Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 86; no. 4; pp. 451 - 456
• Main Authors: Wiklund, Ingela, Edman, Gunnar, Andolf, Ellika
• Format: Journal Article
• Language: English
• Published: Oxford, UK Informa UK Ltd 01.01.2007; Blackwell Publishing Ltd; Taylor & Francis
• Subjects: Adult; Adult and adolescent clinical studies; anxiety; Anxiety - epidemiology; awareness; Biological and medical sciences; birth; Birth experience; breast feeding; Breast Feeding - epidemiology; Breast Feeding - psychology; cesarean section; Cesarean Section - psychology; Cesarean section on maternal request; Cohort Studies; delivery; Depression; Depression, Postpartum - epidemiology; Depression, Postpartum - psychology; Edinburgh Postnatal Depression Scale; Elective; Elective Surgical Procedures - psychology; expectation; Female; fetus death; First-time mothers; Gynecology. Andrology. Obstetrics; Health Status; human; Humans; labor; Labor, Obstetric - psychology; Medical sciences; Medicin och hälsovetenskap; Mood disorders; normal human; Obstetric; Parity; Patient Satisfaction; Postpartum; Pregnancy; primipara; priority journal; Prospective Studies; prospective study; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; puerperal depression; questionnaire; Self Concept; self evaluation; Social Support; Surgical Procedures; Sweden; Sweden - epidemiology; third trimester pregnancy; vaginal delivery; Sweden; Mood disorder; Depressions; Health; Gynecology; Depression; birth experience; Birth; Cesarean section on maternal request; Obstetrics; first-time mothers; Treatment; Mother; Surgery; Expectation; Cesarean section
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.1080/00016340701217913

Objective. The purpose of this study was to investigate first-time mothers undergoing cesarean section in the absence of medical indication, their reason for the request, self-estimated health, experience of delivery, and duration of breastfeeding. We also aimed to study if signs of depression postpartum are more common in this group. Method. In a prospective cohort study 357 healthy primiparas from two different groups, "cesarean section on maternal request" (n=91) and "controls planning a vaginal delivery" (n=266) completed three self-assessment questionnaires in late pregnancy, two days after delivery and 3 months after birth. Symptom scores from the Edinburgh postnatal depression scale at three months after birth were also investigated. Results. Women requesting cesarean section experienced their health ass less good (p<0.001) and were more often planning for one child only (p<0.001). They more often reported anxiety for lack of support during labor (p<0.001), for loss of control (p<0.001), and concern for fetal injury/death (p<0.001). After planned cesarean section women in this group reported a better birth experience compared to women planning a vaginal birth (p<0.001). They were breastfeeding to a lesser extent three months after birth (p<0.001). There were no differences in signs of postpartum depression between the groups three months after birth (p=0.878). Conclusion. The knowledge gained from this study may help in understanding why some women prefer to give birth with elective cesarean section. It also elucidates the need for awareness of professional support during vaginal birth.