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BMC Pregnancy and Childbirth

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Open Access 01-12-2024 | Sectio Caesarea | Research

Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

Authors: Franziska Marie Lea Beck-Hiestermann, Lisa Kathrin Hartung, Nadine Richert, Sandra Miethe, Silke Wiegand-Grefe

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Abstract

Background

Empirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes.

Methods

The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS).

Results

For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size).

Limitation

Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation.

Conclusion

The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.

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Title: Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD
Authors: Franziska Marie Lea Beck-Hiestermann
Lisa Kathrin Hartung
Nadine Richert
Sandra Miethe
Silke Wiegand-Grefe
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Sectio Caesarea
Sectio Ceasarea
Postpartum Depression
Postpartum Depression
Post Traumatic Stress Disorder
Published in: BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-024-06267-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

Abstract

Background

Methods

Results

Limitation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Limitation

Conclusion

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