Fathers’ subjective birth experiences, religious and spiritual struggles, and postpartum depressive symptoms: a cross-sectional study

Distressing childbirth experiences have been associated with depressive symptoms among fathers, but little is known about their religious and spiritual correlates. This study examined associations among subjective and objective childbirth experiences, religious and spiritual struggles (RSS), and general and male-specific depressive symptoms among recent fathers. A cross-sectional online survey was completed by 288 Israeli Jewish fathers within six months of childbirth. Participants reported their childbirth experiences, obstetric events, RSS, and depressive symptoms. Structural equation modeling examined direct and indirect associations between subjective childbirth experiences and depressive symptoms through RSS, adjusting for education and religious/spiritual self-identification. More distressing subjective childbirth experiences were positively associated with general (β = 0.32, p < .001) and male-specific depressive symptoms (β = 0.22, p < .001). Statistically significant indirect associations through RSS were also observed for general (β = 0.08, 95% CI [0.02, 0.14]) and male-specific depressive symptoms (β = 0.11, 95% CI [0.04, 0.14]). Objective obstetric events showed small positive bivariate associations with general depressive symptoms and RSS, but not with male-specific depressive symptoms. Religious and spiritual struggles emerged as a relevant correlate of fathers’ childbirth experiences and depressive symptoms. The findings extend research on paternal postpartum adjustment by identifying a religious and spiritual dimension of distress alongside subjective childbirth appraisals. Given the cross-sectional design, the indirect associations do not establish temporal ordering or causal mediation. Longitudinal research is needed to clarify these relationships and their potential clinical relevance.