Abstract
Despite abundant literature on antenatal and delivery care received by pregnant women, there is a wide knowledge gap on the prevalence of symptoms of discomfort or problems during the postpartum period and their relationship with the mode of delivery. This cross-sectional study, carried out with 3324 participants in Spain in 2017, aimed to investigate the association between the mode of delivery and self-reported postpartum symptoms of discomfort and maternal problems during the puerperium. An ad hoc online questionnaire was used to collect data on socio-demographic and obstetric variables, symptoms of discomfort, and maternal problems during the puerperium. The crude odds ratios (OR) and adjusted OR (aOR) and their 95% confidence intervals (95%CI) were calculated using binary logistic regression. In total, 3324 women participated. Compared to a normal vaginal delivery, having a cesarean section was associated with increased odds of an infected surgical wound (aOR: 11.62, 95%CI: 6.77–19.95), feeling sad (aOR: 1.31, 23 95%CI: 1.03–1.68), and symptoms of post-traumatic stress (aOR: 4.64, 95%CI: 2.94–7.32). Instrumental delivery vs. normal vaginal delivery was a risk factor for constipation (aOR: 1.35 95%CI: 25 1.10–1.66), hemorrhoids (aOR: 1.28, 95%CI: 1.04–1.57), urinary incontinence (aOR: 1.30, 95%CI: 26 1.05–1.61), and fecal incontinence (aOR: 1.94, 95%CI: 1.29–2.92) during the puerperium. Women who gave delivery via cesarean section or instrumental delivery had higher incidences of infection and psychological alterations than those who had a normal vaginal delivery. Identifying women at risk of giving birth by cesarean section and informing them about subsequent symptoms of discomfort and maternal problems during the puerperium must be included in pregnancy health program policies and protocols to allow women to make informed decisions regarding their birthing plan.
Highlights
During pregnancy, childbirth, and the puerperium, events may arise that affect a women’s health in physical, psychological, and social terms, while pregnant and during childbirth, and after giving birth, and these may develop into chronic illnesses [1,2,3,4,5,6,7].Int
According to our results, compared with normal vaginal delivery, having a cesarean section was associated with wound infection, headache, back pain, maternal feelings of sadness, anxiety and depression, as well as tiredness and symptoms of post-traumatic stress disorder during the puerperium period
Our results detected a positive association between having an instrumental delivery and having hemorrhoids, constipation, wound infection, perineal pain, and headaches during the postpartum period, as well as symptoms of post-traumatic stress and problems with sexual relations
Summary
Childbirth, and the puerperium, events may arise that affect a women’s health in physical, psychological, and social terms, while pregnant and during childbirth, and after giving birth, and these may develop into chronic illnesses [1,2,3,4,5,6,7]. Res. Public Health 2019, 16, 4564; doi:10.3390/ijerph16224564 www.mdpi.com/journal/ijerph
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