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

Jane Fisher, Jill Astbury, Anthony Smith

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122 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)728-738
Number of pages11
JournalAustralian and New Zealand Journal of Psychiatry
Volume31
Issue number5
DOIs
Publication statusPublished - 1 Jan 1997
Externally publishedYes

Keywords

  • Caesarean
  • Depression
  • Forceps-assisted delivery
  • Posttraumatic stress disorder

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