The relationship between maternal attachment, maternal self-efficacy, and postpartum depressive symptoms in mothers during the early postpartum period: a cross-sectional study.

BACKGROUND: The postpartum period involves critical adjustments where maternal mental health and mother-infant bonding are paramount. While postpartum depression is a known risk factor, the mechanisms linking it to maternal attachment, particularly through the lens of maternal self-efficacy, require further investigation. This study aims to examine the relationship between postpartum depression, perceived maternal parenting self-efficacy, and maternal attachment, and to test the mediating role of self-efficacy. METHODS: This quantitative, correlational study involved 345 mothers recruited from one family health center in Sivas, Turkey, between October 2024 and March 2025. Data were collected using a Personal Information Form, the Perceived Maternal Parenting Self-Efficacy Scale (PMPS-E), the Postpartum Depression Screening Scale (PDSS), and the Maternal Attachment Inventory (MAI). Structural equation modeling (SEM) with the WLSMV estimator was used to test the hypothesized mediation model. Participants were predominantly aged 26-30 years (37.97%), held a university degree (47.83%), were homemakers (72.17%), and reported a middle-income level (84.06%). RESULTS: A significant negative association was also found between maternal self-efficacy and maternal attachment. Given that higher scores on both the PMPS-E and MAI indicate higher levels of self-efficacy and attachment, respectively, this inverse relationship was considered unexpected and was interpreted cautiously. No significant direct relationship was found between postpartum depressive symptoms and maternal attachment. The key finding was that perceived maternal parenting self-efficacy showed a statistically significant indirect effect in the relationship between postpartum depressive symptoms and maternal attachment. CONCLUSIONS: The findings suggest that postpartum depressive symptoms may not directly impair maternal attachment but operate indirectly by undermining mothers' perceived parenting self-efficacy, underscoring the critical protective function of self-efficacy. Interventions aimed at enhancing maternal self-efficacy could be vital in mitigating the adverse effects of depressive symptoms on mother-infant bonding.