Objective: To investigate the psychological profile of a sample of new mothers, who requested an elective caesarean section (CS), compared with a group of women who had a CS in emergency. Furthermore, the study examined psychiatric, environmental, medical and obstetrical risk factors related to the mother's choice of an elective CS, in order to develop specific intervention strategies.Methods: A sample of 16 mothers aged 34.88 ± 8.53 years were enrolled and assessed using a semi-structured face-to-face interview, the Minnesota Personality Inventory Test-2 (MMPI-2) and the Edinburgh Postnatal Depression Scale (EPDS). The sample was divided in two groups: cases (8 women who had an elective CS) and controls (8 women who had a CS in emergency).
Results:The analysis identified a statistical significance among the two groups with a higher prevalence in cases's group of: previous mood disorders (100% of the cases group), maternal comorbidities (100% of the cases group), neuroticism (MMPI-2's scale 'NEGE': p=0.013), 'defensive' attitude (MMPI-2's scale 'K': p=0.013), hypochondria (MMPI-2' scale 'Hs': p=0.046), health concerns (MMPI-2's scale 'Hea': p=0.013) and depression (MMPI-2's scales 'D': p=0.012 and 'Dep': p=0.023; EPDS's scores: p=0.007), with a general tendency to have higher scores of psychopathology (p=0.033). No statistical significance was found concerning socio-demographic information and obstetrical risk factors.
Conclusion:Women who chose CS without medical indications showed more somatic anxiety levels, expressed with a hypochondriac rumination and an obsessive way to control their body. This seems associated with more neuroticism and more symptoms of depression which may lead to a higher risk of develop postnatal depression. Gynaecologists should pay attention to the reasons behind the mother's choice of an election CS by ensuring a detailed psychological counselling and try to mitigate levels of anxiety and fears related to the childbirth.
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