Table 2 Associations of identified psychosocial outcomes and EmCS
Key psychosocial outcomes | Number of studies | Association between EmCS and psychosocial outcomes | Inconclusive associations between EmCS and psychosocial outcomes | Qualitative summary |
|---|---|---|---|---|
Postpartum depression (PPD) | 12 | + | Studies reported inconsistent findings. The majority of studies reported no significant association (n = 7) between EmCS and PPD whereas the remaining studies reported a relationship between EmCS and increased symptoms of PPD (n = 5). | |
Post-traumatic stress disorder (PTSD) | 11 | + | All studies (n = 11) reported consistent findings that EmCS was a contributing factor to increasing post-traumatic stress symptoms and PTSD after childbirth. | |
Health related quality of life | 2 | – | Consistent findings were found across studies (n = 2) that women who had an EmCS had poorer physical functioning compared to other MoDs. | |
Mother infant bonding | 3 | – | Studies reported inconsistent findings. In n = 1 study EmCS appeared to have a negative association with mothers bonding and opening emotions with their baby. In contrast, no significant affect was found in terms of MoD on mother-infant bonding in the remaining studies (n = 2). | |
Infant feeding | 3 | – | Consistent findings were found across studies in that EmCS impacted negatively in varying ways on infant feeding (n = 3). Women who have an EmCS were more likely to have had an unsuccessful first breastfeeding attempt, were less likely to breastfed their baby within the first 24 h and upon leaving the hospital, and to breastfeed for a shorter duration of time compared to other MoDs. | |
Sexual function | 3 | +/− | Studies were inconsistent in their findings (n = 3) in terms of satisfaction with sexual relations after birth and sexual function postpartum. | |
Experiences | 21 | +/− | In terms of quantitative research (n = 9), the majority of studies found that EmCS was more likely to result in a negative birth experience (n = 6), n = 1 study reported MoD had no influence on mother experiences and n = 2 studies reported that EmCS was related to positive experiences in comparison to other MoDs. In terms of the qualitative studies (n = 12) women described a wide variety of emotions as salient aspects to their EmCS experience however, a number of dominating negative experiences were consistent across all studies | |
Satisfaction | 4 | – | Consistent findings were reported across all studies (n = 4) with women who had an EmCS more likely to appraise their deliveries less favourably than those who delivered via other MoDs. | |
Self-esteem | 3 | – | Consistent findings were reported across all studies (n = 3). Women who had an EmCS were more likely to report feelings of emotional vulnerability after delivery including feelings of failure, regret, and lower self-esteem. | |
Distress | 3 | – | Findings were inconsistent in terms of distress after EmCS. No significant association between MoD and distress were reported in a study (n = 1), another study reported other MoD causing more distress than EmCS (n = 1), the final study reported a relationship between EmCS and distress. | |
Fear | 2 | – | Inconsistent findings were reported. With n = 1 study reporting EmCS was associated with increased fear of childbirth in subsequent pregnancies and n = 1 study reporting a correlation with fear of childbirth a few days after the operation, however this decreased one month later. | |
Other | ||||
Childbirth Burden | 1 | + | Women who experienced emergency surgical intervention (i.e EmCS) were more likely to demonstrate higher childbirth burden scores than any other MoD (n = 1). | |
Feelings of control | 1 | – | Women who had a spontaneous VD reflected having a significantly higher sense of control during their labour and childbirth relative to with an instrumental VD, a planned CS, or an EmCS (n = 1). | |