Date of Award

Spring 5-16-2015

Degree Type


Degree Name

PhD Nursing




Marie Foley, Ph.D

Committee Member

Judith Lothian, Ph.D

Committee Member

Karen D'Alonzo


breastfeeding, self-efficacy, perceived stress, birth satisfaction, postpartum, infant feeding


This descriptive correlational study examined the relationships among perceived stress, birth satisfaction, and breastfeeding self-efficacy in women in the early postpartum period. The study, guided by self-efficacy and stress and coping theories, aimed to identify factors related to breastfeeding self-efficacy, an important psychological variable in sustained breastfeeding. The sample (N =107) was comprised of primarily well-educated, higher income, non-Hispanic White (69.8%) women recruited from a single New Jersey hospital in the first four days postpartum. The sample was comprised of nearly equal numbers of primiparous and multiparous women, all of whom expressed an intention to breastfeed, with an overall cesarean section rate of 38.8%. Participants were invited by the researcher to complete three established survey instruments, which measured the main study variables: the Perceived Stress Scale-10, the Birth Satisfaction Scale-Revised, and the Breastfeeding Self-efficacy Scale-Short Form, in addition to a researcher-generated demographic questionnaire. Survey responses were analyzed using a variety of descriptive and inferential statistical analyses.

Study results indicated a small positive correlation between birth satisfaction and breastfeeding self-efficacy and a small negative correlation between birth satisfaction and perceived stress. A statistically significant multivariate model revealed that the main and ancillary variables explored in the study explained 38.5% of the variance in breastfeeding self-efficacy scores. Supplemental formula feeding in the hospital explained the most variance in scores, followed by birth satisfaction, and infant feeding plans.

The study findings elucidate the impact of certain sources of efficacy information, which may inform strategies for nurses and healthcare professionals to impact a woman’s self-efficacy for breastfeeding. Strategies include supporting and guiding women in formulating their infant feeding plans antenatally, promoting birth satisfaction, involving partners in breastfeeding education, and limiting the use of in-hospital supplemental formula unless medically indicated.