Maternal attitudes in prepared and unprepared cesarean deliveries

Women's Psychological Adjustment Following Emergency Cesarean Versus Vaginal Delivery

The present study was designed to investigate possible differences in psychological adjustment and satisfaction between women delivering vaginally and those delivering by emergency cesarean section. Women's satisfaction with the birth experience was distinguished from postpartum psychological adjustment, as measured by depression, anxiety, and confidence in mothering ability. Twenty-two women who delivered vaginally and twenty-two women who delivered by emergency cesarean section were selected according to stringent criteria, to control for factors known to be associated with positive cesarean outcomes. Significant differences were found in level of satisfaction, with cesarean mothers reporting less satisfaction with the delivery than vaginal mothers. However, no differences were found between the groups on the three measures of psychological adjustment. Under optimal conditions, cesarean deliveries are not associated with adverse early postpartum psychological adjustment.

Psychosocial impact of cesarean section on the family: a literature review

This paper reviews the literature linking cesarean section with maternal, paternal and infant/child/familial psychosocial impact. Cesarean section is discussed as both major surgery, with concomitant physical and psychosocial ramifications, and as an increasingly and routinely utilized method of birthing. Also considered are factors associated with the current high cesarean birthrate, as well as socio-cultural based factors contributing to varying parental conceptualizations and expectations of birthing. Empirical research published during the past 14 years associates cesarean section with adverse maternal and paternal psychosocial outcome and with possible negative consequences for the infant/child. Weaknesses/flaws of psychosocial impact studies are discussed, including timing and location of data collection, sample bias, and the difficulties of analyzing vast arrays of complex variables. Enumeration of both physical/environmental variables and psychosocial/cultural variables of maternal psychosocial impact are included. A number of these variables form a profile of a woman at relatively high risk of adverse psychosocial outcome. This profile is useful in identification of approaches and strategies for the prevention of adverse psychosocial outcome as well as in the identification of women who might benefit from focused perinatal psychotherapeutic services. The importance of psychotherapeutic services for cesarean families, including local, national and international cesarean support networks, is discussed. Emphasis is given to the importance of increased awareness of psychosocial issues and of current research on the part of medical care providers and health policy experts.

Postpartum mothers' perceptions of competence for infant care

A descriptive study was undertaken to examine the relationship between mothers' early postpartum experiences and their perceptions of competence for infant feeding and care. A sample of 140 primiparous and multiparous mothers completed a 68-item, self-administered questionnaire before discharge from a midwestern hospital's family-centered unit. The mothers' perceptions of competence for infant feeding and care were associated with in-hospital preparation for bottle-feeding mothers and amount of perceived rest for breastfeeding mothers. The findings suggest the need for early assessment of bottle-feeding mothers' perceived competence for infant feeding and care, and adequate provision of rest during the postpartum period for breastfeeding mothers.

Surgical birth: interpretations of cesarean delivery among private hospital patients and nursing staff

Cesarean delivery, although classified by medical practitioners as major surgery, is simultaneously defined as childbirth by both specialists and laypeople. Women experiencing cesarean delivery, therefore, confront a contradiction which affects postpartum treatment by nursing staff and expectations by family and the postcesarean patient regarding appropriate responses to delivery. Elicitation of the explanatory models of cesarean patients in a private Dallas hospital indicates the ambiguity in the definition of the cesarean reflecting more general trends in American obstetrics. Further, the data demonstrate the limited influence of the natural childbirth movement and the acceptance of technological intervention at birth in this population.