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Arch Womens Ment Health. 2019 Dec;22(6):817-824. doi: 10.1007/s00737-019-00968-2. Epub 2019 Apr 30.

Delivery mode is associated with maternal mental health following childbirth.

Author information

1
Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA, 02129, USA. sdekel@mgh.harvard.edu.
2
Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA. sdekel@mgh.harvard.edu.
3
Interdisciplinary Center, Kanfei Nesharim, 4610101, Herzliya, Israel.
4
Department of Psychiatry, Massachusetts General Hospital, Building 120- 2nd Avenue, Charlestown, MA, 02129, USA.
5
Harvard Medical School, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA.

Abstract

Childbirth is a life-transforming event often followed by a time of heightened psychological vulnerability in the mother. There is a growing recognition of the importance of obstetrics aspects in maternal well-being with the way of labor potentially influencing psychological adjustment following parturition or failure thereof. Empirical scrutiny on the association between mode of delivery and postpartum well-being remains limited. We studied 685 women who were on average 3 months following childbirth and collected information concerning mode of delivery and pre- and postpartum mental health. Analysis of variance revealed that women who had cesarean section or vaginal instrumental delivery had higher somatization, obsessive compulsive, depression, and anxiety symptom levels than those who had natural or vaginal delivery as well as overall general distress, controlling for premorbid mental health, maternal age, education, primiparity, and medical complication in newborn. Women who underwent unplanned cesarean also had higher levels of childbirth-related PTSD symptoms excluding those with vaginal instrumental. The risk for endorsing psychiatric symptoms reflecting clinically relevant cases increased by twofold following unplanned cesarean and was threefold for probable childbirth-related PTSD. Maternal well-being following childbirth is associated with the experienced mode of delivery. Increasing awareness in routine care of the implications of operative delivery and obstetric interventions in delivery on a woman's mental health is needed. Screening at-risk women could improve the quality of care and prevent enduring symptoms. Research is warranted on the psychological and biological factors implicated in the mode of delivery and their role in postpartum adjustment.

KEYWORDS:

Childbirth; Delivery mode; Mental health; Postpartum PTSD; Postpartum depression

PMID:
31041603
PMCID:
PMC6821585
[Available on 2020-12-01]
DOI:
10.1007/s00737-019-00968-2

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