Development and initial validation of a measure of body image in the postpartum period: the postpartum body image scale

Background: Despite the importance of body image in the puerperium, tools specifically assessing postpartum body image are lacking. To address this gap, we developed the Postpartum Body Image Scale (PPBI-S), a measure encompassing both negative and positive key aspects of postpartum body image. Methods: The reliability and validity of the PPBI-S were evaluated across three studies. In Study 1, item formulation and content validity were established through expert evaluation and cognitive interviews (n = 20). Study 2 involved 250 postpartum women and employed exploratory factor analysis (EFA), revealing a trifactorial structure: Postpartum Body Image Concerns, Postpartum Positive Body Image, and Postpartum Dieting, accounting for 25.1%, 21.7%, and 17.1% of the variance, respectively. In Study 3, confirmatory factor analysis (CFA) was conducted on a sample of 258 postpartum women to examine internal consistency and convergent validity. Results: The CFA confirmed the three-factor model, showing good internal consistency across subscales. Convergent validity was demonstrated through significant correlations with established measures of body image and psychological well-being. Predictive validity was also supported, with PPBI-S scores significantly associated with breastfeeding intentions three months later. Conclusions: The PPBI-S is a reliable and valid instrument for assessing postpartum body image, capturing both its positive and negative dimensions. This tool provides researchers and clinicians with a comprehensive measure to evaluate body image experiences during the postpartum period.