arousal or disgust occur, it is important that the mother controls herself, that she takes time to evaluate her feelings. In other words, it is necessary that she sets boundaries and becomes aware that it is her abuse reawakening; that her child deserves pure love. She has to feel able to withdraw, go to her partner and communicate these feelings if she is unable to process them herself.

When this does not work, it is necessary that the mother seeks the help of a professional who will assist her in going through the emotions of abuse disgust, shame, etc. At the same time, the mother feels contempt for and disgust with herself for having these feelings. These feelings and real bodily sensations are unfair, both on the mother who experiences them and on the child who, through the projection-introjection identification, senses and feels her distress or, even more, when the child drinks these feelings of abuse on her bosom [ 29 ].

In such an atmosphere, it is more likely that the unresolved feelings perhaps even the action itself will lead to an intergenerational transmission of the trauma of sexual abuse, which we will discuss in the next section. Johnson [ 62 ] claims that people who are victims of emotional, physical or sexual abuse are six times more likely to continue the abuse they have suffered. Other studies [ 63 ] have shown that half of the mothers whose children have been sexually abused have, themselves, been victims of sexual abuse.

If the act of sexual abuse is not transmitted, this does not mean that the children of sexually abused parents will be safe from sexual abusers. Relational family therapy [ 16 ] discusses the unresolved effects of abuse, including disgust, shame and anger. These are vertically transmitted from the abused parent to the child through the mechanism of projection-introjection identification. Miller suggests something similar in her The Body Never Lies: The Lingering Effects of Hurtful Parenting [ 65 ]. Here, she argues that childhood abuse is resolved in two ways: Alternatively, the effects are suffered by the body of the abused person with psychosomatic or chronic diseases.

In their work, McCloskey and Bailey [ 66 ], state that it is three to four times more likely that a daughter of a mother who was a victim of sexual abuse would herself would be sexually abused, than in cases when mothers had no experience of sexual abuse. They believe that a common reason for the transmission of sexual abuse between generations is the preservation and continuation of contacts with the family members involved in the sexual abuse of the mother and then, also, the daughter.

Other studies have shown that mothers of children who had been sexually abused like them exhibit a higher degree of stress and symptoms of post-traumatic stress disorder [ 67 ]. Additionally, they express fear that they will be bad mothers, directing hostility and frustrations towards their children [ 55 ]. Sexually abused mothers also show difficulties establishing a structure, expressing affection and love for their children. They feel mixed emotions towards them and fear that their children will also become victims. This often results in them socially isolating their children, in order to protect them [ 55 ].

The results of a study by Hall, Sachs and Rayens [ 68 ] show that mothers with a history of sexual abuse use physical punishment on their children six times more often than mothers who have not been sexually abused. Cohen [ 69 ] stresses that, if they have not worked through the abuse, sexually abused mothers are less skilful and functional in the parental role. For example, if the mother has been sexually abused as a little girl just as she started saying her first words, she may subconsciously feel an intense dislike and negative attitude towards her child when it starts to talk.


  1. Psychological and psychophysiological considerations regarding the maternal-fetal relationship.
  2. Introduction.
  3. MY ANCESTRAL VOICES: STORIES OF FIVE GENERATIONS OF THE BLACKBURN FAMILY FROM SLAVERY TO NOW.
  4. BioMed Research International.
  5. chapter and author info?

She will not know what is going on but her body will testify to her distress. If she is able to take this distress seriously and allow herself to feel the girl inside her, then she will be able to accept her child. If not, this rejection and refusal of the child may intensify to a degree of neglect [ 30 ]. Some cases of unprocessed and repressed sexual abuse of a mother can come to light when, at a certain age, a child begins to frequently get ill or when various psychosomatic signs appear, sometimes also behavioural or learning problems.

Usually the age at which certain symptoms emerge, e. With an ailing child, the mother may feel powerlessness, fear and even anger for having to keep going to the doctors. However, all of these feelings actually belong to her sexual abuse. Her child merely activates and reawakens them as they have not yet been processed. This is because she is not in contact with them. As a girl, when her body was exposed and unprotected, she felt fear and powerlessness. She had to suppress her anger at an injustice she suffered. This will help not only her child, but also the little girl still living inside her who never really received any compassion, safety and support.

The body never forgets sexual abuse. Even if the psyche pushes it to the subconscious because the pain is too great, the body will cry for help in every possible way through psychosomatic troubles, health issues, addiction, workaholism, conflicts in a partner relationship, depressions, etc. Years, even decades, can go by before the consequences of the abuse surface.

If the abused woman functions normally, it may seem that she has no problems. However, one trigger, like pregnancy or childbirth, may suffice for sensations and feelings similar to the ones during the sexual abuse to start uncontrollably emerging. Most survivors do not even relate this to the original trauma, looking for the causes somewhere else completely. Yet, the problem is not solved until the trauma is. In the safe and trusting therapeutic environment, there is a way out of the vicious circle of distress and pain. However, it is a long process for which the abused needs a lot of strength, determination, resolution and encouragement, especially when the occasional crises occur.

Clinical experiences have shown that, with an in-depth and successful therapy, an individual can live a very good and decent life. At the same time, due to the distinction between the present when something merely awakens and the past when something actually happened , such a person is much more relaxed as a parent. She can trust her intuition and body and feel her child as a mother. This means, of course, that she does everything to protect the child from experiencing a violence similar to the one she had.

She emotionally equips the child so it is able to go out into the world. She ensures to sever the intergenerational transmission of the trauma of sexual abuse. Embed this code snippet in the HTML of your website to show this chapter.

Help us write another book on this subject and reach those readers. Login to your personal dashboard for more detailed statistics on your publications. We are IntechOpen, the world's leading publisher of Open Access books. Built by scientists, for scientists. Our readership spans scientists, professors, researchers, librarians, and students, as well as business professionals. April 15th DOI: Introduction Sexual abuse is a traumatic experience that marks a person for the rest of their life and has numerous consequences.

Definition of sexual abuse Sexual abuse is a traumatic experience involving an involuntary sexual contact between the abuser and the victim, with the intention of sexually arousing the perpetrator who transgresses all limits of human dignity [ 1 ]. The consequences of sexual abuse In general, it is difficult to say how sexual abuse impacts an abused person.

The trauma of sexual abuse, body and health issues Sexual abuse first occurs at a physical level. Katarina Neff [ 28 ], a doula who has a lot of experience with pregnant women who have been sexually abused, believes that when a sexual abuse survivor with PTSD becomes pregnant, she may develop the following symptoms: Fear of the intensity of her feelings Fear that the child will be born deformed like her Fear that the child will be born dead i.

It seemed to me that those who said it was a serious trauma exaggerated, since my life was quite okay. I was overwhelmed by the uncontrollable feelings of panic. Once, I even had to go to the ER. I felt guilty because I just wanted to pull the child right out, since every movement that was not under my control unnerved me intensely.

At moments, I even wished for the child to die so that the distress would stop but I knew that, then, another would begin. I was somewhat appeased by being told I was having a girl because I realized that a boy would obviously remind me too much of the perpetrator. You lie there like a victim, while he shines his light down there and touches you. I find the stirrups particularly horrible. But, on the other hand, I am also aroused.

Like a rape I myself wanted. I was very much aroused when I went home and I was quite ashamed. I felt disgusted with myself and wished that someone would actually rape me. I go there when they send me the third invitation because I have to have regular check-ups. There I am, all stiff, keep my eyes closed and try to think of anything but this dreadful, humiliating, disgusting position I am in. Childbirth and the history of sexual abuse It is normal for every pregnant woman to be afraid of giving birth. I can never completely relax. I also faced traumas during childbirth.

Horror, despair, panic, tears, anger Despite the labour pains and big belly, I lifted my backside from the bed and sought refuge at the wall. The simple fact that someone wanted to examine me in the middle of my labour pains seemed extremely intrusive and horrible!

When I should have pushed out my baby, I failed, despite numerous attempts, and so the child was born with a CS. When I got pregnant the second time, the push-out was what I was afraid of most. I feared that the same psychical and physical pain would repeat.

I started going to therapy and I was set at ease when my therapist helped me understand what transpired during my first childbirth. The pain I felt in my vagina subconsciously reminded me of the pains I felt when, after practice, my coach would grope me and shove in my vagina everything - from his fingers and various objects to his penis. I always considered that part of my body the most dirty and disgusting.

As long as she was in my belly, she was still pure but then I had the feeling that she would have to swallow all the sperm and all the disgust the coach had given me. With this awareness and strongly determined that my body was clean, while the perpetrator was dirty, I went to give birth for the second time; this time, my son.

I gave myself strength with words that my body could not be dirty, ugly and damaged if it was going to give birth to a new life. The birth itself would finally heal old wounds and give me back my dignity as a woman. Although my brain knew all this, the moment the midwife announced that I was fully dilated and ready for the push-out, I started feeling the same horror and anxiety as the first time. As if an invisible force wanted to drag me away again to the world of abuse. I started calling to God for help.

And he actually answered. In my mind, I heard the words of my therapist calmly and tenderly resounding: The earthquake is over. This is only a reawakening of the feelings you were not allowed to feel during abuse Your uterus is a place where life is born and your body has a remarkable power," she said. Prouder than ever in my life, I heard the cry of my second-born child! But the more the pain grew, the less present I was emotionally.

Only now and then I still managed to look around and the only thing I remember is the doctor coming to me and calling me by my name. However, other studies have found no was directly related to birth satisfaction and inversely related to statistically significant differences in maternal psychological ad- postpartum depression, regardless of the mode of delivery.

While studies have separately examined women wood, Birth Experience Social support during childbirth has been identified as One way to better understand how the mode of delivery affects another important facet of the subjective birth experience. Researchers have described calm the mother, increase her feelings of control, and aid her a large number of factors that contribute to a positive subjective ability to communicate with the staff Green et al.

As such, it is influenced by the strom, Negative birth experiences also are indicated by not feel- with their infant. For example, Durik et al. Green and Baston Mothers who deliver by cesarean are more likely to report found birth satisfaction to be directly related to three do- feeling out of control, a lack of adequate information, and having mains of control: Studies conducted by Teti and Gelfand suggest a direct relationship among these variables and maternal e.

Yet, few studies have examined the relation petence and lower feelings of competency in the mothering role. Thus, mothers who perceived perceptions of their babies in the same study. These findings underline that caregiving e. Studies have shown a positive relation between ma- babies at 6 weeks. Maternal self-esteem also has been linked to overall year of life. Giving birth is tion of delivery method over the first year. These researchers the first experience mothers have with their babies in the outside reported observable differences in mother—infant interactions at Infant Mental Health Journal DOI George 4 months, with women who delivered vaginally demonstrating in relation to either objective or subjective birth experience.

This more positive affect than did women who had a cesarean deliv- study addressed three questions: These differences were no longer significant at 12 months. Are the effects of mode of delivery mediated by subjective examined mother—infant interaction as a function of deliv- birth experience? The direct effects of mode of delivery will be partially function of neuroticism across the first year. These differences were RQ3. Are these relations related to infant age? Neuroticism mediated the re- H3. The au- thors speculated that the women who were high in neuroticism would experience the highest level of violated expectations be- METHODS cause they were likely prone to anticipate what could go wrong Participants during birth and thus have their expectations confirmed when there is an emergency while women low in neuroticism are less likely The sample consisted of mothers living in the United States to do so.

The distribution of delivery modes were The present study ad- comprising slightly less than half Web announcements were lation between mode of delivery and subjective aspects of birth posted on parent-oriented Web sites e. Postcards advertising the self-esteem at different points across the first year of life. This study were distributed in toy stores and community centers in the study extends previous work by examining mothers whose infants San Francisco Bay Area, Seattle, New York City, and Boston.

This study also extends previous work by including maternal the terms of participation, and the required consent of the partici- self-esteem in the analyses, a construct that has not been assessed pant to continue with the survey. Descriptive Frequencies scores were calculated as the percentage of negative adjectives of the total number of adjectives selected. Maternal self-esteem was measured using Multipara Education Some High School 5 1. Caretaking ability Some College 62 Items are rated on a scale White Demographic Covariates Measures Parity.

Parity was measured by asking mothers to indicate whether Mode of delivery. Mothers were asked to indicate whether they they had previous children and the ages of their other children. Income was assessed by asking mothers to indicate which Subjective birth experience. The Birth Experience Questionnaire range their household income fell into: In addition to the Mplus during childbirth e. Moderation was examined us- birth e. Subscale summary scores were calculated by predictors, mediator, and outcomes; that is, whether the strength taking the mean of the subscale items, and the BEQ total summary of the model relations differed as a function of infant age.

We ran score was calculated as the mean of the subscales. Mothers were asked to describe their baby followed by a model in which paths are constrained to be equal using Green et al. Mothers across groups, and then will use chi-square difference test to deter- were asked to select adjectives that described their babies from mine whether constraining the pathways led to significantly poorer an established list of eight positive adjectives e.

If infant age moderates these pathways, then the con- eight negative adjectives e. Description of baby strained model will show poorer fit. George these pathways, then there should not be a difference in the model Indirect Effects fit because the freely estimated pathways will estimate coefficients The second research question was whether the effects of mode of that are close in value.

Infer- but were required to answer each of the items on that measure ences for indirect effects were based on the Mplus estimation of before they could move on to the next page of the survey. There was no evidence of mediation for and did not complete the full survey. There was evidence of indirect effects of mode of lations among variables of interest see Table 2. Prior research delivery on maternal self-esteem that was mediated through sub- has shown parity and income to consistently contribute to the birth jective birth experience, indirect effects estimate: While a com- thus relating maternal self-esteem, albeit indirectly.

There were no significant demographic differences between mothers who de- To address the third research question of whether infant age mod- livered vaginally and those who had either planned or unplanned erated the relations of mode of delivery and subjective birth expe- cesarean deliveries. Infant Direct Effects age was grouped in three ways: First, how- 9 to 12 months; c two age groups: Age was grouped in these three ways in an attempt to rience was tested using a separate OLS regression independent of detect whether there was a specific age at which the effect shifted.

The results showed that examined as a continuous variable. As seen in Figure 2, vaginal delivery was related were freely estimated across groups. Second, a model was run that to a more positive subjective birth experience than was cesarean constrained all pathways being tested to be equal across groups. Mothers who delivered vagi- significantly from each other, and whether the constrained model nally used a smaller proportion of negative adjectives to describe fits the data more poorly than does the freely estimated model, their babies than did mothers who delivered by cesarean section.

Mothers who re- Results of the moderation analyses did not show support for ported more positive birth experiences used a smaller proportion of moderation, regardless of how infant age was grouped. The con- negative adjectives to describe their babies than did mothers with strained models did not fit the data significantly more poorly than more negative birth experiences. This indicates that infant age does not mod- reported higher maternal self-esteem.

This study extended previous work by including mothers whose infants were beyond the immediate postpartum pe- riod. The majority of studies of birth motherhood Slade et al. This dominant focus fails to address the potential importance ability as mothers. It is difficult to ences being significantly associated with higher maternal self- discern, therefore, whether the mode of delivery is the source of esteem.

Mode of delivery did not have a direct effect on maternal study results. The present study sought to fill this gap by examining self-esteem, but it did have an indirect effect that was partially FIGURE 2. Results of moderated mediation path analysis. George mediated through subjective birth experience. This finding indi- ther exploration in future studies. The findings of the current study cates that the strength of the relation between mode of delivery and cannot differentiate the direction of the observed associations.

It subjective birth experience spills over into the effects of subjective might be the case that mothers who negatively describe their baby birth experience on maternal self-esteem, even though the mode also recall negative birth experiences. On the other hand, it also is of delivery is not directly predictive. These findings support the possible that these women may have more negative perceptions of possibility that the mixed findings of previous studies that have ex- a wider range of domains in their life, which includes their birth amined the early postpartum period e.

Future research using a longitudinal design et al. The present findings show that mothers pain-relief medication. Recent studies also have their babies. This suggests both as po- replication of the findings in this study is needed for confirma- tential risk factors that might increase the difficulty mothers may tion of the relations identified in our model.

In addition, it seems have in providing optimal care for their infant. In addition, this likely that the conditions under which a woman has a cesarean sec- indicates that professionals working with mothers who perceive tion affects her feelings about the procedure; thus, future studies their infant negatively should inquire about their birth expe- may want to examine differences between women whose cesarean riences and explore the degree to which that experience may deliveriess were emergency, unplanned, planned, elective, or on- be affecting their views of their baby and their feelings about demand.

The sample was relatively homogenous regarding ethnic Baby age did not moderate any model effects; that is, the effect background, level of education, and household income, limiting strength was consistent across the first year of life. However, other generalization to other populations. Future research should exam- studies have found that there are no observable differences as a ine these constructs in a more diverse sample.

In addition, data function of mode of delivery at 12 months e. Although efforts were made to reveal an important point about the ways in which differences man- recruit participants from Web sites and Internet communities that ifest depending on the measurement tools used.

Moreover, women who did not want to discuss their birth sentations, but does not similarly impact their actual behavior. This experiences possibly because their birth was difficult or traumatic study was not longitudinal, and we did not observe mother—infant did not participate, which may have skewed the data toward more dyads. Future research should investigate whether birth experience positive birth experiences. There is a actual caregiving behavior, and the degree to which each effect need for longitudinal studies that explore the transition from pre- endures.

Given the self-report na- delivery and a negative subjective experience may heighten the risk ture of the instruments used in the present study, these results are of developing negative perceptions of the baby. This in turn may likely subject to subjective mother data bias; future studies in this have negative implications for their developing relationship with area should include observational measures of mother—infant in- the baby.