Psychological Burden in the Immediate Postpartum Period: Fear of Childbirth, Depressive Symptoms, Fatigue and Sleep Quality

Background

The immediate postpartum period is associated with substantial psychological and physical challenges, including Fear of Childbirth (FoC), depressive symptoms, fatigue, and poor sleep quality. However, the coexistence and interrelationships of these conditions during the earliest postpartum phase remain inadequately characterized. This study assessed the prevalence of FoC, depressive symptoms, fatigue, and sleep disturbance and examined their interrelationships among postpartum women.

Materials and Methods

A prospective analytical study was conducted among 81 women in the immediate postpartum period at a tertiary care teaching hospital in Bengaluru, India. Participants were assessed using the Wijma Delivery Expectancy/Experience Questionnaire Version B (W-DEQ-B), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Assessment of Fatigue (MAF), and Pittsburgh Sleep Quality Index (PSQI). Associations with sociodemographic and obstetric characteristics were evaluated using appropriate statistical tests, and Spearman correlation analysis was performed to examine relationships among the four psychological domains.

Results

Severe FoC was observed in 77 women (95.1%). Mild depressive symptoms were present in 44 participants (54.3%), moderate fatigue in 45 (55.6%), and moderate sleep difficulty in 41 (50.6%). Employment status showed a significant association with severe FoC (p=0.03), whereas age, educational status, socioeconomic status, parity, mode of delivery, and pre-existing health conditions were not significantly associated. The mean W-DEQ-B score was 104.2±17.2, the mean EPDS score was 12.3±4.8, the mean MAF score was 25.4±8.9, and the mean PSQI score was 7.9±3.3. Fatigue demonstrated a significant positive correlation with depressive symptoms (r=0.312, p=0.005), while no significant correlations were observed between FoC and depressive symptoms, fatigue, or sleep quality.

Conclusion

Women in the immediate postpartum period exhibited an exceptionally high prevalence of severe fear of childbirth together with substantial fatigue, sleep disturbance, and depressive symptoms. The significant association between fatigue and depressive symptoms and the relative independence of FoC from other psychological domains highlight the need for multidimensional postpartum screening and early psychological support.