Maternal performance after childbirth and its predictors: a cross sectional study.

BACKGROUND AND OBJECTIVES: Birthing parents need to use specialized skills as the first caregiver of the newborn. Several factors may affect performance. Yet there is a paucity of research in this area, and evidence remains inconsistent. Consequently, this study aimed to determine maternal performance after childbirth and its predictors. METHODS: This cross-sectional study was conducted with those (n = 450) who had given birth (< two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the childbirth experience 2 (CEQ2), Barkin maternal performance and maternal self-efficacy scales. Multiple linear regression was used to investigate the predictive effect of the independent variables of childbirth experience, maternal self-efficacy, demographic and obstetric variables on the dependent variable of maternal performance. RESULTS: The mean age of the participants was 26.78 and the mean total score of maternal performance was 91.04 (0-120). The highest and lowest scores related to the 'maternal competence' and the 'maternal needs' domains, with mean score calculated at 77.51 and 72.81 respectively. 'Childbirth experience' and 'maternal self-efficacy' domains had a statistically significant relationship with maternal performance (P < 0.05). Among the predictive factors of maternal performance, the results of our linear regression demonstrated the variables of birth experience (B = 0.63), maternal self-efficacy (B = 1.53), spouse's employment status (B = 5.78 for worker level, B = 3.99 for employee level), the number of previous childbirth experiences (B = -8.46), frequency of receiving antenatal care (B = -6.68), length of stay in the birth suite (B = -2.22) and length of stay in the hospital (B = 2.84) remained in the model. 53.2% of changes in maternal performance can be explained by these independent variables. CONCLUSION: The promotion of evidence-based, person-centered, and respectful perinatal care during pregnancy and childbirth are of paramount importance. Strategies to improve the experience of childbirth and self-efficacy are especially required to improve maternal performance in the postpartum period. Prenatal care aimed at improving maternal function after childbirth will be important in achieving this overall.

From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months.

This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.

Este estudio examina el papel de las estrategias calmantes maternas para explicar la asociación entre auto efectividad materna y la regulación del infante (comportamiento de llanto y de dormir). Información de cuestionario de N = 150 madres de trasfondos étnicos y educativos mixtos se recogió cuando los infantes tenían tres y siete meses de nacidos. Dos tipos de estrategias calmantes maternas se identificaron: estrategia calmante cercana, la cual trata del contacto físico y emocional cercano, y estrategia calmante distante, la cual trata del distanciamiento físico y emocional con el infante. Un estudio de Modelo de Ecuación Estructural (SEM) transversal a los tres meses indicó que la auto efectividad materna se asocia con la reportada regulación del infante a través de estrategias calmantes distantes. La baja auto efectividad materna se asoció con el frecuente uso materno de estrategias calmantes distantes, lo cual a su vez se relacionó con los reportados problemas de regulación del infante, tales como el no calmarse y la mayor frecuencia del llanto. El uso frecuente de estrategias calmante cercanas se asoció con el reportado comportamiento de dormir del infante, tal como el frecuente despertar nocturno. Un estudio de tipo SEM longitudinal indicó más allá que los efectos de las estrategias calmantes cercanas persistían por lo menos hasta que los infantes tenían siete meses de edad. El estudio mostró cómo la baja auto efectividad materna, el uso incrementado de estrategias calmantes distantes, así como los reportados tempranos problemas de regulación del infante están entremezclados y que, debido a su persistente efecto positivo en calmar al infante, las estrategias calmantes cercanas apoyan mejor el desarrollo del infante.

Cette étude examine le rôle des stratégies maternelles d'apaisement pour expliquer le lien de l'auto-efficacité maternelle avec la régulation du nourrisson (pleurs et comportement du sommeil). Des données d'une questionnaire de N = 150 mères issues de milieux ethniques et éducationnels différents ont été recueillies quand les nourrissons avaient trois et sept mois. Deux types de stratégies maternelles d'apaisement ont été distingués: l'apaisement proche, avec un contact physique et émotionnel proche, et l'apaisement distant, avec une distanciation physique et émotionnelle du nourrisson. Une coupe transversale SEM à trois mois a indiqué que l'auto-efficacité maternelle est liée à la régulation infantile signalée au travers de stratégies d'apaisement distantes. Une auto-efficacité maternelle faible était liée à l'utilisation maternelle fréquente de stratégies d'apaisement, qui à son tour était liée aux problèmes signalés de régulation du nourrisson, comme par exemple le fait de ne pas pouvoir être apaisé ou une fréquence de pleurs plus grande. L'utilisation fréquente de stratégies d'apaisement proche était liée au comportement de sommeil du nourrisson signalé, comme par exemple des réveils nocturnes fréquents. Un SEM longitudinal a de surcroit indiqué que les effets de stratégies d'apaisement proches persistaient au moins jusqu'à l'âge de sept mois des nourrissons. L'étude a montré comment l'auto-efficacité maternelle faible, une utilisation accrue de stratégies d'apaisement distant et les problèmes signalés de régulation précoce des nourrissons sont imbriqués et que, du fait de leur effet positif persistant sur l'apaisement du nourrisson, les stratégies d'apaisement proches soutiennent mieux le développement du nourrisson.

Promotion of self-efficacy in mothers with infants discharged from neonatal intensive care units.

INTRODUCTION: The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy. OBJECTIVE: To evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU. METHOD: Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days' post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick. RESULTS: The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6-9.5); after the intervention it showed a median of 9.6 points (RI of 10-8.7); a statistically significant p-value<0.001 was obtained before and after the intervention with the Wilcoxon rank test. CONCLUSIONS: Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.

The association between parenting styles, maternal self-efficacy, and social and emotional adjustment among Arab preschool children.

Parenting styles and parental self-efficacy are major factors that affect the overall adjustment of children. The current study examined parenting styles and maternal self-efficacy and their association with social-emotional adjustment among Arab preschool children living in Israel. Parenting Styles Questionnaire, Maternal Self-Efficacy Questionnaire, and Adjustment Questionnaire were administered to 420 Arabic-speaking mothers of 3- to 4-year-old children. After employing multiple regression analyses, the results indicated that parenting styles and the overall adjustment of children were significantly correlated. More precisely, a significant association between authoritative parenting style and higher levels of social-emotional adjustment among preschool children was found. Furthermore, maternal self-efficacy was significantly correlated to the overall adjustment of children. In this regard, higher maternal self-efficacy is associated with increased social-emotional adjustment among preschool children. The findings of our study show the applicability of these constructs found relevant across numerous cultures in a unique sample of Arab children living in Israel. Lastly, this study supports intervention programs that promote authoritative parenting style and parental self-efficacy in Arab communities.

Maternal Self-Efficacy as a Mediator in the Relationship Between Postpartum Depression and Maternal Role Competence: A Cross-Sectional Survey.

INTRODUCTION: This study aimed to (1) examine the relationships among postpartum depression, maternal self-efficacy, and maternal role competence, and to (2) test whether maternal self-efficacy mediates the relationship between postpartum depression and maternal role competence. METHODS: Using a cross-sectional design, we conveniently sampled 343 postpartum mothers from 3 primary health care facilities in Eswatini. Data were collected using the Edinburgh Postnatal Depression Scale, Maternal Self-Efficacy Questionnaire, and Perceived Competence Scale. Multiple linear regression models and structural equation modeling were performed in IBM SPSS and SPSS Amos to examine the studied associations and to test the mediation effect. RESULTS: The participants were aged 18 to 44 (mean, 26.4; SD, 5.86) years, and the majority were unemployed (67.1%), had an unintended pregnancy (61.2%), received education during antenatal classes (82.5%), and fulfilled the cultural norm of the maiden home visit (58%). Adjusting for covariates, postpartum depression was negatively associated with maternal self-efficacy (ß = -.24, P < .001) and maternal role competence (ß = -.18, P = .001), whereas maternal self-efficacy was positively associated with maternal role competence (ß = .41, P < .001). In the path analysis, postpartum depression only related to maternal role competence indirectly through maternal self-efficacy (ß = -.10, P = .003). DISCUSSION: High maternal self-efficacy was associated with high maternal role competence and fewer postpartum depression symptoms, suggesting that improving maternal self-efficacy may help reduce postpartum depression and may improve maternal role competence.

The effectiveness of an internet-based support program on maternal self-efficacy, postpartum depression and social support for primiparous women during the COVID-19 pandemic: Randomized controlled trial.

Background: Many primiparous women usually encounter various parenting and mental health issues after childbirth. The effects of intervention based on internet platform on parenting and mental health outcomes for Chinese first-time mothers remain unknown during the COVID-19 pandemic. Therefore, our research aimed to evaluate the effectiveness of an internet-based support program (ISP) on maternal self-efficacy (MSE), postpartum depression (PPD) and social support for primiparous women amid the pandemic. Methods: A multicenter randomized controlled trial (RCT) was conducted. From May 2020 to March 2021, 242 primiparous women were recruited in the maternity wards of two hospitals in Shenzhen City, China and randomly assigned to the intervention group and the control group. Women in control group (n = 118) received the routine postpartum care, and women in intervention group (n = 118) accessed to the ISP intervention (expert education and peer support) and routine postpartum care. Intervention outcomes were measured at baseline before randomization (T0), post-intervention (T1), and three-month follow up (T2) through questionnaires. The chi-square (χ2), the independent sample t-test and the repeated measures multivariate analysis of covariance were performed, and the two-tailed p-value <0.05 was regarded as statistically significant. Results: In comparison with women in the control group, women in the intervention group had a significantly higher score of MSE at T1 (mean: 73.53, standard deviation [SD]: 6.21) and at T2 (mean: 72.90, SD: 6.73); and a lower score of PPD at T1(mean: 6.03, SD: 2.50) and T2 (mean: 5.70, SD: 2.23); and a higher score of social support at T1 (mean: 45.70, SD: 3.73), but no significant difference at T2 (mean: 42.90, SD: 3.29). Conclusions: The effect of ISP was evaluated to significantly increase the levels of MSE, social support, and to alleviate PPD symptoms for Chinese first-time mothers. As an effective and easily accessible intervention, ISP could become a significant source for health professionals to support primiparous women on parenting and mental health during the COVID-19 pandemic. Trial registration: The trial is registered at the Chinese Clinical Trials Registry (ChiCTR2000033154).

Postpartum depression, social support and maternal self-efficacy between adolescent and adult mothers during the COVID-19 pandemic: A comparative cross-sectional study.

AIMS: To determine the rate and level of postpartum depression (PPD), as well as to examine and compare PPD, social support and maternal self-efficacy between adolescent and adult mothers at 8 weeks postpartum during the COVID-19 pandemic. BACKGROUND: Policy measures to reduce the rapid spread of COVID-19 have disrupted many aspects of life and decreased social connections, which negatively impacts psychological well-being of the general population. However, studies focused on the impact of COVID-19 on mental health and maternal self-efficacy in postpartum mothers, particularly adolescent mothers, are limited. DESIGN: A comparative cross-sectional study was carried out following the STROBE guidelines. METHODS: An online questionnaire was administered from February to March 2021. Data were collected by the Edinburgh Postnatal Depression Scale (EPDS), the Postpartum Support Questionnaire (PSQ) and the Parenting Sense of Competence (PSOC) at 8 weeks postpartum. One-way MANOVA was used to analyse the data. RESULTS: Data from 63 adolescent mothers and 63 adult mothers were analysed. There were significant correlations between PPD, social support and maternal self-efficacy of the COVID-19 pandemic. Both adolescent and adult mothers had significantly negative impacts from the pandemic on mental health, social support and maternal self-efficacy. However, the adolescent mothers had higher rates of depressive symptoms (36.5% and 23.8%, respectively) as well as lower PSQ score (121.25 and 130.52, respectively) and PSOC scores (62.54 and 70.94, respectively) compared with adult mothers in the first 8 weeks postpartum during the pandemic. CONCLUSION: Adolescent mothers had a significantly higher rate of depressive symptoms and significantly lower social support and maternal self-efficacy scores compared to adult mothers at 8 weeks postpartum during the COVID-19 pandemic. IMPACT: Midwives or nurses should emphasize the negative mental health impacts during the COVID-19 situation and routinely screen for depressive symptoms, especially in adolescent mothers, which could help identify the at-risk mothers for developing PPD. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor the public were directly involved in the study.

Impact of COVID-19 restrictions on the postpartum experience of women living in Eastern Canada during the early pandemic period: A cross-sectional study.

OBJECTIVES: To (1) compare changes in parenting self-efficacy, social support, postpartum anxiety, and postpartum depression in Canadian women before and during the early COVID-19 pandemic; (2) explore how women with a newborn felt during the pandemic; (3) explore ways that women coped with challenges faced. METHODS: A cross-sectional design was used. Prior to the pandemic, an online survey was conducted with women who an infant 6 months old or less in one of the three Eastern Canadian Maritime provinces. A similar survey was conducted during the pandemic in mid-2020. RESULTS: Pre-COVID, 561 women completed the survey, and 331 women during the pandemic. There were no significant differences in parenting self-efficacy, social support, postpartum anxiety, and depression between the cohorts. Difficulties that women reported because of COVID-19 restrictions included lack of support from family and friends, fear of COVID-19 exposure, feeling isolated and uncertain, negative impact on perinatal care experience, and hospital restrictions. Having support from partners and families, in-person/virtual support, as well as engaging in self-care and the low prevalence of COVID-19 during the summer of 2020 helped women cope. CLINICAL RELEVANCE: Women identified challenges and negative impacts due to the COVID-19 pandemic, although no differences in psychosocial outcomes were found. Consideration of public health policy during the postpartum period for the ongoing COVID-19 pandemic is needed. CONCLUSION: While there were no significant differences in psychosocial outcomes, there were still challenges and negative impacts that women identified.

The association between parenting styles, maternal self-efficacy, and social and emotional adjustment among Arab preschool children

Abstract Parenting styles and parental self-efficacy are major factors that affect the overall adjustment of children. The current study examined parenting styles and maternal self-efficacy and their association with social-emotional adjustment among Arab preschool children living in Israel. Parenting Styles Questionnaire , Maternal Self-Efficacy Questionnaire , and Adjustment Questionnaire were administered to 420 Arabic-speaking mothers of 3- to 4-year-old children. After employing multiple regression analyses, the results indicated that parenting styles and the overall adjustment of children were significantly correlated. More precisely, a significant association between authoritative parenting style and higher levels of social-emotional adjustment among preschool children was found. Furthermore, maternal self-efficacy was significantly correlated to the overall adjustment of children. In this regard, higher maternal self-efficacy is associated with increased social-emotional adjustment among preschool children. The findings of our study show the applicability of these constructs found relevant across numerous cultures in a unique sample of Arab children living in Israel. Lastly, this study supports intervention programs that promote authoritative parenting style and parental self-efficacy in Arab communities.

Maternal self-efficacy development from pregnancy to 3 months after birth.

The present study uses a prospective longitudinal study design to investigate the development of maternal self-efficacy in the transition phase to parenthood, drawing on a large sample of socially and/or culturally disadvantaged families (N = 292). Parity, maternal education, migration, informal and formal social support are considered as potential predictors. Results indicate that previous birth experience, being born abroad, and higher levels of formal and informal social support during pregnancy jointly predict higher levels of maternal self-efficacy three months after birth. First-time mothers and mothers born in Germany (where the study was conducted) benefit more from formal support than mothers with previous experience and mothers born outside of Germany. Overall, maternal self-efficacy increases significantly. Implications for prenatal maternal care are discussed.

El presente estudio usa un diseño de estudio longitudinal potencial para investigar el desarrollo de la auto efectividad materna en la fase de transición a ser madre. Usando una muestra grande de familias desfavorecidas social y/o culturalmente (N = 292). Se consideran como potenciales factores de predicción la paridad, la educación materna, la migración, y el apoyo social informal y formal. Los resultados indican que una previa experiencia de dar a luz, el haber nacido en el extranjero, así como altos niveles de apoyo social formal e informal durante el embarazo predicen en conjunto altos niveles de auto efectividad materna tres meses después del parto. Las madres primerizas y las madres nacidas en Alemania (donde se llevó a cabo el estudio) se beneficiaron más del apoyo formal que las madres con experiencia previa y las madres nacidas fuera de Alemania. En general, la auto efectividad materna aumentó significativamente. Se discuten las implicaciones para el cuidado materno prenatal.

Cette étude utilise un plan d'étude prospectif longitudinal pour se pencher sur le développement de l'auto-efficacité maternelle dans la phase de transition à la parenté, en utilisant un grand échantillon de familles socialement et/ou culturellement défavorisées (n = 292). La parité, l'éducation maternelle, la migration, le soutien social informel et formel sont considérés comme des prédicteurs potentiels. Les résultats indiquent qu'une expérience de la naissance antérieure, le fait d'être née à l'étranger et des hauts niveaux de soutien social formel et informel durant la grossesse prédisent ensemble des niveaux élevés d'auto-efficacité maternelle après la naissance. Les mères étant mères pour la première fois et les mères nées en Allemagne (où l'étude a été faite) ont plus bénéficié d'un soutien formel que les mères ayant déjà donné naissance à un enfant et que les mères nées en dehors de l'Allemagne. Dans l'ensemble l'auto-efficacité maternelle a augmenté de manière importante. Les implications pour le soin maternel prénatal sont discutées.

Adverse childhood experiences and maternal self-efficacy: Examining the mediating role of intimate partner violence and the moderating role of caste membership in rural India.

Maternal self-efficacy (MSE) is associated with healthy functioning in mothers and children globally. Maternal exposure to adverse childhood experiences (ACEs) and intimate partner violence (IPV) is known to negatively impact MSE in high-income countries; however, the association has not been examined in low-and-middle-income countries, such as India, which face socioeconomic risks including poverty, illiteracy, and discrimination based on caste membership. The present study examines the mediating role of IPV in the association between ACEs (specifically-emotional, physical, and sexual abuse, neglect, household dysfunction, and discrimination) and MSE and tests caste membership as a moderator. A community-based, cross-sectional survey was performed with 316 mothers with at least one child between 0 and 24 months in a rural area in the North Indian state of Uttar Pradesh. A structural equation framework was used to test the moderated-mediation model. Results from the moderated-mediation model indicate that greater ACEs exposure was associated with lower MSE and this association was mediated by IPV exposure for low-caste but not high-caste mothers, even after controlling for wealth and literacy. These findings add to existing evidence on ACEs exposure as a significant burden for rural Indian mothers, negatively impacting parenting outcomes such as MSE. The critical role of caste membership is also highlighted, providing implications for future research.

La autoeficacia materna (MSE) se asocia con el saludable funcionamiento en las madres y niños globalmente. Se conoce que el hecho de que la madre haya estado expuesta a experiencias adversas en la niñez (ACE) y a la violencia de la pareja íntima (IPV) tiene un negativo impacto en MSE en países de altas entradas económicas; sin embargo, esta asociación no se ha examinado en países donde las entradas económicas son bajas o medias, como India, que enfrenta riesgos socioeconómicos entre los que se incluyen la pobreza, el analfabetismo, así como la discriminación basada en la pertenencia a una casta. El presente estudio examina el papel mediador de IPV en la asociación entre ACE (específicamente - el abuso emocional, físico y sexual, negligencia, disfuncionalidad en el hogar y discriminación) y MSE, y pone a prueba la pertenencia a una casta como aspecto moderador. Se llevó a cabo una encuesta de base comunitaria e inter-seccional con 316 madres con por lo menos un niño entre 0 y 24 meses de edad en un área rural en el estado de Uttar Pradesh en el norte de India. Se usó un marco de trabajo de ecuación estructural para examinar el modelo de moderación y mediación. Los resultados del modelo de moderación y mediación indican que una mayor exposición a ACE estaba asociada con una más baja MSE y que la exposición a IPV mediaba esa asociación para madres de castas bajas, pero no para madres de castas altas, aun después del factor control de recursos económicos y alfabetismo. Estos resultados contribuyen a la existente evidencia de que el haber estado expuesta a ACE es una carga significativa para las madres en la India rural, la cual tiene un impacto negativo en los resultados de crianza tales como MSE. También se subraya el papel esencial de la pertenencia a una casta, lo cual aporta implicaciones para la investigación futura.

L'auto-efficacité maternelle (MSE en anglais) est globalement liée à un fonctionnement sain chez les mères et les enfants. L'exposition maternelle à des expériences de l'enfance adverses (ACE en anglais) et à la violence intime ou conjugale (IPV) est connue comme impactant de manière négative l'auto-efficacité maternelle dans les pays à revenus élevés. Cependant ce lien n'a pas toujours été examiné dans les pays à faibles ou moyens revenus, tels que l'Inde qui fait face à des risques socioéconomiques qui comportent la pauvreté, l'illettrisme, la discrimination en fonction de l'appartenance à une caste. Cette étude examine le rôle médiateur de la violence conjugale (ou violence entre partenaires intimes) dans le lien entre les ACE (plus spécifiquement l'abus émotionnel, physiques, sexuel, la négligence, la dysfonction au sein du foyer et la discrimination) et l'auto-efficacité maternelle et les tests d'appartenance à une caste en tant que modérateurs. Un questionnaire communautaire, en coupe transversale, a été présenté à 116 mères ayant au moins un enfant entre l'âge de 0-24 mois dans une région rurale de l'état du nord de l'Inde, Uttar Pradesh. Un cadre d'équation structurelle a été utilisé pour tester le modèle de modération-médiation. Les résultats de ce modèle de modération-médiation indiquent que plus l'exposition aux ACE est grande, plus l'auto-efficacité maternelle est basse et cette association est affectée par l'exposition à la violence conjugale pour les castes moins élevées mais pas pour les mères des castes plus élevées, même en effectuant un contrôle pour la richesse et l'alphabétisation. Ces résultats s'ajoutent aux preuves existantes sur l'exposition aux ACE en tant que poids important pour les mères indienne de milieux ruraux, ce qui impacte de manière négative les résultats de parentage telles que l'auto-efficacité maternelle. Le rôle critique de l'appartenance à une caste est également mis en lumière, offrant des implications pour les recherches à venir.

Systematic Review of Self-Report Measures of Maternal Self-Efficacy.

OBJECTIVE: To synthesize the literature to identify self-report measures used to assess maternal self-efficacy (MSE) among mothers of infants 0 to 1 year of age. DATA SOURCES: OVID (MEDLINE), CINAHL, PsycINFO, Scopus, Google Scholar. STUDY SELECTION: We searched for research articles that included self-report measurement of MSE and were published from January 2000 to September 2021. We selected this time frame to focus on a contemporary context and to build on an earlier systematic review of self-report measures of self-efficacy in parents that captured a subset of MSE measures across a broader time period (1970-2016). DATA EXTRACTION: We extracted measures of MSE with descriptive details, including level of self-efficacy assessed (e.g., global, domain-specific, task-specific), concept(s) assessed, reliability, eligible age ranges, instrument origins, development, use, and translations. DATA SYNTHESIS: In many studies of MSE, researchers used measures not specifically designed for self-efficacy and instead used measures for closely related concepts such as confidence or competence. We identified only four measures that were used to assess MSE among mothers of infants. Among these, we found variation in the level of self-efficacy being measured and the intended age range. Importantly, we also found that measures of MSE were primarily validated for use within Western and/or English-speaking cultures/countries. CONCLUSION: We identified four instruments to measure MSE in mothers of infants, and each has strengths and weaknesses. Future researchers should focus on clear conceptual and operational alignment between MSE and its measurement; the development of an English, task-specific MSE measure; and further development and testing of measures of MSE outside of Western and/or English-speaking cultures/countries.

Maternal self-efficacy and emotional well-being in Chilean adolescent mothers: the relationship with their children's social-emotional development.

Background: Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being. Methods: A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships. Results: A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation. Conclusions: The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.

Maternal Self-Efficacy Buffers the Effects of COVID-19-Related Experiences on Postpartum Parenting Stress.

OBJECTIVE: To examine the associations of maternal self-efficacy (MSE) and perceived social support with parenting stress during the postpartum period during the COVID-19 pandemic and whether these two psychosocial factors account for variance in parenting stress in addition to the effects of COVID-19-related experiences and sociodemographic factors. DESIGN: Cross-sectional survey. SETTING: Online survey, the Perinatal Experiences and COVID-19 Effects (PEACE) study, launched in May 2020. PARTICIPANTS: Participants included 310 women who gave birth in the past 24 weeks. METHODS: The survey included self-report quantitative measures of MSE, social support, COVID-19-related experiences, parenting stress, symptoms of depression and anxiety, and a range of sociodemographic factors. RESULTS: Hierarchical multiple regression analysis indicated that MSE and social support were negatively associated with postpartum parenting stress in addition to the effects of COVID-19-related experiences, maternal symptoms of depression and anxiety, and a range of demographic factors. Furthermore, MSE interacted with COVID-19-related experiences such that higher levels of MSE mitigated the effects of COVID-19-related experiences on parenting stress. CONCLUSION: Our findings underscore the importance of protective factors at the individual and interpersonal levels and provide insights for prevention and intervention programs aimed at mitigating postpartum parenting stress during a wide-scale disaster such as the COVID-19 pandemic.

Exclusive Breastfeeding Experiences of Thai Mothers in Metropolitan Bangkok.

INTRODUCTION: In 2019, only 14% of mothers in Thailand performed six-month exclusive breastfeeding. This study sought to understand the pathways that mothers in Bangkok Metropolitan took to achieve successful six-month exclusive breastfeeding. METHODS: A total of 50 mothers living in Bangkok with children aged 6-12 months, who achieved and not achieved 6-month exclusive breastfeeding, were recruited for in-depth interviews during February to July 2020. Inductive thematic analysis of participants' viewpoints was applied for data analysis and interpretation. RESULTS: Four themes that contributed to six-month exclusive breastfeeding were i)  maternal breastfeeding self-efficacy;  ii)  support provided by family members;  iii)  engagement with and support from healthcare professionals; and iv)  employers' support and workplace environments. Mothers with strong breastfeeding intentions and "perceived capability" to succeed at breastfeeding tended to prioritize breastfeeding and overcome and cope well with unforeseen breastfeeding challenges. Supportive family members, who were convinced of the benefits of breastfeeding, engaged in maternal decision-making, and provided optimal support, contributed to successful exclusive breastfeeding. Health professionals were key in supporting mothers throughout pregnancy until the postpartum period. Lactating-mother-friendly working conditions, flexible working hours and enabling workplace environments, including the provision of breastfeeding breaks and a dedicate space for breast milk expression, were enabling factors for successful exclusive breastfeeding among working mothers. CONCLUSION: We recommend that all mothers and their family members are fully informed and convinced of the benefit from breastfeeding and trained with practical skill during their visit to antenatal care clinics. These interventions aim to develop mothers' self-efficacy for breastfeeding and to prepare them to manage common breastfeeding challenges. Health professionals should provide regular follow-up and counseling sessions on breastfeeding practices to mothers and families throughout the lactating period, especially working mothers for breastfeeding continuation after resume to work. Enhanced societal collective actions such as breastfeeding-friendly policy in workplace, including breastfeeding break-time and corner, can create enabling environments for successful exclusive breastfeeding.

Predictors of maternal self-efficacy and the mediating role of postpartum fatigue for Jewish and Arab women in Northern Israel.

OBJECTIVE: The study aims to investigate positive and negative social interactions as predictors of maternal self-efficacy and to examine the mediating role of postpartum fatigue. DESIGN: Participants included 450 Arab and Jewish mothers of healthy one-month-old infants who visited 14 well-baby care clinics located in northern Israel. The study used a prospective longitudinal cohort design. Participants completed the first questionnaire and agreed to a follow-up phone interview three months later. Both ethnic groups had a response rate of 90% for the follow-up interview. The questionnaire included six scales that measured socioeconomic status and demographics, obstetric characteristics, social networks and support, negative social interactions, fatigue and maternal self-efficacy (MSE). The phone interview was a shorter version of the written questionnaire focusing on MSE and fatigue. Maternal self-efficacy four month after birth was examined with social support, negative interactions and fatigue, using multiple linear regressions within each ethnic group. FINDINGS: In both groups, negative social interactions decreased perceptions of maternal self-efficacy. Women who reported higher social support after birth experienced a greater sense of maternal self-efficacy four months after birth, though the association was stronger among Jewish women. Post-partum fatigue affects Arab and Jewish mothers differently. Among Arab mothers, fatigue at one month mediates MSE as well as the relationship between social support and negative interactions at four months. Among Jewish mothers, these factors are directly related to MSE, with no mediation effect. IMPLICATIONS FOR PRACTICE: The correlations found between social interactions, fatigue and maternal self-efficacy can be useful in providing appropriate care that includes information and parental support. Health professionals working with postpartum women must assess degree of postpartum fatigue and negative postpartum social interactions as well as social support during the postpartum period.

Personal resources associated with peripartum depression among mothers of NICU hospitalised preterm infants.

OBJECTIVE: The high prevalence of peripartum depression (PPD) among mothers of preterm infants concerns health professionals due to its implications for mothers' and infants' health. A model for explaining PPD, consisting of four personal resources was examined: locus of control, intolerance to uncertainty, maternal self-efficacy, and quality of the couple relationship. DESIGN: In one of the largest Neonatal Intensive Care Unit (NICU) in Israel, 129 mothers of 215 preterm infants completed self-report questionnaires regarding their background variables, locus of control, intolerance to uncertainty, maternal self-efficacy and quality of couple relationship. MAIN OUTCOME MEASURES: PPD symptoms and high risk for diagnosing clinical PPD. RESULTS: The examined personal resources explained 43.9% of the variance in PPD symptoms. Intolerance to uncertainty was positively associated with PPD symptoms, while internal locus of control, high levels of maternal self-efficacy, and high quality of couple relationships were found to be negatively associated with PPD symptoms. Additionally, these variables predicted the likelihood for clinical PPD. CONCLUSION: The findings indicate a potential likelihood of reducing PPD through healthcare professional interventions, by strengthening personal resources. Associations between personal resources and PPD are discussed in light of the transactional theory of coping.

The Role of Maternal Self-efficacy in the Link Between Childhood Maltreatment and Maternal Stress During Transition to Motherhood.

The transition to motherhood is a significant developmental milestone in many women's lives. This transitional period may be more stressful for women with a history of childhood maltreatment (CM) than for women without such a history. This study tested whether parental self-efficacy (PSE) accounts for the link between CM and parental stress in mothers transitioning to motherhood. The study used a convenience sample of 1,306 first-time mothers of children aged two years or younger. Mothers filled out online self-report questionnaires assessing history of CM, PSE, and prenatal stress. Consistent with the hypotheses, exposure to CM was directly associated with greater parental stress. Also, PSE partially mediated the associations between CM and parental stress, such that mothers with a history of childhood abuse reported a lower level of PSE, which in turn was associated with greater parental stress. In conclusion, the study highlights the important role of negative cognitions related to parenting for maternal dysfunction following exposure to childhood abuse. These findings suggest a need to incorporate preventive interventions designed to promote PSE for mothers exposed to CM. Such programs may alleviate parental stress and further support the healthy development of the child.

Development of a Mobile Application of Internet-Based Support Program on Parenting Outcomes for Primiparous Women.

Primiparous women usually experience various parenting problems after childbirth that have negative effects on the well-being of mothers and infants. Although e-Support technology could provide an innovative and easily accessible intervention approach, mobile-phone interventions remain limited for Chinese primiparous women. Therefore, a new mobile application (APP) called the "Internet-based Support Program" ("ISP") was designed, incorporating the self-efficacy theory and the social-exchange theory for Chinese first-time mothers to improve their levels of maternal self-efficacy (MSE), social support, and satisfaction, as well as to reduce their postpartum depression symptoms. The research was conducted to develop and optimize the "ISP" APP for new mothers via a theory-, evidence-, and person-based approach. Five modules of "learning forum", "communication forum", "ask-the-expert forum", "baby home forum", and "reminder forum" were included in the APP to meet various parenting needs of first-time mothers; and its contents and functions were validated by the experts and primiparous women. The majority of participants gave positive feedback on the APP's perceived ease of use and usefulness. The "ISP" APP was the first designed for Chinese primiparous women, and a multicenter randomized controlled trial (RCT) will be conducted to measure its effectiveness on parenting outcomes.

The Effect of a Voice-Centered Psycho-Educational Program on Maternal Self-Efficacy: A Feasibility Study.

This study examined the effect of a brief psycho-educational program, Time Together, on maternal self-efficacy, mother-infant bonding, and mood/anxiety for community-based mothers. This program centered on maternal voice, timing of interplay, and recognition of infant cues. A convergent parallel mixed-methods design included quantitative measures: the Karitane Parenting Confidence Scale, the Mother-Infant Bonding Scale, Edinburgh Postnatal Depression Scale and State & Trait Anxiety Inventory, and a sequential qualitative analysis to elaborate on the quantitative findings. Significant changes on the Karitane Parenting Confidence Scale were found. Qualitative analysis of the participant interviews and reflective diaries from the two weeks following the psycho-educational program confirmed that participation enhanced mothers' ability to understand their infant, to soothe their infant when distressed, to play and to establish an effective bedtime routine. This feasibility study indicated that this is a promising approach to improve early mother-infant interaction and maternal self-efficacy.