Postpartum Mothers' Mental Health in a Conflict-Affected Region: A Cross-Sectional Study of Emotion Regulation and...

Background: The transition through pregnancy, childbirth, and postpartum significantly impacts maternal mental health, influencing both individual and family well-being. While social support and emotion regulation serve as protective factors generally, their role and impact during periods of conflict remains understudied. Methods: We conducted a cross-sectional study of 400 Jewish mothers (up to two years postpartum) from a representative sample in Israel during a period of conflict. Participants were recruited through the Sekernet platform, a validated online survey tool in Israel. The study population included Jewish mothers up to two years postpartum, aged 18-45, without a history of diagnosed mental health disorders. Inclusion criteria specified mothers aged 18-45 and within two years postpartum, while exclusion criteria included mothers under 18, over 45, more than two years postpartum, or with a history of diagnosed mental illness or psychiatric disorders. Using validated instruments, we assessed psychological well-being (PWB), anxiety (GAD-7), perceived stress (PSS), resilience (CD-RISC), emotion regulation strategies (ERQ), quality of life (WHO-5), social support (MSPSS), and post-traumatic stress symptoms (PCL-5). Additionally, exposure to conflict-related media and direct exposure to war events were measured using self-reported questionnaires evaluating frequency and type of exposure during the conflict period. Results: Cognitive reappraisal and resilience positively correlated with psychological well-being (p < 0.01), while expressive suppression and general stress negatively correlated with both psychological well-being and quality of life (p < 0.01). Mediation analysis revealed that social support significantly mediated the effects of stress on psychological well-being (β = -0.060; p < 0.05) and quality of life (β = -0.05; p < 0.05). Additionally, exposure to conflict-related media and post-traumatic stress symptoms correlated with reduced well-being and increased anxiety. Conclusions: Our findings emphasize the vital roles of social support systems and adaptive emotional regulation strategies during the postpartum period, particularly in conflict settings. Healthcare providers should implement interventions that strengthen social support networks and teach adaptive emotion regulation skills to postpartum mothers in conflict zones.