A systematic review of influences and outcomes of body image in postpartum via a socioecological framework

Abstract

ABSTRACT Background Women in the postpartum period come under multi-level pressure to return to pre-pregnancy body shape and size. This pressure can lead to reduced body image satisfaction, self-esteem, and mood. In this systematic review we explored the influences and outcomes of body dissatisfaction during the postpartum period. Methods Four databases were searched using keywords: postpart* OR postnatal OR peripart* OR ‘new mother’ OR ‘breast feed*’ AND ‘body image’ OR ‘body dissatisf*’ OR ‘body satisf*’ OR ‘body attitude’ OR ‘body shape’. Results The influences and outcomes of body image dis/satisfaction in the postpartum period from 55 international studies were found to align within four of the five factors of the socioecological model. Intrapersonal factors: weight and body shape concerns, mental health and stressors, attitudes and behaviours, and protective coping skills and interventions. Interpersonal factors: social support (partner, family, and friends) and sexual functioning. Institutional factors: experiences with the healthcare system and returning to work. Societal factors: culture and ethnicity, media influences and social norms such as the thin ideal. Conclusions A focus on intrapersonal factors alone is insufficient to understand women’s experiences of body dis/satisfaction during the postpartum period. This suggests a need for better education and policy practices in pre-natal and postpartum care directed at body image and education to dispel societal norms such as the thin ideal. Doing so shifts the focus to include interpersonal, institutional, and societal influences alongside intrapersonal experiences. Research is needed to explore the utility and efficacy of broader approaches for women during this vulnerable life period.