Childbirth as a Salutogenic Experience
Downe, Calleja Agius, Balaam and Frith (2020) describe birth not merely as a medical event but as a complex salutogenic phenomenon that can promote health when the surrounding environment supports the mother’s resources and sense of meaning [1]. This perspective shifts focus from risk‑management to strengthening the mother’s sense of competence, social connections, and personal agency.
Maternal Sense of Competence & Self‑Efficacy
Omidvar & Liraviani (2019) identified parental self‑efficacy and cognitive emotion‑regulation strategies as key predictors of a mother’s perceived competence [2]. In a Chinese longitudinal cohort, Zhu et al. (2022) confirmed that higher parenting sense of competence predicts more positive infant development outcomes [1].
Bandura’s classic theory (1977) underpins these findings, emphasizing that belief in one’s ability to manage parenting tasks drives actual performance [2].
Practical Levers
- Targeted education based on self‑efficacy theory reduces anxiety and improves birth outcomes (Gandomi et al., 2022) [77].
- Home‑based counseling after cesarean section boosts maternal functioning and self‑efficacy (Farasati et al., 2024) [67].
- Digital tools such as LINE‑based breastfeeding self‑efficacy programs show measurable improvements for cesarean mothers (Chuektong et al., 2023) [11].
Post‑partum Anxiety, Depression, & PTSD
Post‑partum anxiety affects up to 10‑15 % of new mothers (Dennis et al., 2013) [4]. Field (2017) reviews predictors such as previous anxiety, low social support, and traumatic birth experiences [5].
Cesarean delivery is repeatedly linked to higher mental‑health risk. Dekel et al. (2019) found that delivery mode predicts maternal anxiety and depression [8]. Post‑traumatic stress disorder (PTSD) after cesarean sections reaches notable levels (Chen et al., 2020) [9]. Emergency cesarean sections further increase PTSD risk (Orovou et al., 2025) [10].
Screening tools such as the State‑Trait Anxiety Inventory (STAI) can identify at‑risk mothers within hours of delivery (Dennis et al., 2013) [4], enabling early psychosocial interventions.
Sense of Coherence (SOC) – The Resilience Backbone
Antonovsky’s (1979) SOC model links comprehensibility, manageability, and meaningfulness to better stress coping [32]. Validation studies confirm its reliability across cultures, including a 13‑item Iranian version (Mahammadzadeh et al., 2010) [56].
Research links higher SOC to smoother deliveries (Oz et al., 2009) [29] and to lower anxiety during pregnancy (Mato & Tsukasaki, 2019) [40]. In first‑time mothers, SOC correlates with breastfeeding enjoyment and longer duration (Granberg et al., 2020) [60].
Boosting SOC in Perinatal Care
- Empowerment‑focused education (e.g., self‑management models) raises SOC scores in chronic‑illness populations and is being adapted for pregnant women (Hourzad et al., 2018) [45].
- Group accompaniment during elective cesarean delivery reduces maternal anxiety (Gutiérrez et al., 2023) [14].
- Auriculotherapy shows short‑term anxiety reduction after cesarean section (Sharifi et al., 2024) [15].
Empowerment, Social Support, & Parenting Outcomes
Social support consistently predicts better mental health and parenting competence (Maryami et al., 2020) [3]. Male involvement in pregnancy and childbirth, studied in Tanzania, improves maternal confidence and reduces anxiety (Maluka & Peneza, 2018) [16].
Breastfeeding self‑efficacy programs delivered via messaging apps (LINE) increase exclusive breastfeeding rates after cesarean section (Chuektong et al., 2023) [11]. Similarly, prenatal education videos raise initiation and exclusivity of breastfeeding in low‑income populations (Kellams et al., 2016) [73].
Pro Tip
Integrate brief self‑efficacy check‑ins into routine postpartum visits: ask mothers to rate confidence in feeding, soothing, and self‑care on a 0‑10 scale. Scores below 5 flag the demand for targeted counseling.
Technology‑Enhanced & Integrated Interventions
Mobile health (mHealth) platforms are expanding. The LINE‑based program (Chuektong et al., 2023) and early oral feeding protocols after cesarean (Chen et al., 2024) illustrate how digital tools can streamline evidence‑based practices [59]. Integrated childbirth education programs that combine mindfulness, anxiety reduction, and self‑efficacy training have demonstrated lower fear of childbirth and depressive symptoms (Kuo et al., 2022) [79].
Future Trends to Watch
- Holistic Salutogenic Models – Expect more research integrating SOC, self‑efficacy, and empowerment into standard prenatal curricula.
- Personalized Digital Coaching – AI‑driven chatbots will tailor self‑efficacy exercises based on real‑time mood tracking.
- Family‑Centered SOC Interventions – Qualitative work (Ngai & Chan, 2021) suggests that strengthening the family’s sense of coherence during the parental transition improves maternal outcomes [63].
- Integrated Mental‑Health Screening – Combining STAI, PSOC, and SOC scales in electronic health records will enable early detection of anxiety, depression, and PTSD.
- Community‑Based Empowerment Programs – Group sessions that blend health literacy, coping‑strategy training, and peer support are likely to become standard in low‑resource settings (Koelen & Lindström, 2005) [43].
Frequently Asked Questions
- What is the Parenting Sense of Competence (PSOC) scale?
- The PSOC, developed by Gibaud‑Wallston & Wandersmann (1978), measures mothers’ self‑perceived competence and satisfaction in parenting [3].
- How does sense of coherence differ from self‑efficacy?
- SOC reflects a global orientation toward life’s stressors (comprehensibility, manageability, meaningfulness), while self‑efficacy is task‑specific confidence (e.g., breastfeeding self‑efficacy) [32, 53].
- Can digital apps really improve breastfeeding rates?
- Yes. A quasi‑experimental study using the LINE app showed increased breastfeeding self‑efficacy and higher exclusive‑breastfeeding rates after cesarean delivery [11].
- What simple screening can identify postpartum anxiety?
- The State‑Trait Anxiety Inventory (STAI) administered within 24 hours postpartum can flag mothers at risk for anxiety disorders [4].
- Is male involvement important for maternal mental health?
- Qualitative evidence from Tanzania demonstrates that fathers’ active participation improves maternal confidence and reduces anxiety [16].
Join the Conversation
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