Abstract

BackgroundAlthough the impact of emergency procedures on the childbirth experience has been studied extensively, a possible association of childbirth experience with indications for emergency interventions has not been reported.ObjectivesTo compare the impacts on childbirth experience of ‘planned’ delivery (elective cesarean section and vaginal delivery) versus ‘unplanned’ delivery (vacuum extraction or emergency cesarean section); the intervention itself (vacuum extraction versus emergency cesarean section); and indications for intervention (arrest of labor versus risk to the mother or fetus).Study designA total of 469 women, up to 72 hours post-partum, in the maternity ward of one tertiary health care institute completed the Subjective Childbirth Experience Questionnaire (score: 0–4, a higher score indicated a more negative experience) and a Personal Information Questionnaire. Intra-partum information was retrieved from the medical records. One-way analysis of variance and two-way analysis of variance, followed by analysis of covariance, to test the unique contribution of variables, were used to examine differences between groups in outcome. Tukey's Post-Hoc analysis was used when appropriate.ResultsPlanned delivery, either vaginal or elective cesarean section, was associated with a more positive experience than unplanned delivery, either vacuum or emergency cesarean section (mean respective Subjective Childbirth Experience scores: 1.58 and 1.49 vs. 2.02 and 2.07, P <0.01). The difference in mean Subjective Childbirth Experience scores following elective cesarean section and vaginal delivery was not significant; nor was the difference following vacuum extraction and emergency cesarean section. Interventions due to immediate risk to mother or fetus resulted in a more positive birth experience than interventions due to arrest of labor (Subjective Childbirth Experience: 1.9 vs. 2.2, P <0.01).ConclusionsCompared to planned interventions, unplanned interventions were shown to be associated with a more negative maternal childbirth experience. However, the indication for unplanned intervention appears to have a greater effect than the nature of the intervention on the birth experience. Women who underwent emergency interventions due to delay of birth (arrest of labor) perceived their birth experience more negatively than those who underwent interventions due to risk for the mother or fetus, regardless of the nature of the intervention (vacuum or emergency cesarean section). The results indicate the importance of follow-up after unexpected emergency interventions, especially following arrest of labor, as negative birth experience may have repercussions in a woman's psychosocial life and well-being.

Highlights

  • IntroductionA positive delivery experience may have a long lasting effect on a woman’s feelings of self-worth [1]

  • Childbirth is an important life event for women

  • The indication for unplanned intervention appears to have a greater effect than the nature of the intervention on the birth experience

Read more

Summary

Introduction

A positive delivery experience may have a long lasting effect on a woman’s feelings of self-worth [1]. A recent meta-analysis demonstrated that the risk factors most strongly associated with post-partum PTSD were negative subjective birth experience, operative birth [assisted vaginal or cesarean section (CS)], lack of support, and dissociation [6]. The performance of fewer interventions in delivery was reported to be associated with a more positive childbirth experience [7, 8]. The performance of more obstetric interventions was found to be associated with a traumatic experience [9]. Other studies have suggested that the degree of women’s involvement in decision-making, support during labor, effective analgesia [10] and personal expectations [11] may have greater impact than mode of delivery on childbirth experience. The impact of emergency procedures on the childbirth experience has been studied extensively, a possible association of childbirth experience with indications for emergency interventions has not been reported

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call