Traumatic Birth Perception and Postpartum Depression Among Postpartum Women in Türkiye: The Indirect Association of Perceived Social Support

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Abstract
Background/Objectives: Traumatic birth perception has been associated with adverse psychological outcomes during the postpartum period, including postpartum depressive symptoms. Perceived social support may be related to both traumatic birth perception and maternal mental health. However, the associations among these variables remain insufficiently understood. This study aimed to examine the relationships among traumatic birth perception, perceived social support, and postpartum depression in postpartum women in Türkiye and to explore the indirect association of perceived social support in this relationship. Methods: This cross-sectional study was conducted with 297 postpartum women in Türkiye using an online survey. Data were collected using a Personal Information Form, the Traumatic Birth Perception Scale, the Perceived Social Support Scale (F-SozU K-3), and the Edinburgh Postnatal Depression Scale. Data were analyzed using descriptive statistics, Pearson correlation analysis, and regression-based indirect association analysis using Hayes’ PROCESS macro. Results: Traumatic birth perception was positively associated with postpartum depression (p < 0.001), whereas perceived social support was negatively associated with postpartum depression (p < 0.001). Traumatic birth perception was also negatively associated with perceived social support (p < 0.001). The indirect association analysis indicated that perceived social support was significantly associated with the relationship between traumatic birth perception and postpartum depression. Women reporting higher traumatic birth perception tended to report lower perceived social support and higher postpartum depressive symptoms. Conclusions: The findings suggest that traumatic birth perception, perceived social support, and postpartum depression are significantly interrelated among postpartum women. Higher levels of perceived social support were associated with lower levels of postpartum depressive symptoms. Given the cross-sectional nature of the study, causal inferences cannot be made. Longitudinal studies are needed to clarify the temporal relationships among these variables.

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