The role of sense of coherence, self-efficacy, social support and perceived stress on postpartum depression during the transition to motherhood : a path analysis

Abstract

Background: The transition to motherhood is a women's life event that, while often joyful, can present challenges leading to postpartum depression. Understanding the roles of sense of coherence, self-efficacy, and social support in mitigating postpartum depression is crucial, particularly among Ethiopian mothers, where cultural practices may influence these dynamics. Objectives: The objective of this study to evaluate the effect of sense of coherence, self-efficacy, social support, and stress on postpartum depression during the transition to motherhood. Methods: This cross-sectional study involved 200 mothers recruited from Woldia Comprehensive Specialized Hospital, Ethiopia. The data collection conducted by two BSc midwives from 10 to 30 November 2024. Path analysis using Maximum Likelihood Estimation was performed to evaluate the effects of sense of coherence, self-efficacy, social support, and perceived stress on postpartum depression. Model fit evaluated using indices such as the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root-Mean-Square Error of Approximation (RMSEA). Results: The modified path model demonstrated a good fit with the data, indicated by χ2 = 1.64 (p > 0.44), CFI = 1.00, TLI = 1.02, RMSEA <0.001, and SRMR = 0.02. The model explained 29.8 % of the variance in postpartum depression. A higher sense of coherence significantly predicted lower levels of postpartum depression, with a path coefficient of β = −0.15 (p = 0.02). Similarly, sense of coherence was associated with lower perceived stress (β = −0.21, p = 0.02), while perceived stress was a significant positive predictor of postpartum depression (β = 0.49, p < 0.001). The model also demonstrated that both social support and self-efficacy were inversely related to postpartum depression. Conclusions: Sense of coherence plays a direct role in preventing postpartum depression, while the effects of social support and self-efficacy on depressive symptoms are mediated through sense of coherence and perceived stress levels.