Disrespectful Maternity Care and Postpartum Depression at 2 Months: A Population‐Based Study

Objective To assess the association between maternity care experienced as disrespectful and postpartum depression (PPD) symptoms 2 months after childbirth. Design Nationwide, population‐based, cross‐sectional study from the 2021 Enquête Nationale Périnatale (ENP) survey. Setting All maternity units in metropolitan France. Population Women who gave birth during 1 week in March 2021 and completed the 2‐month follow‐up questionnaire. Methods The experience of disrespectful maternity care was retrospectively assessed at follow‐up. The association with 2‐month PPD symptoms was estimated using Poisson regression with robust variance, adjusted for confounders and weighted to account for attrition. Main Outcome Measures Two‐month PPD symptoms, defined as an Edinburgh Postnatal Depression Scale score ≥ 13. Results Among the 7189 women analysed, 24.9% (95% confidence interval [CI], 23.8–26.0) reported experiencing disrespectful maternity care, and the prevalence of 2‐month PPD symptoms was 16.6% (95% CI, 15.7–17.6). After adjustment, women reporting disrespectful maternity care were more likely to have 2‐month PPD symptoms (adjusted relative risk [aRR] 1.37; 95% CI 1.20–1.56). Conclusions One‐quarter of women reported experiencing disrespectful maternity care. After adjustment for most of the known vulnerability factors, this experience was associated with a higher prevalence of PPD symptoms at 2 months. Improving respectful maternity care may be a modifiable factor in reducing PPD, whose incidence and consequences are concerning.