Peer-reviewed article

Longitudinal associations between maternal negative birth experience, mother-child bonding, and child emotional-behavioral problems: Findings from two cohort studies.

Isabel Jaramillo, Mirjam Oosterman, Tilmann von Soest, Annaleena Holopainen, Ariane Göbel et al. · 7 Apr 2026

Abstract

BACKGROUND: A negative maternal birth experience can influence mother-child bonding, which in turn may influence children's emotional-behavioral development. This study examined these longitudinal associations across two cohort studies. METHODS: Data were drawn from the German DREAM study (N = 1608) and the Dutch Generations2 study (N = 1783). Negative birth experience was modeled as latent factor using three indicators measured two (DREAM) and three (Generations2) months postpartum. Child emotional-behavioral problems were assessed at ages three (DREAM) and four (Generations2), with the Strengths and Difficulties Questionnaire. Mother-child bonding was assessed at 12-14 months after birth using the Postpartum Bonding Questionnaire (DREAM) and the Attachment Scale of the Parenting Stress Index (Generations2). Structural equation modeling tested associations. RESULTS: Negative birth experience predicted mother-child bonding (DREAM: β = 0.11, p = .008, Generations2: β = 0.09, p = .040). Bonding difficulties were associated with increased emotional-behavioral problems, particularly conduct and hyperactivity-inattention problems (DREAM mothers: β = 0.17-0.27, p < .006; Generations2: β = 0.13-0.20, p < .022; DREAM partners: β = 0.15-0.17, p < .003). Small indirect effects of negative birth experience on conduct and hyperactivity-inattention problems through bonding were observed only in the German sample (DREAM mothers and partners: β = 0.02-0.03, p < .043). CONCLUSIONS: Results suggest that negative birth experiences may predict emotional-behavioral problems primarily through bonding difficulties. Promoting positive and empowering birth experiences, alongside early identification and support for bonding difficulties, may represent promising targets for preventive efforts aimed at improving child developmental outcomes.