Adverse psychological impact of operative obstetric interventions: a prospective longitudinal study

Aust N Z J Psychiatry. 1997 Oct;31(5):728-38. doi: 10.3109/00048679709062687.

Abstract

Objective: This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures.

Method: Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period.

Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem.

Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cesarean Section / psychology*
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / psychology
  • Extraction, Obstetrical / psychology*
  • Female
  • Follow-Up Studies
  • Grief
  • Humans
  • Infant, Newborn
  • Male
  • Personality Assessment
  • Personality Inventory
  • Pregnancy
  • Prospective Studies
  • Self Concept
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology