Abstract
Objective: The present study was designed to evaluate women postpartum quality of life after different modes of delivery in Pakistan.Methods: A descriptive cross-sectional study design was used. A pre-validated tool SF-36 was self-administered to a sample of 382 women in the postpartum period (6-8 w, 10-12 w, 14-16 w,>9 mo,>15 mo) undergone through elective/emergency cesarean sections or normal vaginal delivery and had delivered a single live child. After data collection, data was cleaned coded and entered in SPSS version 21.0. Descriptive statistics comprising of frequency and percentages was calculated. The non-parametric tests including Mann-Whitney and Kruskal-Walis (p ≥ 0.05) were performed to find out the difference among different variables.Results: Comparison of HRQOL domains by mode of delivery using Mann-Whitney test demonstrated a significant difference (p=0.01) between normal delivery and cesarean section. Women undergoing normal delivery had significantly higher scores as compared to women having cesarean section. Also, a significant difference (p=0.027) among HRQOL scores was observed between working women and house wives and as well who had better socioeconomic status (p=0.018).Conclusion: The results of the present study concluded that postpartum quality of life of most of the women undergoing normal vaginal delivery was better as compared to women undergoing cesarean sections in twin cities of Pakistan. Surgical intervention during cesarean section might lead to consistent postpartum pain, inability to cope with needs of newborn and family which in turn can reduce postpartum quality of life among women.
Highlights
Cesarean sections have been increasing worldwide and have become a global concern
23.3% (n=89) women were belonging to postpartum period 6-8 w, 15.2% (n=58) were from 10-12 w postpartum period, 27.2% (n=104) women were from 14-16 w postpartum period, 22.8% (n=87) women were from 9 mo postpartum period and 11.5% (n=44) women were from 15 mo postpartum period
The results of the present study revealed that women with female newborn infants had worst mean scores on all domains of HRQOL as compared to mothers who delivered male infants, but there was no significant difference in their health related quality of life
Summary
Cesarean sections have been increasing worldwide and have become a global concern. Cesarean sections should be reserved to treat or prevent fetal and maternal complications, but in reality, this has not been the actual practice [1]. According to World Health Organization, the reasonable rate of cesarean sections is 10-15%. This practice is rather above this limit in developing countries and the impact of this inappropriate rise in cesarean section has led to poor postpartum quality of life and depression among women. Doctors frequently had been persuading their patients to accept a scheduled cesarean section for conditions that either did not exist or did not justify the procedure. The reason behind this unethical practice might be money making or inadequate knowledge of gynecologists. The risk of instrumental delivery, induced labor and thereby increased cesarean section rate was reported in obese pregnant women [2]
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