Mother’s mental health after childbirth: Does the delivery method matter?

Tonei, Valentina

doi:10.1016/j.jhealeco.2018.11.006

Cited by 26 publications

(20 citation statements)

References 66 publications

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“…What we provide regarding health outcomes is an analysis of the effect of the budget cuts on short-term birth outcomes, but we cannot provide an analysis of the potential long-term consequences, which are reported in other papers in the literature. Regarding maternal health, C-sections have been associated with some postpartum maternal health problems, including urinary dysfunction, gastrointestinal dysfunction, dyspareunia, difficulties breastfeeding, psychological health challenges, intensified exhaustion, lack of sleep, and bowel problems ( Thompson et al 2002 , Guilliam, 2006 , Tonei, 2019 ). We cannot observe any of these maternal health variables in our sample, but we do have information on the rate of maternal death during delivery.…”

Section: Baseline Resultsmentioning

confidence: 99%

The effect of budget cuts on C-section rates and birth outcomes: Evidence from Spain

Bertoli

Grembi

Hesse

et al. 2020

Social Science & Medicine

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Using data from Spain, we show the impact of significant health-sector budget cuts introduced in 2012 on the rates of cesarean sections and on infant health outcomes at birth, which we use as a proxy for the quality of birth centers. Exploiting a difference-in-differences fixed-effects approach at the hospital level, we estimate a 3% increase in C-sections as a result of the budget restrictions, with no significant consequences on health outcomes at birth. Given the additional evidence in the literature on the negative short- and long-term effects of non-medically indicated C-sections, our paper provides important policy implications for population health.

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Section: Baseline Resultsmentioning

confidence: 99%

The effect of budget cuts on C-section rates and birth outcomes: Evidence from Spain

Bertoli

Grembi

Hesse

et al. 2020

Social Science & Medicine

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“…To eliminate the potential impact of unobserved factors, following [31][32]11], we also applied instrumental variables regressions, i.e. used potentially exogenous variables that affect the probability of C-section but are otherwise independent of mental health, such as the day of birth (weekday vs. weekend), the relative distance of the mother from hospitals with high vs. low C-section rates, or the presentation of the foetus.…”

Section: Discussionmentioning

confidence: 99%

“…Also, a recent paper, using instrumental variable techniques, estimates that caesarean delivery substantially increases the probability of post-traumatic distress and depression. [11] We contribute to this strand of the literature by using an objective indicator of depression (antidepressant use), and by looking at the detailed time pattern of antidepressant use at a long period, up to three years before and three years after delivery.…”

Section: Introductionmentioning

confidence: 99%

Caesarean delivery and the use of antidepressants

Bíró

Elek

2020

European Journal of Public Health

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Background The high ratio of caesarean sections (C-sections) is a major public health issue in the developed world; but its implications on maternal mental health are not well understood. Methods We use individual-level administrative panel data from Hungary between 2010 and 2016 to analyze the relationship between caesarean delivery and antidepressant consumption, an objective indicator of mental health. We focus on low-risk deliveries of mothers without subsequent birth in 3 years, and include around 135 000 observations. Results After controlling for medical and socio-economic variables, antidepressant use before delivery is associated with an elevated risk of C-section (adjusted OR = 1.10, 95% CI 1.05–1.14) and C-section is associated with a higher probability of antidepressant use within 1–3 years after delivery (e.g. adjusted OR = 1.21, 95% CI 1.12–1.30, within 3 years after delivery, among mothers without pre-delivery antidepressant consumption). Our data restriction ensures that the results are not driven by a mechanical impact of decreasing fertility on the continuation of antidepressant use after a C-section. Conclusions The results suggest that C-section is associated with worse mental health over the 1- to 3-year horizon after birth. This relationship is particularly important if a caesarean delivery is not necessary due to medical reasons, and physicians as well as expectant mothers should be made aware of the potential mental health implications of the mode of delivery.

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“…The baseline wave of the MCS was in the late postnatal period, when the study children were around nine months of age. At this wave mothers were asked whether they had felt low or sad for a period of two weeks or more since the baby was born, consistent with low-threshold questions that are sometimes used in screening for postnatal depression [41], and which has been used as a measure of postnatal depression [42]. Mothers also completed a modified version of the Rutter Malaise Inventory on which a score of more than 4 indicated depressive symptoms [43].…”

Section: Measures Of Maternal Depressionmentioning

confidence: 99%

Is socioeconomic inequality in postnatal depression an early-life root of disadvantage for children?

Ride

2019

Eur J Health Econ

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This paper investigates the role that socioeconomic inequality in postnatal depression might play in intergenerational transmission of inequality. Infants' development is thought to be particularly sensitive to mothers' mental health at this time, suggesting that greater early life exposure to maternal depression among disadvantaged groups might be a root of later socioeconomic inequalities. Heightened contact with health services during this period presents opportunities for intervention, but higher unmet need for treatment of postnatal depression among the disadvantaged might be widening inequalities. The aim of this study is to quantify the potential contribution of postnatal depression to socioeconomic inequalities in adverse childhood health and development outcomes. Regression-based decomposition of the concentration index is used to explore the association between income inequality in postnatal depressive symptoms and income inequality in children's outcomes. Four problems of early adolescence are explored: emotional and conduct problems, special educational needs, and low self-assessed health. Data are taken from the UK Millennium Cohort Study, with a sample of 4,359 mothers and children with complete data on outcomes and covariates, and a second sample of 5,441 when missing covariates are filled using multiple imputation. The key finding is that socioeconomic inequality in maternal postnatal depression is a significant contributor to inequalities in special educational needs, emotional problems, and low self-assessed health for children at age 11, even after accounting for a range of other factors that might explain such associations. These findings highlight the importance of understanding the impact of postnatal depression interventions on inequalities, and the downstream influence on children's outcomes. Addressing inequalities in mothers' postnatal depression might be an avenue for reducing early life disadvantage for children.

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Mother’s mental health after childbirth: Does the delivery method matter?

Cited by 26 publications

References 66 publications

The effect of budget cuts on C-section rates and birth outcomes: Evidence from Spain

The effect of budget cuts on C-section rates and birth outcomes: Evidence from Spain

Caesarean delivery and the use of antidepressants

Is socioeconomic inequality in postnatal depression an early-life root of disadvantage for children?

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