BACKGROUND: Animal research demonstrates that pelvic sensory signaling at parturition initiates behavioral and emotional changes that are protective for mother and offspring. In contrast, research with humans has found no effect of cesarean delivery (i.e., procedure that blocks pelvic signaling) on mother's mental health. The lack of effect may reflect little consideration for the use of epidurals, another intervention that blocks pelvic signaling. The following study examines whether blocking pelvic signaling during delivery predicts postpartum depression symptomatology. METHOD: Longitudinal mental health data were collected prospectively from 142 primiparous women who had a cesarean delivery and/or received epidural anesthesia (Intervention) or delivered vaginally without anesthesia (No-Intervention). Measurements began in late pregnancy and continued through the first postpartum year. RESULTS: Intervention mothers reported more depressive symptoms at the end of the first postpartum year compared to those in the No-Intervention group. This effect was independent of socio-cultural factors known to predict levels of depressive symptoms. CONCLUSION: These results suggest that pelvic sensory signaling may help to prepare women for the postpartum period. Considering there are many factors influencing the mental health of mothers, the present finding suggest that populations vulnerable to postpartum depression should consider a delivery without intervention, when medically permissible.
BACKGROUND: Animal research demonstrates that pelvic sensory signaling at parturition initiates behavioral and emotional changes that are protective for mother and offspring. In contrast, research with humans has found no effect of cesarean delivery (i.e., procedure that blocks pelvic signaling) on mother's mental health. The lack of effect may reflect little consideration for the use of epidurals, another intervention that blocks pelvic signaling. The following study examines whether blocking pelvic signaling during delivery predicts postpartum depression symptomatology. METHOD: Longitudinal mental health data were collected prospectively from 142 primiparous women who had a cesarean delivery and/or received epidural anesthesia (Intervention) or delivered vaginally without anesthesia (No-Intervention). Measurements began in late pregnancy and continued through the first postpartum year. RESULTS: Intervention mothers reported more depressive symptoms at the end of the first postpartum year compared to those in the No-Intervention group. This effect was independent of socio-cultural factors known to predict levels of depressive symptoms. CONCLUSION: These results suggest that pelvic sensory signaling may help to prepare women for the postpartum period. Considering there are many factors influencing the mental health of mothers, the present finding suggest that populations vulnerable to postpartum depression should consider a delivery without intervention, when medically permissible.
Authors: James E Swain; Esra Tasgin; Linda C Mayes; Ruth Feldman; R Todd Constable; James F Leckman Journal: J Child Psychol Psychiatry Date: 2008-09-03 Impact factor: 8.982