From Delivery to Depression: Exploring the Role of Perceived Partner Support in the Link Between Obstetric Violence and Postpartum Depression

Abstract

Obstetric violence is linked to postpartum depression, yet the mechanisms underlying this relationship remain underexplored. This study examined perceived partner support as a mediating mechanism among 535 women who had given birth within the past 18 months. Results indicated that obstetric violence was associated with higher postpartum depression and lower perceived partner support. Perceived partner support was negatively related to depression. Mediation analyses showed that perceived partner support partially mediated the association between obstetric abuse and violence and postpartum depression and fully mediated the link between perceived obstetric violence and postpartum depression. These findings suggest that obstetric violence may contribute to depressive symptoms partly by undermining women's perceptions of partner support.

Keywords

obstetric violence obstetric abuse postpartum depression perceived partner support labor

Get full access to this article

View all access options for this article.

References

Allport

G. W.

(1954). The nature of prejudice. Addison-Wesley.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Batson

C. D.

Batson

J. G.

Slingsby

J. K.

Harrell

K. L.

Peekna

H. M.

Todd

R. M.

(1991). Empathic joy and the empathy-altruism hypothesis. Journal of Personality and Social Psychology, 61(3), 413–426. https://doi.org/10.1037/0022-3514.61.3.413

Beck

A. T.

(1976). Cognitive therapy and the emotional disorders. International Universities Press.

Birinci

Ş.

Parpucu

Ü. M.

(2023). When a caesarean section is necessary: Analysis of cesarean sections performed in the Republic of Turkey in 2022 in accordance with the World Health Organization Multi-Country Research Guidelines. Turkish Journal of Obstetrics and Gynecology, 20(3), 184–190. https://doi.org/10.4274/tjod.galenos.2023.35919

Bogdan

P. C.

(2025). One decade into the replication crisis, how have psychological results changed? Advances in Methods and Practices in Psychological Science, 8(2), 25152459251323480. https://doi.org/10.1177/25152459251323480

Bohren

M. A.

Vogel

J. P.

Hunter

E. C.

Lutsiv

Makh

S. K.

Souza

J. P.

Aguiar

Saraiva Coneglian

Diniz

A. L.

Tunçalp

Javadi

Oladapo

O. T.

Khosla

Hindin

M. J.

Gülmezoglu

A. M.

(2015). The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLoS Medicine, 12(6), e1001847. https://doi.org/10.1371/journal.pmed.1001847

Brazelton

T. B.

Greenspan

S. I.

(2000). The irreducible needs of children: What every child must have to grow, learn, and flourish. Perseus Publishing.

Carlander

Hultstrand

J. N.

Reuterwall

Jonsson

Tydén

Kullinger

(2023). Unplanned pregnancy and the association with maternal health and pregnancy outcomes: A Swedish cohort study. PLoS ONE, 18(5), e0286052. https://doi.org/10.1371/journal.pone.0286052

10.

Castro

Frias

S. M.

(2020). Obstetric violence in Mexico: Results from a 2016 national household survey. Violence Against Women, 26(6-7), 555–572. https://doi.org/10.1177/1077801219836732

11.

Cetin

S. A.

Ergün

Işık

(2023). Obstetric violence in southwestern Turkey: Risk factors and its relationship to postpartum depression. Health Care for Women International, 45(2), 217–235. https://doi.org/10.1080/07399332.2023.2172411

12.

Cho

Lee

Choi

Cho

H. N.

Park

Suh

Rhee

Choi

K. S.

(2022). Author correction: Association between social support and postpartum depression. Scientific Reports, 12(1), 3128. https://doi.org/10.1038/s41598-022-08119-x

13.

Chrisler

J. C.

Barney

Palatino

(2016). Ageism can be hazardous to women's health: Ageism, sexism, and stereotypes of older women in the healthcare system. Journal of Social Issues, 72(1), 86–104. https://doi.org/10.1111/josi.12157

14.

Cohen

Wills

T. A.

(1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310

15.

Cox

J. L.

Holden

J. M.

Sagovsky

(1987). Detection of postnatal depression. British Journal of Psychiatry, 150(6), 782–786. https://doi.org/10.1192/bjp.150.6.782

16.

Damsarsan

Ören

(2024). The effect of spousal support on postpartum depression and quality of life. Clinical and Experimental Health Sciences, 14(1), 176–182. https://doi.org/10.33808/clinexphealthsci.1259700

17.

Dasgupta

Rayment-Jones

Horgan

Begum

Peter

Silverio

S. A.

Magee

L. A.

(2025). Understanding care-seeking of pregnant women from underserved groups: A systematic review and meta-ethnography. Frontiers in Public Health, 13, 1683740. https://doi.org/10.3389/fpubh.2025.1683740

18.

D’Gregorio

R. P.

(2010). Obstetric violence: A new legal term introduced in Venezuela. International Journal of Gynecology & Obstetrics, 111(3), 201–202. https://doi.org/10.1016/j.ijgo.2010.09.002

19.

Durukan

İlhan

M. N.

Bumin

M. A.

Aycan

(2011). 2 Hafta-18 aylık bebeği olan annelerde postpartum depresyon sıklığı ve yaşam kalitesi. Balkan Medical Journal, 2011(4), 385–393. https://doi.org/10.5174/tutfd.2010.04117.3

20.

Engindeniz

A. N.

Küey

Kültür

(1996). Edinburgh Postnatal Depression Scale—Turkish version (EPDS) [Database record]. APA PsycTests. https://doi.org/10.1037/t66697-000

21.

Erdfelder

Faul

Buchner

(1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments & Computers, 28(1), 1–11. https://doi.org/10.3758/BF03203630

22.

Ferrão

A. C.

Sim-Sim

Almeida

V. S.

Zangão

M. O.

(2022). Analysis of the concept of obstetric violence: Scoping review protocol. Journal of Personalized Medicine, 12(7), 1090. https://doi.org/10.3390/jpm12071090

23.

Fraser

L. K.

Cano-Ibáñez

Amezcua-Prieto

Khan

K. S.

Lamont

R. F.

Jørgensen

J. S.

(2025). Prevalence of obstetric violence in high-income countries: A systematic review of mixed studies and meta-analysis of quantitative studies. Acta Obstetricia et Gynecologica Scandinavica, 104(1), 13–28. https://doi.org/10.1111/aogs.14962

24.

Gökçe İsbir

İnci

Kömürcü Akik

Abreu

Thomson

(2023). Birth-related PTSD symptoms and related factors following preterm childbirth in Turkey. Current Psychology, 42(31), 27656–27667. https://doi.org/10.1007/s12144-022-03805-5

25.

Goodman

J. H.

(2004). Postpartum depression beyond the early postpartum period. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(4), 410–420. https://doi.org/10.1177/0884217504266915.091401

26.

Gotlib

I. H.

Krasnoperova

Yue

D. N.

Joormann

(2004). Attentional biases for negative interpersonal stimuli in clinical depression. Journal of Abnormal Psychology, 113(1), 127–135. https://doi.org/10.1037/0021-843X.113.1.121

27.

Götz

F. M.

Gosling

S. D.

Rentfrow

P. J.

(2022). Small effects: The indispensable foundation for a cumulative psychological science. Perspectives on Psychological Science, 17(1), 205–215. https://doi.org/10.1177/1745691620984483

28.

Gremigni

Mariani

Marracino

Tranquilli

A. L.

Turi

(2011). Partner support and postpartum depressive symptoms. Journal of Psychosomatic Obstetrics & Gynecology, 32(3), 135–140. https://doi.org/10.3109/0167482X.2011.589017

29.

Hakimi

Allahqoli

Alizadeh

Ozdemir

Soori

Turfan

E. C.

Sogukpinar

Alkatout

(2025). Global prevalence and risk factors of obstetric violence: A systematic review and meta-analysis. International Journal of Gynecology & Obstetrics, 169(3), 1012–1024. https://doi.org/10.1002/ijgo.16145

30.

Henshaw

(2003). Mood disturbance in the early puerperium: A review. Archives of Women's Mental Health, 6(0), s33–s42. https://doi.org/10.1007/s00737-003-0004-x

31.

Horowitz

J. A.

Goodman

(2004). A longitudinal study of maternal postpartum depression symptoms. Research and Theory for Nursing Practice, 18(2/3), 149. https://doi.org/10.1891/rtnp.18.2.149.61285

32.

Hotun-Şahin

N. H.

Dişsiz

Dinç

ve Soypak

(2014). Erken lohusalık sürecinde kadınların algıladıkları eş desteği: Ölçek geliştirme çalışması. Journal of Anatolia Nursing and Health Sciences, 17(2), 73–79.

33.

Kızılırmak

Calpbinici

Tabakan

Kartal

(2021). Correlation between postpartum depression and spousal support and factors affecting postpartum depression. Health Care for Women International, 42(12), 1325–1339. https://doi.org/10.1080/07399332.2020.1764562

34.

Kohan

Mena-Tudela

Youseflu

(2025). The impact of obstetric violence on postpartum quality of life through psychological pathways. Scientific Reports, 15(1), 4799. https://doi.org/10.1038/s41598-025-88708-8

35.

Kömürcü Akik

(2023). Obstetric violence questionnaire: Adaptation of a Turkish self-report tool. Violence Against Women, 29(15–16), 3288–3301. https://doi.org/10.1177/10778012231181050

36.

Lakey

Cassady

P. B.

(1990). Cognitive processes in perceived social support. Journal of Personality and Social Psychology, 59(2), 337–343. https://doi.org/10.1037//0022-3514.59.2.337

37.

Lakey

Orehek

(2011). Relational regulation theory: A new approach to explain the link between perceived social support and mental health. Psychological Review, 118(3), 482–495. https://doi.org/10.1037/a0023477

38.

Lovakov

Agadullina

E. R.

(2021). Empirically derived guidelines for effect size interpretation in social psychology. European Journal of Social Psychology, 51(3), 485–504. https://doi.org/10.1002/ejsp.2752

39.

Lumley

(2005). Attempts to prevent postnatal depression. BMJ, 331(7507), 5–6. https://doi.org/10.1136/bmj.331.7507.5

40.

Malich

Munafò

M. R.

(2022). Introduction: Replication of crises—Interdisciplinary reflections on the phenomenon of the replication crisis in psychology. Review of General Psychology, 26(2), 127–130. https://doi.org/10.1177/10892680221077997

41.

Martinez-Vázquez

Rodríguez-Almagro

Hernández-Martínez

Martínez-Galiano

J. M.

(2021). Factors associated with postpartum post-traumatic stress disorder (PTSD) following obstetric violence: A cross-sectional study. Journal of Personalized Medicine, 11(5), 338. https://doi.org/10.3390/jpm11050338

42.

Miller

L. J.

(2002). Postpartum depression. JAMA: Journal of the American Medical Association, 287(6), 762–765. https://doi.org/10.1001/jama.287.6.762

43.

Misri

Kostaras

Fox

Kostaras

(2000). The impact of partner support in the treatment of postpartum depression. The Canadian Journal of Psychiatry, 45(6), 554–558. https://doi.org/10.1177/070674370004500607

44.

Monti

Agostini

Marano

, et al. (2008). The course of maternal depressive symptomatology during the first 18 months postpartum in an Italian sample. Archives of Womens Mental Health, 11(3), 231–238. https://doi.org/10.1007/s00737-008-0017-6

45.

Nugrahaeni

M. T.

Untari

N. Y.

Veibiani

N. A.

(2022). Meta analysis: The effect of social support in preventing postpartum depression in postpartum mothers. Journal of Epidemiology and Public Health, 7(1), 80–91. https://doi.org/10.26911/jepublichealth.2022.07.01.07

46.

O'Hara

M. W.

McCabe

J. E.

(2013). Postpartum depression: Current status and future directions. Annual review of clinical psychology, 9(1), 379–407. https://doi.org/10.1146/annurev-clinpsy-050212-185612

47.

O'Hara

Wisner

K. L.

(2014). Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3–12. https://doi.org/10.1016/j.bpobgyn.2013.09.002

48.

O'Neill

(2023). Obstetric violence and postpartum adjustment: Exploration of risk and resilience factors [Master's thesis]. East Tennessee State University.

49.

Pearlstein

Howard

Salisbury

Zlotnick

(2009). Postpartum depression. American Journal of Obstetrics and Gynecology, 200(4), 357–364. https://doi.org/10.1016/j.ajog.2008.11.033

50.

Pitt

(1973). Maternity blues. British Journal of Psychiatry, 122(569), 431–433. https://doi.org/10.1192/bjp.122.4.431

51.

Preziosi

Portaleone

Colagiovanni

Tedesco

Rizzi

Rega

M. L.

Danza

Lanzone

Anderson

(2025). Predictors of cultural competence among healthcare professional in maternity department: A systematic review. Midwifery, 142(1), 104285. https://doi.org/10.1016/j.midw.2025.104285

52.

Ravaldi

Skoko

Battisti

Cericco

Vannacci

(2018). Abuse and disrespect in childbirth assistance in Italy: A community-based survey. European Journal of Obstetrics and Gynecology and Reproductive Biology, 224, 208–209. https://doi.org/10.1016/j.ejogrb.2018.03.055

53.

Richard

F. D.

Bond

C. F.

Jr. Stokes-Zoota

J. J.

(2003). One hundred years of social psychology quantitatively described. Review of General Psychology, 7(4), 331–363. https://doi.org/10.1037/1089-2680.7.4.331

54.

Sah

L. K.

Hatzidimitriadou

Sah

R. K.

(2026). Pregnancy under pressure: A socioecological understanding of pregnancy and mental well-being in Nepal. Women's Reproductive Health, 1–16. https://doi.org/10.1080/23293691.2026.2623522

55.

Sando

Abuya

Asefa

Banks

K. P.

Freedman

L. P.

Kujawski

Jolivet

R. R.

(2017). Methods used in prevalence studies of disrespect and abuse during facility based childbirth: Lessons learned. Reproductive Health, 14(1), 1–18. https://doi.org/10.1186/s12978-017-0389-z

56.

Seefeld

Handelzalts

J. E.

Horesh

Horsch

Ayers

Dikmen-Yildiz

Kömürcü Akik

Garthus-Niegel

(2024). Going through it together: Dyadic associations between parents’ birth experience, relationship satisfaction, and mental health. Journal of Affective Disorders, 348(1), 378–388. https://doi.org/10.1016/j.jad.2023.12.044

57.

Silva-Fernandez

C. S.

de la Calle

Arribas

S. M.

Garrosa

Ramiro-Cortijo

(2023). Factors associated with obstetric violence implicated in the development of postpartum depression and post-traumatic stress disorder: A systematic review. Nursing Reports, 13(4), 1553–1576. https://doi.org/10.3390/nursrep13040130

58.

Silva-Fernández

C. S.

Garrosa

Ramiro-Cortijo

(2025). Qualitative study of maternity healthcare vulnerability based on women’s experiences in different sociocultural context. Nursing Reports, 15(3), 105. https://doi.org/10.3390/nursrep15030105

59.

Szkody

Stearns

Stanhope

McKinney

(2020). Stress-buffering role of social support during COVID-19. Family Process, 60(3), 1002–1015. https://doi.org/10.1111/famp.12618

60.

Tach

C. L.

Toebes

Feriato

J. M.

(2020). Obstetric violence: A women’s human and personality rights violation. Revista Juridica, 1(58), 187. https://doi.org/10.21902/revistajur.2316-753x.v1i58.3841

61.

Uchino

B. N.

(2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science, 4(3), 236–255. https://doi.org/10.1111/j.1745-6924.2009.01122.x

62.

Ulgu

M. M.

Birinci

Altun Ensari

Gözükara

M. G.

(2023). Cesarean section rates in Turkey 2018–2023: Overview of national data by using Robson ten group classification system. Turkish Journal of Obstetrics and Gynecology, 20(3), 191–198. https://doi.org/10.4274/tjod.galenos.2023.68235

63.

Vega-Sanz

Halty

Goñi-Dengra

Pitillas

Berástegui

(2025). Exploring traumatic childbirth: Associations between obstetric violence indicators and perinatal posttraumatic stress. PLoS ONE, 20(6), e0324461. https://doi.org/10.1371/journal.pone.0324461

64.

World Health Organization. (2014). The prevention and elimination of disrespect and abuse during facility-based childbirth: WHO statement. World Health Organization. https://iris.who.int/handle/10665/134588

65.

Xie

R. H.

Koszycki

Walker

Wen

S. W.

(2009). Prenatal social support, postnatal social support, and postpartum depression. Annals of Epidemiology, 19(9), 637–643. https://doi.org/10.1016/j.annepidem.2009.03.008

66.

Yalley

A. A.

Jarašiūnaitė-Fedosejeva

Kömürcü-Akik

De Abreu

(2024). Addressing obstetric violence: A scoping review of interventions in healthcare and their impact on maternal care quality. Frontiers in Public Health, 12, 1388858. https://doi.org/10.3389/fpubh.2024.1388858

67.

Yavuz

M. Y.

Bilge

(2022). Annelik hüznünden postpartum depresyon ve psikoza. Haliç Üniversitesi Sağlık Bilimleri Dergisi, 5(1), 1–10. https://doi.org/10.48124/husagbilder.845299

68.

Zajonc

R. B.

(1968). Attitudinal effects of mere exposure. Journal of Personality and Social Psychology, 9(2, Pt.2), 1–27. https://doi.org/10.1037/h0025848

69.

Zanardo

Volpe

de Luca

Giliberti

Giustardi

Parotto

, …, Soldera

(2020). Maternity blues: A risk factor for anhedonia, anxiety, and depression components of Edinburgh Postnatal Depression Scale. The Journal of Maternal-Fetal & Neonatal Medicine, 33(23), 3962–3968. https://doi.org/10.1080/14767058.2019.1593363

70.

Zimbardo

P. G.

(1969). The human choice: Individuation, reason, and order versus deindividuation, impulse, and chaos. Nebraska Symposium on Motivation.