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Operative intervention in delivery is associated with compromised early mother-infant interaction
1Key Centre for Women's Health in Society, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia.
Objective:
To investigate the effects of mode and place of delivery on first mother-infant contact and maternal emotional wellbeing.
Design:
A prospective, longitudinal study.
Participants:
A sociodemographically representative sample of 203 consecutive primiparous women was recruited, of whom 81% (n = 164) were followed up.
Setting:
Four metropolitan hospitals, including one accredited baby friendly hospital, in Melbourne, Australia, 1997.
Methods:
During the postnatal hospital stay women were interviewed and medical records were inspected.
Participants:
completed two self-report psychometric measures: the Edinburgh Postnatal Depression Scale (EPDS) and the Profile of Moods States (POMS). Follow up at eight months postpartum comprised completion of a postal questionnaire and repeat administration of the standardised self-report psychometric mood questionnaires.
Results:
The First Contact Index provides a measure of the first contact between a mother and her baby after the birth. Two-way analysis of variance revealed significant differences in First Contact Index between three modes of delivery groups: spontaneous, instrumentally-assisted, and caesarean section (P < 0.001) and four hospital of delivery groups (P < 0.001), but there was no significant interaction effect (P = 0.55). Significant negative correlations existed between the First Contact Index and both the POMS and EPDS scores at two days postpartum (POMS, r = -0.339, 95% Cl -0.46 to -0.22; EPDS, r = -0.279, 95% CI -0.41 to -0.16), even within delivery groups, and these were still present at eight months postpartum (POMS, r = -0.298, 95% CI -0.44 to -0.14, EPDS, r = -0.206, 95% CI -0.36 to -0.03).
Conclusion:
Instrumental and surgical delivery exert a negative impact on first postnatal contact between a mother and her baby which has persistent adverse maternal emotional correlates. Hospital practices associated with obstetric intervention in delivery also varied and are amenable to change, enabling optimal first mother-baby interaction regardless of mode of delivery.