Archives of Women's Mental Health

, Volume 19, Issue 2, pp 219–227 | Cite as

Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study

  • A. F. Bell
  • C. S. Carter
  • J. M. Davis
  • J. Golding
  • O. Adejumo
  • M. Pyra
  • J. J. Connelly
  • L. H. Rubin
Original Article


We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N = 4657–4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score ≥ 13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score ≥ 9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25–1.85] and 8 months (OR 1.30, 95 % CI 1.06–1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women’s childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression.


Postpartum Depression Anxiety Birth ALSPAC 



We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses (with special thanks to Karen Birmingham and Maxine McRae).

Conflict of interest

The authors declare that they have no competing interests.

Contribution to authorship

AFB, JMD, JG, JJC, and CSC contributed to study conception and design. AFB supervised the project. AFB, LHR, and OA drafted the manuscript. LHR, OA, and MP managed the dataset and performed statistical analyses. All the authors contributed to interpretation of results and manuscript editing.

Details of ethics approval

The ALSPAC Law and Ethics Committee and local research ethics committees granted ethical approval for the study. All women gave their consent prior to inclusion in the ALSPAC study.


The project described was supported by The Fetzer Institute, through Grant #3091.00, and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) through Grant #KL2TR000048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The UK Medical Research Council and the Wellcome Trust (Grant ref: 092731) and the University of Bristol provide core support for ALSPAC.


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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  1. 1.Department of Women Children and Family Health ScienceUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Kinsey Institute and Department of Biology, Morrison Hall 13Indiana UniversityBloomingtonUSA
  3. 3.Department of PsychiatryUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Centre for Child and Adolescent Health, School of Social & Community MedicineUniversity of BristolBristolUK
  5. 5.Department of PsychiatryUniversity of Illinois at ChicagoChicagoUSA
  6. 6.Department of PsychologyUniversity of VirginiaCharlottesvilleUSA

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