An empirical evaluation of a psychoanalytic theory of mothering orientation: implications for the antenatal prediction of postnatal depression

Abstract

This study was designed to determine (a) whether women's antenatal expectations of childbirth, their future baby and early motherhood vary in line with Raphael‐Leff's Facilitator–Reciprocator–Regulator model of mothering orientation, and (b) whether a Regulator orientation confers greater relative risk for early postnatal depression. A sociodemographically representative sample of 205 primiparous women completed a maternal orientation measure and the General Health Questionnaire in late pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at 6–8 weeks postpartum. Hierarchical cluster analysis was employed to cluster cases on the basis of antenatal expectations of their future baby and early motherhood and yielded a clear three‐cluster solution. Between‐cluster comparisons of women's ratings on these variables, and of childbirth and feeding expectations, suggested cluster membership did correspond with Facilitator, Regulator and Reciprocator mothering orientations. In line with theory, women reporting a Regulator mothering orientation were at increased independent risk (OR 3.28, 95% CI 1.23–9.25) for above‐threshold postnatal depression symptom levels (EPDS>10.5). Furthermore, in a hierarchical regression analysis, Regulator mothering orientation accounted for a significant proportion of variance in postnatal symptom level even after controlling for antenatal depression symptom level.