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Aust N Z J Psychiatry. 1997 Oct;31(5):728-38.

Adverse psychological impact of operative obstetric interventions: a prospective longitudinal study.

Author information

  • 1Key Centre for Women's Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.

Abstract

OBJECTIVE:

This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures.

METHOD:

Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period.

RESULTS:

Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem.

CONCLUSIONS:

The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.

PMID:
9400879
[PubMed - indexed for MEDLINE]
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