Maternal Emotional Wellbeing: The Role of Parental Self-Efficacy, Breastfeeding Self-Efficacy and Expectations

Background and Purpose: Maternal emotional wellbeing is strongly embedded in social norms and expectations, such as the expectations to be “a perfect mother” and to exclusively breastfeed. As a result, women develop expectations of how to behave and cope as mothers. When a mother feels she cannot stand up to society’s expectations or when she holds on to rigid expectations, which frequently are not compatible to reality, her perceived parental self-efficacy (i.e., belief and confidence in her ability to be a parent and successfully carry-out a parental role) and emotional wellbeing may decrease. Although emotional wellbeing can moderate the negative effects of emotional distress and contribute to overall mental health, the vast majority of studies on postpartum women focused on their emotional distress. This study examined the contribution of mothers’ expectations, perceived breastfeeding self-efficacy and perceived parental self-efficacy to maternal emotional wellbeing.

Methods: In this cross-sectional study, 203 women, aged 18 and above, who gave birth and were up to six months postpartum, filled out an online self-report questionnaire assessing their perceived emotional wellbeing, parental self-efficacy, breastfeeding self-efficacy and rigidity of expectations. A link to the questionnaire was posted on various mothers’ Facebook and WhatsApp groups. Data were analyzed using bivariate analyses, linear regression and PROCESS mediation analyses.

Results: Pearson correlations demonstrated positive associations between parental and breastfeeding self-efficacy and emotional wellbeing (r=.55, p<.01; r=.22, p<.01; respectively), and a negative association between rigidity of expectations and emotional wellbeing (r=-.39, p<.01). Yet, in the final stage of a regression analysis only rigidity of expectations and parental self-efficacy were associated with emotional wellbeing (B=-.28, p<.001; B=.41, p<.001; respectively). Furthermore, parental self-efficacy fully mediated the association between breastfeeding self-efficacy and emotional wellbeing (B=.10 [CI 95% = .05-.15]) and partially mediated the association between rigidity of expectations and emotional wellbeing (B=-.39 [CI 95% = -.16-.05]).

Conclusions and Implications: Parental self-efficacy seems to play an important role in maternal emotional wellbeing, and breastfeeding self-efficacy seems to be part of parental self-efficacy. Hence, if a woman feels confident and capable with breastfeeding her baby then her parental self-efficacy may increase. However, if she does not feel efficacious in breastfeeding then feeling efficacious in other areas of parenting (such as the ability to sooth the baby) may help buffer the negative effects low breastfeeding self-efficacy may have on maternal emotional wellbeing. Furthermore, holding on to rigid expectations may decrease maternal emotional wellbeing, directly or through decreasing parental self-efficacy. Social workers working with expectant and new mothers should discuss mothers’ expectations of the postpartum period, potential gaps between expectations and reality and ways in which expectations can become more flexible. Also discussing breastfeeding and its personal pros and cons is of importance as well as helping mothers raise their perceived parental self-efficacy. Moreover, social workers should take an active role in advancing social justice for mothers by helping challenge and change potential offensive societal norms and expectations of mothers.