Background Obstetricians are often reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear. To date, it is unknown if an ECS on request improves mental well-being in the mother in the peripartum period and if possible beneficial effects on anxiety and depression could outweigh the increased risk of complications associated with a surgical delivery. A systematic review was conducted to explore the effect of ECS on request on peripartum anxiety and depression. Methods We searched on PubMed, PsychoInfo and Embase. Studies were included with primary data on anxiety and/or depression postpartum in women with childbirth fear who had requested an ECS. After full-text evaluation of 65 papers and quality analysis of four papers, three papers were included. Of one paper additional and yet unpublished data were provided. Studies varied in outcome measures, hence no meta-analysis was performed. Results Women who requested an ECS had higher antepartum depression and anxiety levels but no different postpartum depression levels than women who delivered vaginally. One study of good quality examined the effect of vaginal delivery in women preferring ECS: These women had significantly higher symptom levels of post-traumatic stress disorder (PTSD) and depression than women with normal vaginal delivery. Conclusions The prospect of an ECS does not lower antepartum anxiety and/or depression levels in women requesting an ECS. If women resolutely persist in wishing an ECS despite adequate counselling and/or psychiatric treatment, the risk of developing depressive and PTSD symptoms in case of vaginal delivery should be taken into account, and an ECS may be considered as a valid alternative.

/pdf/the-effect-of-an-elective-cesarean-section-on-maternal-892mh0dreb.pdf

The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review

Resume La peur de l’accouchement est tres frequente chez les femmes enceintes d’un premier enfant. Elle semble liee a des consequences specifiques a l’accouchement et en post-partum, dont l’apparition de symptomes post-traumatiques (SPT), de meme que le blues ou la depression post-partum (DPP). Or, la plupart des etudes realisees reposent sur des echantillons tres restreints, montrent des resultats contradictoires ou tiennent peu compte des interactions entre les facteurs impliques. Objectif Cette etude vise a verifier si la peur de l’accouchement de femmes enceintes nullipares est liee au deroulement de l’accouchement et a la presence de consequences post-partum (c’est-a-dire symptomes de DPP et de SPT). Methode Au total, 176 femmes ont repondu a deux temps de mesure (pre- et post-partum). Resultats La peur de l’accouchement est liee a la douleur percue a la naissance chez les femmes accouchant par voie vaginale, en l’absence d’anesthesie. Elle est aussi liee aux symptomes de DPP et de SPT, independamment du recours ou non a l’anesthesie. La peur apparait aussi liee fortement aux symptomes de SPT chez les femmes ayant vecu une cesarienne non planifiee. Les symptomes de SPT post-partum pourraient jouer un role mediateur dans le lien unissant la peur d’accoucher et la depression post-partum. Conclusions Ces resultats supportent la pertinence de tenir compte de la peur de l’accouchement et de la douleur percue en lien avec les symptomes de SPT et de DPP aupres de nullipares. La peur de l’accouchement pourrait rendre l’experience de la naissance plus negative et predisposer au SPT et a la DPP post-partum. D’autres etudes sont necessaires pour preciser ces relations.

La peur de l’accouchement chez des nullipares : lien avec la douleur lors de l’accouchement, les symptômes de stress post-traumatique et les symptômes dépressifs post-partum

Background: Recent research has suggested that pretraumatic stress related to a forthcoming predictable traumatic event might exist and that such stress reactions would be a key, ‘but largely ignor...

Childbirth as a forthcoming traumatic event: pretraumatic stress disorder during pregnancy and its psychological correlates

/pdf/antenatal-fear-of-childbirth-as-a-risk-factor-for-a-bad-3d6wkkar.pdf

Antenatal Fear of Childbirth as a Risk Factor for a Bad Childbirth Experience

Background. In European countries, postpartum depression (PPD) occurs in 13–19% of women. !e statistics indicate that postpartum depressive disorders a\"ect up to 300,000 women in Russia annually. !ere is still an extremely acute lack of psychological comfort provided to women during labor in Russia. Objective. To our knowledge, ours is the #rst study that examines the association between childbirth experience and the risk of PPD in Russia. Design. We collected data from 190 Russian-speaking mothers, ages 19 to 46, (M = 32 ± 4.3) two months a%er their delivery. Results. Birth satisfaction and physical well-being two months a%er delivery were signi#cantly inversely associated with PPD. Birth satisfaction negatively correlated with the perceived severity and unpredictability of labor, and positively correlated with physical well-being two months a%er delivery. !e presence of a partner and a personal midwife or doula at birth was associated with higher birth satisfaction. Conclusion. Our results emphasize the signi#cance of childbirth satisfaction in the context of PPD and suggest the importance of individual professional support during labor.

/pdf/postpartum-depression-and-birth-experience-in-russia-mhln3ux6a3.pdf

Postpartum Depression and Birth Experience in Russia

Resume La peur de l’accouchement, caracteristique centrale de la tocophobie, est frequente chez les femmes enceintes de leur premier enfant. Elle est associee a des consequences majeures comme la depression pre- et post-natale. Malgre cela, peu d’instruments valides sont disponibles, notamment en francais, pour evaluer ce construit. Cet article comporte les resultats de deux etudes ayant pour but d’adapter et de valider une echelle mesurant l’intensite de la peur de l’accouchement chez des femmes enceintes francophones, soit le Traumatic Event Scale (TES) adapte a la peur de l’accouchement (Soderquist et al., 2004 [21] ). La premiere presente une etape preliminaire visant a evaluer la qualite de cet instrument, de meme que sa fidelite et sa validite (convergente et factorielle) aupres d’un echantillon de meres ayant un enfant âge de 36 mois et moins (n = 65). La seconde etude verifie les proprietes psychometriques d’une version ajustee de l’instrument aupres d’un echantillon de femmes enceintes primipares (n = 204). Les resultats de l’etude 1 revelent des proprietes psychometriques adequates et une solution factorielle en cinq facteurs. Les resultats de l’etude 2 reproduisent cette solution sur la base d’analyses factorielles confirmatoires. Ces resultats confirment les qualites psychometriques de cet instrument. Une discussion entourant les contextes et avantages d’utilisation de cet outil est presentee.

https://www.encephale.com/content/download/91037/1648772/version/1/file/main.pdf

Évaluation de la peur de l'accouchement. validation et adaptation française d'une échelle mesurant la peur de l'accouchement

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La peur de l’accouchement chez des nullipares : lien avec la douleur lors de l’accouchement, les symptômes de stress post-traumatique et les symptômes dépressifs post-partum

Évaluation de la peur de l'accouchement. validation et adaptation française d'une échelle mesurant la peur de l'accouchement