The Emotional State During Cesarean Section and Vaginal Delivery

Year 2024, Volume: 46 Issue: 2, 174 - 182, 18.03.2024

Hatice Yılmaz Dogru , Filiz Özsoy , Serkan Dogru , Jonny Coppel , Zeki Özsoy , Bülent Çakmak , Tuğba Karaman , Aynur Sahin

https://doi.org/10.20515/otd.1326997

Abstract

Alterations in emotional, social, or psychological factors of a woman's life in postpartum could lead to impairing mood disturbances. Depressed mood in mothers in the first days after delivery is named maternity blues and accepted as a common phenomenon in the postpartum phase. The aim of the present study is to determine the mood of the women with pregnancy after delivery. After approval of Clinical Research Ethics Committee, this cross-sectional designed study was enrolled women in postpartum period who underwent vaginal delivery or cesarean section in Department of Obstetrics and Gynaecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey. All subjects were invited to complete the questionnaires including Pain Catastrophizing Scale, Beck Depression Inventory, Beck Anxiety Inventory and Short Form-36 in the first 24th hour of postpartum period. The lumbopelvic pain intensity associated with cesarean section incision or episiotomy was evaluated using visual analog scale. The mean age of the participants was 28.43∓5.14. In catastrophizing group, the mean role limitations due to physical health problems, Beck Depression Inventory-C, Beck Depression Inventory-S, Beck Depression Inventory, Beck Anxiety Inventory and visual analog scale in women with cesarean section, and general mental health in women with vaginal delivery were significantly higher compared to each other (p=0.037, p=0.002, p=0.003, p=0.01, p=0.042, p<0.01, p=0.005, respectively). The present study revealed that the psychological condition and quality of life of women may impair after cesarean section, hence it might be beneficial to provide emotional support for patients after cesarean section.

Keywords

pain catastrophizing, postpartum depression, anxiety, cesarean section, delivery

Sezeryan ve Vajinal Doğum Sırasında Duygusal Durum

Abstract

Doğum sonrası dönemde kadının yaşamındaki duygusal, sosyal veya psikolojik faktörlerdeki değişiklikler, olumsuz duygudurum bozukluklarına yol açabilir. Doğumdan sonraki ilk günlerde annelerde yaşanan depresif duygudurum, annelik hüznü olarak adlandırılmakta ve doğum sonrası dönemde sık görülen bir olgu olarak kabul edilmektedir. Bu çalışmanın amacı hamile kadınların doğum sonrası ruh hallerini belirlemektir. Klinik Araştırmalar Etik Kurulu onayı alındıktan sonra, kesitsel olarak tasarlanan bu çalışmaya, Gaziosmanpaşa Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda vajinal doğum veya sezaryen operasyonu geçiren postpartum dönemdeki kadınlar dahil edildi. Doğum sonrası ilk 24 saat içinde tüm denekler Ağrı Felaketleştirme Ölçeği, Beck Depresyon Envanteri, Beck Anksiyete Envanteri ve Kısa Form-36'yı içeren anketleri doldurmaya davet edildi. Sezaryen insizyonu veya epizyotomi ile ilişkili lumbopelvik ağrı yoğunluğu görsel analog skala kullanılarak değerlendirildi. Katılımcıların ortalama yaşı 28.43∓5.14 idi. Felaketleştirme grubunda fiziksel sağlık sorunlarına bağlı ortalama rol sınırlamaları, Beck Depresyon Envanteri-C, Beck Depresyon Envanteri-S, Beck Depresyon Envanteri, Beck Anksiyete Envanteri ve sezaryenli kadınlarda görsel analog ölçeği ve genel zihinsel vajinal doğum yapan kadınların sağlık durumları birbirine göre anlamlı derecede yüksekti (sırasıyla p=0,037, p=0,002, p=0,003, p=0,01, p=0,042, p<0,01, p=0,005). Bu çalışma, sezaryen sonrası kadınların psikolojik durumunun ve yaşam kalitesinin bozulabileceğini, bu nedenle sezaryen sonrası hastalara duygusal destek verilmesinin faydalı olabileceğini ortaya koydu.

Keywords

katastrofik ağrı, doğum sonrası depresyon, anksiyete, sezaryen, doğum

References

• 1. Schiller CE, Meltzer-Brody S, Rubinow DR. The Role of Reproductive Hormones in Post-partum Depression. CNS Spectrums 2015; 20: 48-59.
• 2. Takahashi Y, Takamoshi K. Factors associated with early postpartum maternity blues an depression tendency among Japanese mothers with full-term healthy infants. Nagoya J Med Sci 2014; 76: 129-138.
• 3. Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: Development and vali-dation. Psychol Assess 1995; 7: 524-532.
• 4. MacArthur C, Winter HR, Bick DE, Knowles H, Lilford R, Henderson C, Lancashire RJ, Braunholtz DA, Gee H. Effects of redesigned community postnatal care on womens' health 4 months after birth: A cluster randomised controlled trial. Lancet 2002; 359: 378-385.
• 5. Quartana PJ, Campbell CM, Edwards RR. Pain catastrophizing: A critical review. Expert Review of Neurotherapeutics 2009; 9: 745-758.
• 6. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 2001; 17: 52-64.
• 7. Suso-Ribera C, Garcia-Palacios A, Botella C, Ribera-Canudas MV. Pain Catastrophizing and Its Relationship with Health Outcomes: Does Pain Intensity Matter? Pain Res Manag 2017; Article ID 9762864.
• 8. Ferber SG, Granot M, Zimmer EZ. Catastrophizing labor pain compromises later maternity adjustments. Am J Obstet Gynecol 2005; 192: 826-831.
• 9. Santos Soares AD, Couceiro TC, Lima, LC, Flores FL, Alcoforado EM, Filho Rde O. As-sociation of pain catastrophizing with the incidence and severity of acute and persistent per-ineal pain after natural childbirth: Longitudinal cohort study. Brazilian Journal of Anesthesiol-ogy 2013; 63: 317-321.
• 10. Süren M, Okan I, Gökbakan AM, Kaya Z, Erkorkmaz U, Arici S, Karaman S, Kahveci M. Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population. Turk J Med Sci 2014; 44: 104-108.
• 11. Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum Depression: Is Mode of Delivery a Risk Factor? ISRN Obstetrics and Gynecology 2012; Arti-cle ID 616759.
• 12. Dekel S, Stuebe C, Dishy G. Childbirth induced posttraumatic stress syndrome: A sys-tematic review of prevalence and risk factors. Front Psychol 2017; 8: 560.
• 13. Dekel S, Ein-Dor T, Ruohomäki A, Lampi J, Voutilainen S, Tuomainen TP, Heinonen S, Kumpulainen K, Pekkanen J, Keski-Nisula L, Pasanen M, Lehto SM. The dynamic course of peripartum depression across pregnancy and childbirth. J Psychiatr Res. 2019; 113: 72-78.
• 14. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Ques-tionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011; 63: S240-52.
• 15. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Anto-nio, TX: Psychological Corporation. 1996.
• 16. Emmons CA, Fetting JH, Zonderman AB. A comparison of the symptoms of medical and psychiatric patients matched on the Beck Depression Inventory. Gen Hosp Psychiatr 1987; 9: 398-404.
• 17. Hisli N. Beck Depresyon Envanterinin üniversite ögrencileri için geçerliligi ve güvenilirligi. Türk Psikoloji Dergisi 1989; 6: 3-13.
• 18. Kapçı EG, Uslu R, Türkçapar H, Karaoğlan A. Beck Depression Inventory II: Evaluation of the Psychometric Properties and Cut-Off Points in a Turkish Adult Population. Depress Anxiety 2008; 25: 104-110.
• 19. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988; 56: 893-897.
• 20. Ulusoy M, Sahin H, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psycho-metric properties. J Cognit Psychother 1998; 12: 153-162.
• 21. Ware J, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME. Determin-ing important differences in scores. User’s Manual for the SF-36v2 Health Survey. Lincoln, RI: Quality Metric Inc. 2007.
• 22. Neu J, Rushing J. Cesarean versus vaginal delivery: long-term infant outcomes and the hygiene hypothesis. Clin Perinatol 2011; 38: 321-331.
• 23. Flink IK, Mroczek MZ, Sullivan MJ, Linton SJ. Pain in childbirth and postpartum recov-ery: the role of catastrophizing. Eur J Pain 2009; 13: 312-316.
• 24. Luoma I, Tamminen T, Kaukonen P, Laippala P, Puura K, Salmelin R, Almqvist F. Longi-tudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Ado-lesc Psychiatr 2001; 40: 1367-1374.
• 25. Sinclair D, Murray L. Effects of postnatal depression on children's adjustment to school. Teacher's reports. Br J Psychiatr 1998; 172: 58-63.
• 26. Bennell KL, Ahamed Y, Jull G, Bryant C, Hunt MA, Forbes AB, Kasza J, Akram M, Metcalf B, Harris A, Egerton T, Kenardy JA, Nicholas MK, Keefe FJ. Physical therapist-delivered pain coping skills training and exercise for knee osteoarthritis: Randomized con-trolled trial. Arthritis Care Res 2016; 68: 590-602.
• 27. Keefe FJ, Caldwell DS, Williams DA, Gil KM, Mitchell D, Robertson C, Martinez S, Nun-ley J, Beckham JC, Crisson JE, Helms M. Pain coping skills training in the management of osteoarthritic knee pain: A comparative study. Behavior Therapy 1990; 21: 49-62.