Anxiety reduction through obstetric consultation combined with ultrasound examination in women after cesarean section

Abstract

• Literature on how to help women process and facilitate their birth experience after CS is scarce. • An obstetric consultation combined with an ultrasound examination decreases anxiety in women after CS. • The higher the state anxiety before the appointment the more positive effect of the appointment is. • A special consideration for women after a CS is important, particularly for those who have experienced trauma in relation to their CS. Women are at increased risk of developing anxiety or depression disorders after Cesarean section (CS). This study aims to evaluate whether an appointment with a senior obstetrician combined with an ultrasound examination reduces levels of anxiety in women after CS. A prospective observational study was conducted in Sweden. Women underwent an appointment with an obstetrician 6–9 months after their first CS. Before the appointment, women were asked to fill in the state and trait subscales of the Spielberger State-Trait Anxiety Inventory and the Beck's Depression Inventory. The women's experience of the childbirth was discussed and an ultrasound examination of the hysterotomy scar was performed. After the appointment, the participants filled in the state scale again. The women were divided into low trait anxiety (< 40) and high trait anxiety (≥ 40) groups for comparisons. 147 women were included. Of those, 114 (78%) had lower trait score <40 (mean 29.2 ± 5.4) and 33 (22%) had higher trait score ≥ 40 (mean 47.4 ± 6.5). Mean difference of state score in the low trait anxiety group before and after the examination was 4.8 ± 5.6 (95% CI 7.20 to 11.97, p <0.0001) and in the high trait anxiety group, the mean difference was 9.2 ± 6.5 (95% CI 3.77 to 5.82, p <0.0001). A clinical examination with a diagnosis of depression in these women was not made by a psychiatrist. Conclusions: A supportive obstetric consultation combined with an ultrasound examination of the uterine scar decreased anxiety levels in women after CS, particularly in patients with higher anxiety