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caesarean ops 'no help for blues'



 
 
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  #1  
Old April 12th 05, 08:06 PM
Anna
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Default caesarean ops 'no help for blues'

I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?

Thanks Anna
  #2  
Old April 12th 05, 10:26 PM
Chotii
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"Anna" wrote in message
om...
I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?


I suspect that women who have poor birth experiences, which in many cases
include cesareans (when women feel railroaded or forced into the surgery
against their will), will be more likely to experience post-natal
depression. And of course, women who have traumatic natural birth (or more
likely, operative vaginal birth) experiences, who think they should have had
cesareans, will likewise be more prone to depression. Why? Because *some*
depression is anger turned inward. If you can't be angry at your doctor
("Because he saved my life!!!") then you have to be angry at someone. And
that only leaves yourself or your baby.

Of course, much Post Natal Depression is chemical in nature. That's a
separate issue.

--angela


  #3  
Old April 12th 05, 10:55 PM
Emily
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Anna wrote:
I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?

Thanks Anna


There was a news article about a study of this connection (with
a headline similar to your subject, btw -- maybe you know of
it already?). If you haven't seen it, I think you'd find it
interesting, though perhaps not convincing. It was discussed on
this group, though I don't have time to google it right now.

Emily
  #4  
Old April 12th 05, 11:15 PM
Donna Metler
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"Anna" wrote in message
om...
I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?

Thanks Anna

I can only give you anecdotal data, but I can tell you that for me, the pain
following my C-section DEFINITELY made it harder to deal with everyday baby
stuff, and therefore made it much easier to feel overwhelmed and depressed.
Add that to at least some guilt feelings, because of being unable to give
birth the "right" way, and it definitely contributed.



  #5  
Old April 13th 05, 12:53 PM
Hope
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On 12 Apr 2005 12:06:24 -0700, (Anna) wrote:

I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?

Thanks Anna


This isn't what I was lookin for but some of these abstracts might
interest you.

Elective cesarean section vs. spontaneous delivery: a comparative
study of
birth experience.
Acta Obstet Gynecol Scand. 2003 Sep;82(9):834-40
Schindl M, Birner P, Reingrabner M, Joura E, Husslein P, Langer M.
Department of Obstetrics and Gynecology, University of Vienna,
Austria.


BACKGROUND: To investigate birth experience and medical outcome in
women
with elective cesarean section (CS) compared with women with intended
vaginal delivery. METHODS: A total of 1050 pregnant women were
included in
this prospective trial. Psychological factors, pain levels and birth
experience were investigated using a self-designed questionnaire and
three
established psychological tests in gestational week 38, and 3 days and
4
months postpartum. In addition, medical data were evaluated from the
records. RESULTS: Out of 903 women with planned vaginal birth, in 484
women
(53.6%) minimal perineal surgery had to be performed after birth, 41
women
(4.5%) had vacuum deliveries, and in 93 cases (10.3%) emergency CS had
to be
performed. In the 147 elective CS (103 based on medical and 44 on
psychological factors), a significantly lower rate of maternal and
fetal
complications was observed when compared with vaginal birth (5.4% vs.
19.3%;
p 0.0001). Birth experience (Salmon test) was significantly better
in
elective CS compared with vaginal delivery, but worse in women with
emergency CS and worst in those with vacuum delivery. We found that
83.5% of
women with vaginal delivery would choose the same mode of birth again,
74.3%
of women with CS on demand, and 66% of women with medically necessary
CS.
Only 30.1% of women with emergency CS wanted to receive CS at the next
birth. CONCLUSIONS: Elective CS is a safe and psychologically well
tolerated
procedure. The results are comparable with uncomplicated vaginal
delivery
and far superior to secondary intervention such as vacuum delivery or
emergency CS.

PMID: 12911445 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~~
Psychological impact of emergency cesarean section in comparison with
elective cesarean section, instrumental and normal vaginal delivery.
J Psychosom Obstet Gynaecol. 1998 Sep;19(3):135-44.
Ryding EL, Wijma K, Wijma B.
Department of Obstetrics and Gynaecology, Central Hospital,
Helsingborg,
Sweden.

The purpose of the study was to compare the psychological reactions of
women
after emergency Cesarean section (EmCS), elective Cesarean section
(ElCS),
instrumental vaginal delivery (IVD) and normal vaginal delivery (NVD).
The
participants (EmCS, n = 71, ElCS, n = 70, IVD, n = 89, and NVD, n =
96)
answered questionnaires a few days postpartum and 1 month postpartum.
The
EmCS group reported the most negative delivery experience at both
times,
followed by the IVD group. At a few days postpartum the EmCS group
experienced more general mental distress than the NVD group, but not
when
compared with the ElCS or the IVD groups. At 1 month postpartum the
EmCS
group showed more symptoms of post-traumatic stress than the ElCS and
NVD
groups, but not when compared to the IVD group. An unplanned
instrumental
delivery (EmCS or IVD) should be regarded as a pointer with respect to
possible post-traumatic stress.

PMID: 9844844 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~`
Outcomes at 3 months after planned cesarean vs planned vaginal
delivery for
breech presentation at term: the international randomized Term Breech
Trial.
JAMA. 2002 Apr 10;287(14):1822-31
Hannah ME, Hannah WJ, Hodnett ED, Chalmers B, Kung R, Willan A,
Amankwah K,
Cheng M, Helewa M, Hewson S, Saigal S, Whyte H, Gafni A; Term Breech
Trial
3-Month Follow-up Collaborative Group.
Department of Obstetrics and Gynaecology, Sunnybrook and Women's
College
Health Sciences Centre, University of Toronto, Toronto, Ontario,
Canada.


CONTEXT: The Term Breech Trial found a significant reduction in
adverse
perinatal outcomes without an increased risk of immediate maternal
morbidity
with planned cesarean delivery compared with planned vaginal birth. No
randomized controlled trial of planned cesarean delivery has measured
benefits and risks of postpartum outcomes months after the birth.
OBJECTIVE:
To compare maternal outcomes of planned cesarean delivery and planned
vaginal birth at 3 months post partum. DESIGN: Follow-up study to the
Term
Breech Trial, a randomized controlled trial conducted between January
9,
1997, and April 21, 2000. SETTING AND PARTICIPANTS: A total of 1596 of
1940
women from 110 centers worldwide who had a singleton fetus in breech
presentation at term responded to a follow-up questionnaire at 3
months post
partum. MAIN OUTCOME MEASURES: Breastfeeding; infant health; ease of
caring
for infant and adjusting to being a new mother; sexual relations and
relationship with husband/partner; pain; urinary, flatal, and fecal
incontinence; depression; and views regarding childbirth experience
and
study participation. RESULTS: Baseline information was similar for
both the
cesarean and vaginal delivery groups. Women in the planned cesarean
delivery
group were less likely to report urinary incontinence than those in
the
planned vaginal birth group (36/798 [4.5%] vs 58/797 [7.3%]; relative
risk,
0.62; 95% confidence interval, 0.41-0.93). Incontinence of flatus was
not
different between groups but was less of a problem in the planned
cesarean
delivery group when it occurred (P =.006). There were no differences
between
groups in other outcomes. CONCLUSIONS: Planned cesarean delivery for
pregnancies with breech presentation at term may result in a lower
risk of
incontinence and is not associated with an increased risk of other
problems
for women at 3 months post partum,

****although the effect on longer-term outcomes is uncertain.****

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 11939868 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~~`
Women's perceptions of vaginal and cesarean deliveries.
Nurs Res. 1983 Jan-Feb;32(1):10-5.
Cranley MS, Hedahl KJ, Pegg SH.

Three groups of women were compared to determine their perceptions of
giving
birth and the relationships between those perceptions and their degree
of
participation in decision making, the type of anesthesia for delivery,
and
the presence of their husbands at the births. Forty women had vaginal
deliveries; 39 had emergency cesareans, and 43 had planned cesareans.
All
the women were interviewed and completed self-administered
questionnaires
two to four days after delivery. The three groups had significantly
different perceptions of the birth experience with the emergency
cesarean
birth group having the most negative perception. Among women having
cesareans, more positive perceptions were associated with regional
anesthesia, presence of their husbands at delivery, and greater
participation in decision making. Women in the cesarean groups were
less
likely to breast feed, and those having planned cesareans were least
likely
to attend childbirth classes. Many of the women were unaware of the
options
available to them that could influence the birth experiences.

PMID: 6549836 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~~~
Women's perceptions of cesarean and vaginal delivery: another look.
Res Nurs Health. 1992 Dec;15(6):439-46
Fawcett J, Pollio N, Tully A.
School of Nursing, University of Pennsylvania.

Perception of the birth experience was examined in a sample of 106
women who
had unplanned cesarean deliveries, 113 who had planned cesarean
deliveries,
and 254 who had vaginal deliveries. Vaginally delivered women had more
positive perceptions than their unplanned cesarean counterparts (p
..001).
There were no differences in perceptions between the unplanned and
planned
cesarean groups, or between the planned cesarean and vaginal groups.
General
anesthesia for cesarean delivery was associated with more negative
perceptions than regional anesthesia, and regional anesthesia for
vaginal
delivery was associated with more negative perceptions than no or
local
anesthesia. Pain intensity and physical distress were negatively
correlated
with perceptions.

PMID: 1448575 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~~~`
The opinion of Brazilian women regarding vaginal labor and cesarean
section.
Int J Gynaecol Obstet. 2001 Nov;75 Suppl 1:S59-66
Osis MJ, Padua KS, Duarte GA, Souza TR, Faundes A.
Center for Research into Maternal-Infant Diseases of Campinas
(CEMICAMP),
Campinas, Brazil.


OBJECTIVES: The opinions of Brazilian women regarding vaginal delivery
and
cesarean sections was studied. METHODS: Six hundred and fifty-six
women who
had given birth in seven hospitals in Sao Paulo and Pernambuco, using
the
Public Health Service, were interviewed. The opinions of women who had
delivered only by cesarean section was compared with those of women
who had
had at least one vaginal delivery. RESULTS: Significantly more women
who had
experienced at least one vaginal delivery considered this to be the
best way
of giving birth (90.4% vs. 75.9% among C-section-only women). Similar
proportions in both groups (45.5% and 42.8%) stated that vaginal labor
is
better because it causes less pain and suffering for the woman.
Significantly more women who had experienced a vaginal labor (47.1%
vs.
30.3%) reported that it had no disadvantage. More women who had only
had
cesarean sections referred not having contractions/pain as an
advantage of
this method (56.7% vs. 41.7%). CONCLUSIONS: Apparently, pain and
women's
perception of pain were the characteristics which differentiated women
with
history of vaginal delivery from those with cesarean sections in the
sample
studied. However, the opinion that vaginal delivery is better than
cesarean
section was expressed independently of the recognition that pain could
be
its main disadvantage.

PMID: 11742644 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~
Changes in attitudes toward cesarean birth.
J Obstet Gynecol Neonatal Nurs. 1993 Mar-Apr;22(2):159-67
Reichert JA, Baron M, Fawcett J.
Pennsylvania Hospital, Philadelphia.

OBJECTIVE: To compare the findings of three studies of women's
responses to
planned and unplanned cesarean birth. DESIGN: Descriptive. SETTING:
Private
obstetric practices, childbirth education classes, and hospital
postpartum
units. PARTICIPANTS: Study 1: 24 women who had cesarean deliveries
between
1973 and 1980; Study 2: 15 women who delivered in 1981-82; Study 3:
173
women who delivered in 1989-90. MAIN OUTCOME MEASU Qualitative data
were
obtained by an investigator-developed open-ended questionnaire that
was
mailed to participants after cesarean delivery. RESULTS: The findings
from
the three studies indicate that the dominant responses to cesarean
birth are
happiness and excitement about the newborn, accompanied by
disappointment
about having to have a cesarean delivery. The women in Study 1
expressed the
highest proportion of ineffective responses and the lowest proportion
of
adaptive responses (p = .003), whereas the women in Studies 2 and 3
expressed approximately equal percentages of adaptive and ineffective
responses. Women who had unplanned cesarean deliveries had a lower
percentage of adaptive responses and a higher percentage of
ineffective
responses than those who had planned cesarean deliveries (p .05).
Women
who had regional anesthesia had more adaptive responses than those who
had
general anesthesia (p = .0217). CONCLUSION: The findings suggest that
women
who deliver by cesarean section require continued attention and
sensitive
care that takes into account their special needs for information, for
the
presence of their partners throughout the birth experience, and for
sustained contact with their newborn.

PMID: 8478739 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~~~```
The cesarean birth experience: implications for nursing.
Birth Defects Orig Artic Ser. 1981;17(6):129-52
Marut JS, Mercer RT.

A comparative field study was done to collect both quantitative and
qualitative data to determine if women perceived their childbirth
experience
less positively when they had cesarean deliveries and in what ways.
The
hypothesis, primiparas having an emergency cesarean birth will have a
less
positive perception of their birth experience than those who deliver
vaginally, was supported at the .01 level of significance (t test).
Perceptions of 20 primiparas having an emergency cesarean birth and 30
primiparas having a vaginal birth were measured by a 29 item
questionnaire
within 48 hours postpartally. More cesarean delivered women had not
named
their infants; this difference was significant at the 0.005 level.
Within
the cesarean group, those who had general anesthesia had less positive
perceptions of their experience than those who had regional anesthesia
(0.05
level of significance). The presence of a support person with them
during
surgery did not significantly affect perceptions, but further research
is
recommended. The qualitative analysis of the data revealed a number of
concepts. There was an underlying theme that a cesarean delivery
signified
weakness in relation to her potential mothering ability. Cesarean
delivered
mothers suffered a loss in self-esteem, possibly due to unfulfilled
expectations for a vaginal delivery and the physical trauma and
corresponding loss of control due to the surgery. These women
experienced a
sense of failure due to the procedure and expressed doubts that the
infant
was their own newborn. As a group they exhibited little physical or
emotional energy for mothering.

PMID: 7326369 [PubMed - indexed for MEDLINE]
~~~~~~~~~~~~~~~~~~~``
Relationship of psychosocial and perinatal variables to perception of
childbirth.
Nurs Res. 1983 Jul-Aug;32(4):202-7.
Mercer RT, Hackley KC, Bostrom AG.

This study reported on a sample of 294 first-time mothers. Fifty-six
women
who delivered by cesarean birth perceived their childbirth experience
more
negatively than those who delivered vaginally. However, the type of
delivery
accounted for only 1% of the variance when entered with 24 other
psychosocial and obstetrical variables for stepwise multiple
regression
analysis. Mate emotional support contributed 20% and early
maternal-infant
interaction contributed 9.8% of the variance, with total positive
self-concept, fewer medical complications, informative support,
instrumental
support, and type of delivery accounting for the remainder of the
total 39%.

PMID: 6553242 [PubMed - indexed for MEDLINE]

--
Riley 1993 c/s
Tara 2002 HBAC
  #8  
Old April 16th 05, 08:44 PM
Welches
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"Anna" wrote in message
om...
I am currently working on a project to investigate if there is any
link between post natal depression and caesarean sections.

Does anyone have any information that supports or disproves this
theory?

Thanks Anna

You're too late: it's been done!
http://news.bbc.co.uk/1/hi/england/bristol/4451951.stm
Debbie


 




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