Ryding E L, Wijma K, Wijma B
Department of Obstetrics and Gynaecology, Central Hospital, Helsingborg, Sweden.
Birth. 1998 Dec;25(4):246-51. doi: 10.1046/j.1523-536x.1998.00246.x.
Childbirth by emergency cesarean section can be a traumatic experience, but since the result is often a healthy mother and baby, its seriousness is open to doubt.
Fifty-three women were interviewed approximately two days after emergency cesarean section to ascertain whether or not the trauma met the stressor criterion of posttraumatic stress disorder. A time-spatial model from disaster psychiatry was used to chart the women's thoughts and feelings during consecutive phases of the delivery process. The women's causal attributions of the event were also assessed.
Generally speaking, the feeling of the women after they had arrived at the delivery ward changed from one of confidence and safety to one of fear. The decision to undertake a cesarean section brought a feeling of relief, but this was again replaced by fear as the operation approached. The women's thoughts centered around the impending delivery and operation until after the event, when the newborn baby occupied their attention and happiness predominated. In retrospect, 55 percent of the women experienced intense fear for their own life or that of their baby. Eight percent felt very badly treated by the delivery staff and were angry. Almost all the women had adequate knowledge of the reasons for the emergency cesarean section. One in four blamed themselves to some extent for the event.
The stressor criterion of DSM IV is applicable to the trauma of emergency cesarean section. Even if and when a new mother is happy to meet her baby, negative feelings, such as fear, guilt, or anger, may dominate her memories of the birth.
急诊剖宫产分娩可能是一段痛苦的经历，但由于结果往往是母婴健康，其严重性值得怀疑。
对53名女性在急诊剖宫产后约两天进行访谈，以确定这种创伤是否符合创伤后应激障碍的应激源标准。采用灾难精神病学的时空模型来描绘这些女性在分娩过程连续阶段的想法和感受。还评估了这些女性对该事件的因果归因。
一般来说，这些女性到达产房后的感觉从自信和安全转变为恐惧。决定进行剖宫产带来了一种解脱感，但随着手术临近，这种感觉又被恐惧所取代。这些女性的想法集中在即将到来的分娩和手术上，直到事件发生后，新生儿占据了她们的注意力，幸福感占了主导。回顾起来，55%的女性对自己或婴儿的生命感到极度恐惧。8%的女性觉得分娩工作人员对待她们很差并感到愤怒。几乎所有女性都对急诊剖宫产的原因有足够的了解。四分之一的女性在某种程度上为此事自责。
《精神疾病诊断与统计手册》第四版的应激源标准适用于急诊剖宫产的创伤。即使新妈妈很高兴见到自己的宝宝，恐惧、内疚或愤怒等负面情绪可能仍会主导她对分娩的记忆。
