Fisher J, Astbury J, Smith A
Key Centre for Women's Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.
Aust N Z J Psychiatry. 1997 Oct;31(5):728-38. doi: 10.3109/00048679709062687.
This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures.
Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period.
Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem.
The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.
本文报告了一项对272名未生育孕妇进行的前瞻性纵向研究的结果，该研究将产科手术的心理后遗症作为其目标之一进行调查。
参与者在妊娠晚期和产后早期完成结构化访谈以及标准化的、已发表的心理测量问卷，包括罗森伯格自尊量表和情绪状态剖面图。
几乎没有证据支持产科干预的总数与产后情绪恶化有关这一观点。显著的不良心理影响与分娩方式有关。那些自然阴道分娩的女性在妊娠晚期到产后早期期间最有可能情绪明显改善且自尊增强。相比之下，剖宫产的女性情绪恶化和自尊降低的可能性显著更高。在阴道分娩中接受器械干预的组介于其他两组之间，报告情绪和自尊既没有改善也没有恶化。
本研究结果表明，初产时的手术干预存在重大心理风险，使经历这些手术的人易出现悲伤反应或创伤后困扰及抑郁。
