Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study

Möller, Louise; Josefsson, Ann; Bladh, Marie; Lilliecreutz, Caroline; Andolf, Ellika; Sydsjö, Gunilla

doi:10.1186/s12884-017-1514-2

Cited by 10 publications

(11 citation statements)

References 21 publications

(38 reference statements)

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“…This is in line with previous studies, Larsson et al found that counseling for FOC is associated with an increased rate of elective CS and a preference for CS in future childbirth despite being satisfied with the counseling. As previously reported, 11,13,26 we found that women with FOC more often suffer appropriate measurement because it is easy and quick to fill out, thereby lowering the risk of low compliance. This is plausible, as previous studies have shown that a negative birth experience prolongs the time to next delivery, and women with FOC more often consider not having any more children.…”

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort

Möller

Josefsson

Lilliecreutz

et al. 2018

Acta Obstet Gynecol Scand

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Introduction: About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC. Material and methods:All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups.Results: Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P < 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth.Conclusions: FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth.

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Section: Discussionsupporting

confidence: 75%

“…23 We found no difference in the rate of complications during pregnancy and childbirth for either mother or infant; however, this may be due to a lack of power to detect such differences. As previously reported, 11,13,26 we found that women with FOC more often suffer from psychiatric disorders (life-time prevalence; 47.6% vs 12.9%).…”

Section: Discussionmentioning

confidence: 99%

Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort

Möller

Josefsson

Lilliecreutz

et al. 2018

Acta Obstet Gynecol Scand

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“…However, interventions provided by midwives have shown a reduction of CS, and also a preference for vaginal birth in future pregnancies (Fenwick et al, 2015;Larsson et al, 2015;Ryding et al, 2003). Other studies have shown that women who give birth by CS following maternal request, more often suffer from psychiatric illness both before and after the CS (Möller et al, 2017;Olieman et al, 2017). In an interview study with Japanese pregnant nulliparous women (Takegata et al, 2018), all participants denied preferring CS delivery due to the fear.…”

Section: Discussionmentioning

confidence: 99%

Women’s experiences of fear of childbirth: a metasynthesis of qualitative studies

Wigert

Nilsson

Dencker

et al. 2019

International Journal of Qualitative Studies on Health and Well

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Purpose: Women's experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women's experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women's experiences of fear of childbirth interpreted through the metaphor "being at a point of no return". Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other's experiences will not happen to them.

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“…One of the studied factors is the mode of delivery by which women give birth. The mode of delivery has been associated with various maternal complications during the puerperium and also in the long term [13,14,15,16,17,18,19]. One study conducted in China with 7046 women found that a cesarean section vs. instrumental delivery with forceps was associated with increased incidence of maternal infection during the puerperium, but less postpartum hemorrhage [13].…”

Section: Introductionmentioning

confidence: 99%

Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study

Martínez‐Galiano

Delgado-Rodrı́guez

Rodríguez‐Almagro

et al. 2019

IJERPH

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Despite abundant literature on antenatal and delivery care received by pregnant women, there is a wide knowledge gap on the prevalence of symptoms of discomfort or problems during the postpartum period and their relationship with the mode of delivery. This cross-sectional study, carried out with 3324 participants in Spain in 2017, aimed to investigate the association between the mode of delivery and self-reported postpartum symptoms of discomfort and maternal problems during the puerperium. An ad hoc online questionnaire was used to collect data on socio-demographic and obstetric variables, symptoms of discomfort, and maternal problems during the puerperium. The crude odds ratios (OR) and adjusted OR (aOR) and their 95% confidence intervals (95%CI) were calculated using binary logistic regression. In total, 3324 women participated. Compared to a normal vaginal delivery, having a cesarean section was associated with increased odds of an infected surgical wound (aOR: 11.62, 95%CI: 6.77–19.95), feeling sad (aOR: 1.31, 23 95%CI: 1.03–1.68), and symptoms of post-traumatic stress (aOR: 4.64, 95%CI: 2.94–7.32). Instrumental delivery vs. normal vaginal delivery was a risk factor for constipation (aOR: 1.35 95%CI: 25 1.10–1.66), hemorrhoids (aOR: 1.28, 95%CI: 1.04–1.57), urinary incontinence (aOR: 1.30, 95%CI: 26 1.05–1.61), and fecal incontinence (aOR: 1.94, 95%CI: 1.29–2.92) during the puerperium. Women who gave delivery via cesarean section or instrumental delivery had higher incidences of infection and psychological alterations than those who had a normal vaginal delivery. Identifying women at risk of giving birth by cesarean section and informing them about subsequent symptoms of discomfort and maternal problems during the puerperium must be included in pregnancy health program policies and protocols to allow women to make informed decisions regarding their birthing plan.

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Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study

Cited by 10 publications

References 21 publications

Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort

Reproduction, fear of childbirth and obstetric outcomes in women treated for fear of childbirth in their first pregnancy: A historical cohort

Women’s experiences of fear of childbirth: a metasynthesis of qualitative studies

Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study

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