Postpartum Body Image and Self-Esteem

Abstract

The reason this research topic is of interest lies in the fact that the first year after birth is a major transition for all parents, especially for mothers. Thus, the objective of the present paper is to analyze certain psychosocial factors surrounding new mothers during this period and the way in which they can accentuate feelings of incapacity and powerlessness that can contribute to the development of low self-esteem and a negatively perceived body image. These factors can adversely impact the postpartum period. Furthermore, this topic has been very little explored in the Romanian population.

Full text

Bulletin of the Transilvania University of Braşov
Series VII: Social Sciences • Law • Vol. 15(64) No. 2 – 2022
https://doi.org/10.31926/but.ssl.2022.15.64.2.3
POSTPARTUM BODY IMAGE AND
SELF-ESTEEM
L. ANTONIE1 M. VINTILĂ2
Abstract: The reason this research topic is of interest lies in the fact that
the first year after birth is a major transition for all parents, especially for the
mothers. Thus, the objective of the present paper is to analyse certain
psychosocial factors surrounding new mothers during this period and the
way in which they can accentuate feelings of incapacity and powerlessness
that can contribute to the development of low self-esteem and a negatively
perceived body image. These factors can adversely impact the postpartum
period. Furthermore, this topic has been very little explored in the Romanian
population.
Key words: body image, self-esteem, postpartum, perceived social
support, body dissatisfaction
1. Introductory Aspects regarding Postpartum and Body Image
The process of becoming a mother begins long before birth, more precisely in the
traditional three trimesters of pregnancy, but Reva Rubin (1984) has proposed a fourth
trimester of pregnancy, the postnatal period, since the mid-70s. Rubin (1984), describes
this period as one of significant transition and recovery. The postpartum period begins
with the birth of the foetus, however, the end is less well defined and some researchers
believe that women are in the postpartum period up to 12 months after delivery
(Berens, 2020). Postpartum sub-periods were defined as follows: immediate (up to 6
weeks after birth), short (7 weeks to 3 months after birth), medium (3 months to 6
months after birth), and long (6 months to 1 year following birth) (Matenchuk et al.,
2022).
After giving birth, due to the changes that occur in the body, often, a good part of
women come to realise that they may be further from the "perfect body" than they
were before. Immediately after giving birth, the woman's body does not change
significantly, the traces and the impression of a pregnancy are still visible, and this
leaves room for dissatisfaction (Lewis, 2017).
1Universitatea de Vest din Timisoara, loredana.antonie98@e-uvt.ro , corresponding author
2Univeristatea de Vest din Timisoara

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In recent years some studies have been done also on Romanian women. Body
appreciation has been studied on Romanian women by a team of researchers led by Prof
Swami, using the Romanian translation of the Body appreciation scale in 2017 (Swami,
Tudorel, Goian, Barron, Vintila, 2017; Swami, Todd, Goian, Tudorel, Barron, Vintila,
2021). The breast size satisfaction, which is an important part of body satisfaction in
women has also been assessed (Swami et al., 2020). Important changes of both body
and breast occur during pregnancy and while breast feeding. Therefore, these aspects
should be given a special attention.
Experiencing body dissatisfaction in the postpartum period can lead to decreased self-
esteem, depression, anxiety, and negative affect (Petersen, 2017).
Body dissatisfaction can affect a person in a variety of ways, causing perceptual,
affective, cognitive, and behavioural disorders. The transition to parenthood is an event
that can have a major potential to endanger mothers' mental health, and approximately
9-21% of women experience depression and/or anxiety upon transitioning to the
mothering role. Many of them experience subclinical symptoms of depression and
anxiety but also stress, low self-esteem and loss of confidence. A recent study assessed
the mental health knowledge and the level of maternal and paternal postnatal
depression on a Romanian sample and the results showed that this knowledge was very
poor (Swami, Vintila, Goian, Tudorel, Bucur, 2020). The personality structure of the new
mother also plays an important role in how women adapt to the new role of being a
mother Barron, Vintila, Ong, Tudorel, Goian, 2021, Barron, Vintila, Swami, 2020).
Women's emotional well-being is more affected if they have low social support, low
income, raise their children alone or have a poor relationship with their partner
(McLeish and Redshaw, 2017). Social support is extremely important to maintain good
physical and mental health. Social support has been described by Lin et al. (1979) as the
support accessible to an individual through social ties to other individuals, groups and
the larger community. In other words, social support is a person's perception or
experience of being cared for, appreciated, and part of a mutually supportive social
network, which ultimately has beneficial effects on their mental and physical health.
Social support is a wide concept and it is important for people in general and women in
particular to receive social support in any area of their life. In this regard, previous
studies (Rezeanu et al., 2016) have shown that, as the distance to the city centre
increases, people’s access to public services decreases. Thus, compared to women who
live in the city centre, it is possible for women living in the suburban area to feel less
social support, due to the lack of access to public services too.
With the birth of the child, the woman's status changes suddenly, facing new
challenges and finding herself in a situation where she has to offer her child
unconditional love and affection, responding to the child's need for dependence. In
order for this adaptation to the new situation to be successful, the mother needs social
support and psychological balance (Mârza-Dănilă and Mârza-Dănilă, 2017).
Messages about the postpartum woman's body are particularly contradictory: while
medical professionals emphasise the necessity of breastfeeding, directives to "get the
body back to its original shape" abound in the media (Fox and Neiterman, 2015). Thus,
due to the fact that the importance of the media has increased because it often acts like

L. ANTONIE et al.: Postpartum Body Image and Self-esteem
147
a substitute for the everyday experiences of people (Coman, 2004, p.105), the media
can play an essential role in influencing women’s opinion about themselves and about
their bodies.
Rapid weight loss has become a mainstream fixation, reinforced by public figures, TV
celebrities and tabloid characters in the market flaunting their perfect post-pregnancy
bodies. Weight gain during pregnancy lasts 9 months, and realistically speaking, losing
the accumulated pounds will take a long time after the birth of the child (Baby and
Balakrishnan, 2022). The high level of smartphone and internet usage make women very
susceptible to all the information on social media, which is not always the most accurate
and beneficial (Vintila, tudorel, Goia, Barbat, 2018, Tudorel, Vintila, Vlaicu, Balauta,
Goian, Rusu, 2018).
It is well known that exposure to thin ideals or sexualization of women in the media
influences body image, self-esteem, eating behaviours, and eating disorders in women
(Grabe, Ward, & Hyde, 2008, Vintila, Todd, Goian, tudorel, Barbat, Swami, 2020), but
few studies have focused on how these exposures affect a postpartum woman. If a
woman compares herself to an unrealistic image and is far from achieving that image,
she may choose different coping strategies (shopping, eating less, or engaging in
exercise) and may experience low self-esteem or confusion regarding personal identity
(Adomaitis and Johnson, 2019). It is important in this context to mention that the
concept of image is related to the subjective knowledge of a person. Hence, the image
one holds about itself or about other people is mediated and determined by the
interactions one has with the environment in which one lives (Coman, 2010, p.56)
The idea that body beauty has a certain standard is suggested in different ways.
Women state that magazines, social networks, especially Instagram, shape their ideals
of beauty. Among the sources of information about the ideal body are books or blogs on
how to lose weight and how to get fit after pregnancy. Some women also consider their
immediate circle as a source for constructing body ideals, among these are family,
friends, colleagues or mothers' groups (Prinds, Nikolajsen, & Folmann, 2020).
After giving birth, the mother's self-esteem plays a vital role in determining her
postpartum behaviour and self-acceptance. The mother's self-esteem will be related to
how she feels worthy, valuable, useful, and capable of fulfilling her duties as a mother
and wife. A low self-esteem in the postpartum period can affect body satisfaction and
lead to changes in the perception of body image (Bomba et al., 2021). However, the
feeling of fulfilment and of a fulfilled life can be influenced by other factors too,
including: people’s financial situation, the social reputation, the lack of worries or the
amount of knowledge acquired (Coman, 2018, p.245).
2. Methodology
Data were collected through an online questionnaire, made in Google Forms,
consisting of several sections. The questionnaire was distributed on social networks. In
the first section there were questions for the collection of demographic data, followed
by 4 sections dedicated to applied questionnaires. All responses were mandatory and
the first questionnaire to be completed was the Rosenberg Self-Esteem Scale (RSE),

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followed by the Body Shape Questionnaire (BSQ-16B), the Multidimensional Scale of
Perceived Social Support (MSPSS) and Sociocultural Attitudes Towards Appearance
Questionnaire-3 (SATAQ-3). The main eligibility criteria were that all respondents to the
questionnaire were within a maximum period of one year after the birth of the child, the
absence of a new pregnancy at the time of completion and the minimum legal age of
over 18 years. Completing the entire questionnaire took approximately 20-25 minutes
and all participants gave their consent.
2.1. Research Goals and Objectives
The objective of the present paper is to analyse certain psychosocial factors
surrounding new mothers during this period and the way in which they can accentuate
feelings of incapacity and powerlessness that can contribute to the development of low
self-esteem and a negatively perceived body image. Thus, starting from the results of
the aforementioned studies, the following hypotheses were outlined:
Perceived postpartum social support predicts self-esteem.
Internalisation of social ideals significantly predicts body dissatisfaction.
2.1. Research Sample
The participants of this study were 323 women, in the postpartum period of a
maximum of one year after the birth of the child. Of these, 58.8% were in the long
postpartum subperiod (from 6 months to one year after birth), 25.7% in the medium
postpartum subperiod (from 3 months to 6 months after birth), 9.9 % in the short
postpartum subperiod (from 7 weeks to 3 months after birth) and 5.6% in the
immediate postpartum subperiod (up to 6 weeks after birth). They were aged between
18 and 45 years (M=28.83, AS=5.367). The collected data regarding the marital status of
the respondents show that the majority of them are married (83%, N=268), 13.9%
(N=45) are in a relationship, 2.2% (N=7 ) are single and 0.9% (N=3) are divorced.
Regarding the number of children, 74.3% of the participants have 1 child (N=240), 22.3%
(N=72) have 2 children, 1.5% (N=5) have 3 children, 1 .2% (N=4) have 4 children and
0.6% (N=2) have 5 children. Regarding the type of delivery, 62.2% (N=201) delivered by
caesarean section, while 37.8% delivered naturally. Breastfeeding data show that at the
time of completing the questionnaire, 61.3% (N=198) were breastfeeding and 38.7%
(N=125) were not. Data were collected on pre-pregnancy (M=65.01 kg) and completion
(M=71.29 kg) weight.
3. Analysis and Discussion
The statistical analysis of the database corresponding to this study was performed
with the help of the SPSS Statistics program variant 20.0 multilingual.
Linear regression with a single predictor was used to see if perceived social support
predicted postpartum self-esteem.

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Based on the regression model, we can reliably estimate the perceived social support
F(1, 321)= 54.41, p<.001. Perceived social support explains 14% of self-esteem variance,
R2=.14. The perceived social support is a significant and positive predictor of self-esteem
(ß=.38, p<.001). Results that show that perceived social support can have a major impact
on self-esteem were also found in the research of Lazarus and Rossouw (2015) who
talked about how compromising the support network can impact the self-esteem of new
mothers. Moreover, Nunez (2016) pointed out that the husband or romantic partner can
also contribute significantly to the decrease in self-esteem by increasing the pressure on
how the partner should look.
Linear regression with a single predictor was used to test whether internalising social
ideals significantly predicted body dissatisfaction. Based on the regression model, we
can confidently estimate the internalisation of social ideals F(1, 312)=123.69, p<.001.
Internalisation of social ideals is a significant and positive predictor of body
dissatisfaction (ß=.52, p<.001). Internalisation of social ideals explains a considerable
proportion (27%) of body dissatisfaction R2=.27. A number of studies attest to the fact
that internalising social ideals significantly and negatively impacts women's body image
in the postpartum period. The use of social media plays a significant role in relation to
body dissatisfaction Nagl et al., (2021). Moreover, women who are more likely to
perceive pressures about how they should look, engage in social comparisons, and
internalise socio-cultural messages about appearance are more likely to report
increased body dissatisfaction and engage in maladaptive eating behaviours (Sperry,
2011).
4. Conclusions
Being a new mother is one of the most challenging experiences that a woman can face
in her lifetime. This study demonstrated that postpartum body image and self-esteem
undergo drastic changes that may be related to a number of other variables, such as
perceived social support or internalisation of social ideals.
Thus, in order to improve the quality of life of mothers, it is necessary to recognize the
risk factors and crisis situations, in order to be able to offer support to women who face
these difficulties, with the aim of minimising the negative consequences that may arise
later.
It would be helpful for new mothers to be encouraged to seek specialist help if they
feel that their psychological, physical well-being and self-esteem have been significantly
damaged following the transition to motherhood.
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