Postnatal quality of life in women after normal vaginal delivery and caesarean section

Behnaz Torkan,Minoor Lamyian,Sousan Parsay,Anoshirvan Kazemnejad,Ali Montazeri

doi:10.1186/1471-2393-9-4

Abstract

BackgroundCaesarean section might increase the incidence of surgical interventions and problems resulting from hospitalization and thus affecting quality of life in women after delivery. This study aimed to compare quality of life in women after normal delivery and caesarean section.MethodsThis was a prospective study. A sample of women with normal delivery and caesarean section from 5 health care centers in Isfahan, Iran were entered into the study. Quality of life was measured using the SF-36 at two points in time (time 1: 6 to 8 weeks after delivery; time 2: 12 to 14 weeks after delivery). Data were analyzed to compare quality of life in the two study groups.ResultsIn all 100 women were interviewed (50 with normal delivery and 50 with caesarean section). Postnatal quality of life in both groups was improved from time1 to time 2. However, comparing the mean scores between the normal and caesarean delivery groups the results showed that in general the normal vaginal delivery group had a better quality of life for almost all subscales in both assessment times. The differences were significant for vitality (mean score 62.9 vs. 54.4 P = 0.03) and mental health (mean score 75.1 vs. 66.7, P = 0.03) at first assessment and for physical functioning (mean score 88.4 vs. 81.5, P = 0.03) at second evaluation. However, comparing the findings within each group the analysis showed that the normal vaginal delivery group improved more on physical health related quality of life while the caesarean section group improved more on mental health related quality of life.ConclusionAlthough the study did not show a clear cut benefit in favor of either methods of delivery that are normal vaginal delivery or caesarean section, the findings suggest that normal vaginal delivery might lead to a better quality of life especially resulting in a superior physical health. Indeed in the absence of medical indications normal vaginal delivery might be better to be considered as the first priority in term pregnancy.

Highlights

Caesarean section might increase the incidence of surgical interventions and problems resulting from hospitalization and affecting quality of life in women after delivery
The analysis indicated that in all subscales the normal delivery group showed a better condition except for the general health subscale
These differences were statistically significant for the vitality (P = 0.03) and the mental health (P = 0.03)

Summary

Introduction

Caesarean section might increase the incidence of surgical interventions and problems resulting from hospitalization and affecting quality of life in women after delivery. The debate on the best practice (vaginal delivery versus caesarean section) to minimize postnatal morbidity still is a matter of controversy both from professionals' perspectives [3] and from women's perceptions of the childbirth experience [4]. Discussion about such issues goes beyond the scope of this paper but concerns about increase in caesarean section rates remain unresolved, yet this increase is not associated with improvement in postpartum mortality or morbidity [5]. The study suggested that the problem identified in Brazil may extend well beyond Brazil and should be of concern to those with responsibility for ethical behavior in obstetric [7]

Objectives

Methods

Results

Discussion

Conclusion