Association Between Mode of Birth and Self-Reported Maternal Physical and Psychological Health Probelms at 10 Weeks Postpartum

Abstract

AIM: To determine the association between mode of birth and physical and psychological health problems reported at 10 weeks postpartum. METHODS: A cross-sectional, self-report survey was completed by 2,699 Western Australian women at 10 weeks postpartum. Information on birth mode and physical and psychological health was sought. Descriptive statistics and frequency distributions were performed to describe the sample. Logistic regression was used to determine the association between mode of birth and the reported number of physical health problems (two or more and three or more) and two psychological health problems. RESULTS: The occurrence of physical health problems for all women were incontinence (11.5%), no bowel control (2.6%), backache (41%), heavy bleeding (14.1%), and excessive fatigue or tiredness (35.7%). A significant association was found between all cesarean sections (elective and emergency) and the number of physical health problems compared to spontaneous vaginal births. Women who had an emergency cesarean were most likely (OR = 3.15, CI = 2.40-4.13, p < 0.0005) to report two or more physical problems, whereas women who had an elective cesarean were more likely (OR = 2.75, CI = 2.08-3.63, p < 0.0005) to report three or more physical problems. Nearly 15% of women reported being unhappy for more than a few days. This was highest in women having an emergency cesarean (16.4%) and lowest in women giving birth spontaneously (13.5%). Some 6.4% of women stated they were constantly reliving negative thoughts of birth and/or labor. Women who had an emergency cesarean were more likely (OR = 3.10, CI = 1.96-4.89, p < 0.0005) to choose this item and they were also more likely (OR = 2.04, CI = 1.01-4.13, p < 0.047) to experience both psychological health items.CONCLUSION: Women's reports of health problems within the first 10 weeks postpartum are concerning and warrant ongoing attention. The prevalence of health problems was higher in women who had experienced a cesarean. This information on morbidity postbirth is essential for women and their care providers in making informed decisions around available birth options.