Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review

Authors: Renske M. Olieman, Femke Siemonsma, Margaux A. Bartens, Susan Garthus-Niegel, Fedde Scheele, Adriaan Honig

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

Obstetricians are often reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear. To date, it is unknown if an ECS on request improves mental well-being in the mother in the peripartum period and if possible beneficial effects on anxiety and depression could outweigh the increased risk of complications associated with a surgical delivery. A systematic review was conducted to explore the effect of ECS on request on peripartum anxiety and depression.

Methods

We searched on PubMed, PsychoInfo and Embase. Studies were included with primary data on anxiety and/or depression postpartum in women with childbirth fear who had requested an ECS. After full-text evaluation of 65 papers and quality analysis of four papers, three papers were included. Of one paper additional and yet unpublished data were provided. Studies varied in outcome measures, hence no meta-analysis was performed.

Results

Women who requested an ECS had higher antepartum depression and anxiety levels but no different postpartum depression levels than women who delivered vaginally. One study of good quality examined the effect of vaginal delivery in women preferring ECS: These women had significantly higher symptom levels of post-traumatic stress disorder (PTSD) and depression than women with normal vaginal delivery.

Conclusions

The prospect of an ECS does not lower antepartum anxiety and/or depression levels in women requesting an ECS. If women resolutely persist in wishing an ECS despite adequate counselling and/or psychiatric treatment, the risk of developing depressive and PTSD symptoms in case of vaginal delivery should be taken into account, and an ECS may be considered as a valid alternative.
Appendix
Available only for authorised users
Literature
1.
2.
McFarlin BL. Elective cesarean birth: issues and ethics of an informed decision. J Midwifery Women’s Health. 2004;49(5):421–9.CrossRef
3.
Sufang G, Padmadas SP, Fengmin Z, Brown JJ, Stones RW. Delivery settings and cesarean section rates in China. Bull World Health Organ. 2007;85(10):755–62.CrossRefPubMedPubMedCentral
4.
Lumbiganon P, Laopaiboon M, Gülmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P, et al. World Health Organization global survey on maternal and Perinatal Health Research Group. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health2007-08. Lancet. 2010;375(9713):490–9.CrossRefPubMed
5.
Menacker F, Martin JA. BirthStats: rates of cesarean delivery, and unassisted and assisted vaginal delivery, United States, 1996, 2000, and 2006. Birth. 2009;36(2):167.CrossRefPubMed
6.
MacDorman MF, Menacker F, Declercq E. Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol. 2008;35(2):293–307.CrossRefPubMed
7.
Feng, X.L., Guo, L.X.Y., Ronsmans,C. (2012) Factors influencing rising cesarean section rates in China between 1988 and 2008. Bull World Health Organ 90(1):30-39, 39A.
8.
Badakhsh MH, Seifoddin M, Khodakarami N, Gholami R, Moghimi S. Rise in cesarean section rate over a 30-year period in a public hospital in Tehran, Iran. Arch Iran Med. 2012;15(1):4–7.PubMed
9.
Rauh C, Beetz A, Burger P, Engel A, Haberle L, Fasching P, et al. Delivery mode and the course of pre- and postpartum depression. Arch Gynecol Obstet. 2012;286:1407–12.CrossRefPubMed
10.
Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. WHO 2005 global survey on maternal and perinatal health research group. Cesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006;367(9525):1819–29.CrossRefPubMed
11.
12.
Hildingsson I, Nilsson C, Karlström A, Lundgren I. A longitudinal survey of childbirth-related fear and associated factors. JOGNN. 2011;40:532–43.CrossRefPubMed
13.
Yang SN, Shen LJ, Ping T, Wang YC, Chien CW. The delivery mode and seasonal variation are associated with the development of postpartum depression. J Affect Disord. 2011;132:158–64.CrossRefPubMed
14.
Wiklund I, Edman G, Andolf E. Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstet Gynecol. 2007;86:451–6.CrossRef
15.
Chen CH, Wang SY. Psychosocial outcomes of vaginal and cesarean births in Taiwanese primiparas. Res Nurs Health. 2002;25:452–8.CrossRefPubMed
16.
Adams SS, Eberhard-Gran M, Sandvik AR, Eskild A. Mode of delivery and postpartum emotional distress: a cohort study of 55814 women. BJOG. 2012;119:298–305.CrossRefPubMed
17.
Souza, J.P., Gülmezoglu, A., Lumbiganon, P., Laopaiboon, M., Carroli, G., Fawole, B. Ruyan, P. (2010) Caesarean section without medical indication is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO global survey on maternal and Perinatal health. BMC Med 10;8(71): 1-10.
18.
Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective cesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15:221.CrossRefPubMedPubMedCentral
19.
Zhang S, Huang X, Tan H. Prenatal anxiety and cesarean section with non-medical indication. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013;38(10):1070–4.PubMed
20.
Karlström A, Nystedt A, Hildingsson I. A comparative study of the experience of childbirth between women who preferred and had a cesarean section and women who preferred and had a vaginal birth. Sex Reprod Healthc. 2011;2(3):93–9.CrossRefPubMed
21.
Karlström A, Radestad I, Eriksson C, Rubertsson C, Nystedt A, Hildingsson I. Cesarean section without medical reason 1997-2006. A Swedish register study. Birth. 2010;37(1):11–20.CrossRefPubMed
22.
Ecker, J. (2013) Elective cesarean delivery on maternal request. JAMA 8;309(18):1930-1936.
23.
Ryding EL, Lukasse M, Kristjansdottir H, Steingrimsdottir T, Schei B. Pregnant women’s preference for cesarean section and subsequent mode of birth – a six-country cohort study. J Psychosom Obstet Gynecol. 2016;37(3):75–83.CrossRef
24.
Waldenström U, Hildingsson I, Ryding E. Antenatal fear of childbirth and its association with subsequent cesarean section and experience of childbirth. BJOG. 2006;113(6):638–46.CrossRefPubMed
25.
Hildingsson I, Radestad I, Rubertsson C, Waldenström U. Few women wish to be delivered by cesarean section. BJOG. 2002;109(6):618–23.CrossRefPubMed
26.
Karlström A, Engström-Olofson R, Nystedt A, Thomas J, Hildingsson I. Swedish caregivers’ attitudes towards cesarean section on maternal request. Women Birth. 2009;22:57–63.CrossRefPubMed
27.
Halvorsen L, Nerum, H., Oian, P., Sorlie, T. (2008) Is there an association between psychological stress and request for caesarian section? Tidsskr Nor Laegeforen. 12;128(12):1388-1391.
28.
Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of women’s perceptions of the childbirth experience. J Obstet Gynecol Neonat Nursing. 2008;37:24–34.CrossRef
29.
Hildingsson I. How much influence do women in Sweden have on cesarean section? A follow-up study of women’s preferences in early pregnancy. Midwifery. 2008;24:46–54.CrossRefPubMed
30.
Sydsjö G, Möller L, Lilliecreutz C, Bladh M, Andolf E, Josefsson A. Psychiatric illness in women requesting cesarean section. BJOG. 2015;122(3):351–8.CrossRefPubMed
31.
Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women – randomized trial. BJOG. 2013;120(1):75–84.CrossRefPubMed
32.
Saisto T, Toivanen R, Salmela-Aro K, Halmesmäki E. Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand. 2006;85:1315–9.CrossRefPubMed
33.
Sjögren B. Fear of childbirth and psychosomatic support. A follow up of 72 women. Acta Obstet Gynecol Scand. 1998;77:819–25.CrossRefPubMed
34.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
35.
Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011. Available from http://​handbook.​cochrane.​org.
36.
Garthus-Niegel S, von Soest T, Knoph C, Breines Simonsen T, Torgersen L, Eberhard-Gran M. The influence of women’s preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study. BMC Pregnancy Childbirth. 2014;14:191.CrossRefPubMedPubMedCentral
37.
Saisto T, Salmela-Aro K, Nurmi JE, Halmesmäki E. Psychosocial predictors of disappointment with delivery and puerperal depression. A longitudinal study. Acta Obstet Gynecol Scand. 2001;80(1):39–45.PubMed
38.
Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth predicts postpartum depression: a population-based analysis of 511 422 singleton births in Finland. BMJ Open. 2013;28:3(11).
39.
40.
Nielsen FD, Videbech P, Hedegaard M, Dalby SJ, Secher NJ. Postpartum depression: identification of women at risk. BJOG. 2000;107:1210–07.CrossRef
41.
Johnstone SJ, Boyce PM, Hickey AR, Morris-Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Aust N Z J Psychiatry. 2001;35(1):69–74.CrossRefPubMed
42.
Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand. 2012;91:1261–72.CrossRefPubMed
43.
44.
Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN Obstet Gynecol. 2012;2012:616759.PubMedPubMedCentral
45.
Gosselin P, Chabot K, Béland M, Goulet-Gervais L, Morin AJS. La peur de l’accouchement chez des nullipares: lien avec la douleur lors de l’acouchement, les symptômes de stress post-traumatique et les symptômes dépressifs post-partum. L’Encephale. 2015;42:191–6.CrossRef
46.
Fink P, Ørbøl E, Hansen MS, Søndergaard L, De Jonge P. Detecting mental disorders in general hospitals by the SCL-8 scale. J Psychosom Res. 2004;56(3):371–5.CrossRefPubMed
47.
Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19:84–97.CrossRefPubMed
48.
Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.CrossRefPubMed
49.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Brit J Psychiat. 1987;150:782–6.CrossRefPubMed
50.
Cox JL, Chapman G, Murray D, Jones P. Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women. J Affect Disord. 1996;39:185–9.CrossRefPubMed
51.
Rowlands, I.J. and Redshaw, M. (2012) Mode of birth and women’s psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth. 28;12:138.
52.
Law LW, Pang MW, Chung TK, Lao TT, Lee DT, Leung TY, et al. Randomised trial of assigned mode of delivery after a previous cesarean section. Impact on maternal psychological dynamics. J Maternal-Fetal and Neonatal Med. 2010;23(10):1106–13.CrossRef
53.
Nikpour M, Delavar MA, Abedian Z. Type of delivery and self-reported postpartum symptoms among Iranian women. Clin Exp Obstet Gynecol. 2013;40(1):144–7.PubMed
54.
Srkalovi Srkalović Imširagić A, Begić D, Šimičević L, Bajić Ž.(2017). Prediction of posttraumatic stress disorder symptomatology after childbirth - a Croatian longitudinal study. Women Birth. 2017 Feb;30(1):e17-e23.
55.
Blüml V, Stammler-Safar M, Reitinger AK, Resch I, Naderer A, Leithner K. A qualitative approach to examine women’s experience of planned cesarean. JOGNN. 2012;41:E82–90.CrossRefPubMed
56.
57.
Houston K, Kaimal AJ, Nakagawa S, Gregorich SE, Yee LM, Kuppermann M. Mode of delivery and postpartum depression: the role of patient preferences. Am J Obset Gynecol. 2014;211:1. e1-7CrossRef
58.
Saisto T, Samela-Aro K, Nurmi JE, Könönen T, Halsemäki E. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001;98:820–6.PubMed
59.
Weaver J, Browne J, Aras-Payne A, Magill Cuerden J. A comprehensive systematic review of the impact of planned interventions offered to pregnant women who have requested a cesarean section as a result of tokophobia (fear of childbirth). JBI Libr Syst Rev Implement Rep. 2013;11(1):70–122.CrossRef
Metadata
Title
The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review
Authors
Renske M. Olieman
Femke Siemonsma
Margaux A. Bartens
Susan Garthus-Niegel
Fedde Scheele
Adriaan Honig
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1371-z

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue

Research article

Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia

Research article

Comparison of rapid immunoassays for rupture of fetal membranes

Research article

Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study

Research article

The effectiveness of double incision technique in uterus preserving surgery for placenta percreta

Research article

Lack of controlled studies investigating the risk of postpartum haemorrhage in cesarean delivery after prior use of oxytocin: a scoping review

Research article

Increased postpartum haemorrhage, the possible relation with serotonergic and other psychopharmacological drugs: a matched cohort study