Background: Most existing information about the health of US postpartum mothers comes from studies of morbidity and mortality. As a result, relatively little is known about the general well-being of postpartum mothers. Self-rated health (SRH), a single-item, 5-level ordinal measure has been widely used as an indicator of general health status in epidemiologic and population health research. There are no US population studies of maternal SRH in the postpartum period.

Methods: An analytic sample of 6,266 women ages 20-44 was created from the 2007-2018 waves of the National Health and Nutrition Surveys. The 5-level SRH measure was dichotomized into “good” and “poor” levels and multivariate logistic regression analysis was used to characterize the relationship between postpartum status and SRH and to test whether parity, cigarette smoking, pregnancy, depression, sleep duration, tiredness/fatigue, obesity, history of c-section and breastfeeding status independently predict poor SRH in the sub-population of postpartum women (n=508).

Results: There is a significant relationship between postpartum status and SRH that is moderated by pregnancy status. For women who are not pregnant, postpartum status is associated with lower odds of poor SRH (OR 0.52, 95% CI, 0.34-0.79) while for women who are pregnant, postpartum status is associated with increased odds of poor SRH (OR 2.34, 95% CI 0.81-6.78), an association that did not reach statistical significance at a p=0.05 level. Having a high school education (OR 0.35, 95% CI, 0.13-0.95) breastfeeding (OR 0.22, 95% CI 0.10-0.52) were associated with lower odds of poor SRH, while being Hispanic (OR 3.51, 95% CI 1.20-10.27), tired (OR 2.40, 95% CI 1.08-5.57) or obese (OR 2.72, 95% CI, 1.35-5.56) were associated with higher odds of maternal report of poor health.

Discussion: Postpartum status is associated with better SRH. This is not the case; however, for women who are pregnant again in the first postpartum year suggesting that a short interpregnancy interval (IPI) is a threat to postpartum maternal well-being. Breastfeeding, on the other hand, is associated with a strong protective effect on maternal postpartum SRH. These results suggest a need for postpartum contraceptive and breastfeeding promotion efforts that focus on immediate impacts on maternal health. Maternal postpartum obesity and maternal tiredness also emerge as priority areas for maternal postpartum health promotion initiatives. Additional research on the postpartum experience of Hispanic mothers is warranted.