Unplanned cesarean delivery may increase postpartum depression risk
Key takeaways:
- Unplanned cesarean section delivery was tied to higher risk for postpartum depression (PPD) and increased odds of postpartum visit attendance.
- There was no link between PPD risk and a planned cesarean delivery.
Women with an unplanned cesarean delivery had increased odds of developing postpartum depression and attending postpartum visits vs. those who delivered via planned cesarean or vaginally, researchers reported.
“For patients approaching their labor and delivery experience with a certain expectation of the way it is going to go, when that expectation is then not fulfilled, that can result in additional psychosocial stress that can impact the health outcomes of the pregnant person postdelivery,” Nicola F. Tavella, MPH, clinical research program director in the division of maternal-fetal medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York, told Healio.
In a retrospective study presented at The Pregnancy Meeting, researchers analyzed retrospective data from 6,078 pregnancies from the Pregnancy Risk Assessment Monitoring System national dataset. Researchers evaluated the associations between unplanned and planned cesarean and vaginal delivery, postpartum depression (PPD) diagnoses and 6-week postpartum visit attendance.
The primary outcomes were PPD measured by a survey-administered Patient Health Questionnaire-2 and patient-reported survey results and 6-week postpartum visit attendance measured by patient-reported survey results.
Overall, 42.7% of pregnancies were delivered via cesarean section. Of these, 41% were unplanned.
Women with unplanned cesarean deliveries had increased odds of PPD compared with those who delivered vaginally (adjusted OR = 1.19; 95% CI, 1.04-1.44) and were more likely to attend the 6-week postpartum visit (aOR = 1.22; 95% CI, 1.05-1.56). Women who delivered via planned cesarean section vs. vaginal delivery did not differ regarding PPD risk.
“[For] patients who have a certain expectation of their birth plan and ultimately have to go through a different set of steps to deliver their baby safely, it may not be a pleasant experience, and it could potentially have adverse health implications,” Tavella told Healio. “These findings give a more concrete level of evidence to what has previously been anecdotal. This research helps to bridge that gap between the experiences of the clinical providers and the experiences of the patients, so that everyone is getting the best care and the best experience.”
Tavella said more research is needed to explore how intrapartum experiences contribute to PPD development.
“We should make sure that we, as an institution and as clinical providers who are providing these obstetric services, understand that patients in this circumstance might need additional psychosocial support, and we should be able to connect them with those services while they are still in the hospital before they are discharged postpartum,” Tavella told Healio. “This is an opportunity to make sure that the folks who might need extra support are getting it.”
For more information:
Nicola F. Tavella, MPH, can be reached at nicola.tavella@mssm.edu.