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Anxious fathers make caesarean ops more painful for mothers
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Fathers who are anxious during a caesarean operation
may increase the pain experienced by the mother after the delivery
of their baby, according to new research published in the journal
Psychosomatic Medicine.
In a study involving 65 women scheduled for an elective caesarean,
researchers found that the way their birth partners felt during
the operation was related to the woman's own levels of fear and
anxiety about the operation.
This increased the amount of pain the woman felt immediately after
the operation, which could affect her immediate recovery as well
as potentially influence other related factors such as breast feeding
and parent-child bonding.
The lead researchers from the University of Bath (Dr Keogh) and
Imperial College London (Dr Holdcroft) suggest that helping prepare
the birth partner for a caesarean, both at antenatal classes and
before the operation, could help reduce the pain experienced by
the mother and improve the birth experience.
One in four babies born in the UK is now delivered by caesarean
section (CS), with many hospitals delivering almost 30 per cent
in this way. Fear of pain during childbirth is often cited as one
of the contributory factors for the increasing rate of CS delivery.
But despite the popular notion that caesarean deliveries are the
'easy option,' with respect to overall pain experiences compared
with labour pain, this may not be the case.
"Caesarean sections involve major surgery and are often performed
whilst the mother is awake under regional anaesthesia which numbs
the lower part of the body," said Dr Ed Keogh from the University
of Bath.
"Whilst actual pain during a caesarean is usually more controlled
than a vaginal delivery, the whole procedure is not painless.
"Women who have had a caesarean tend to experience much longer
periods of postnatal pain and recovery. They also have mobility
restrictions placed on them whilst they recover from the surgery,
such as picking up heavy items, reaching upwards and driving.
"Whilst it has become a social expectation that birth partners
accompany and support mothers during a caesarean delivery, it is
unclear what part birth partners play in women's experience of childbirth.
"Whilst some women say that birth partners improve birth experiences,
others report less positive outcomes. It is not unreasonable for
the birth partner to have some feelings of anxiety and fear about
the operation they are about to witness."
The women involved in the study were recruited from the Chelsea
and Westminster Hospital in London during regular ante-natal check
ups.
Almost all of the women (61) had chosen their husband or partner
to be their birth partner, with just four deciding on a female birth
partner.
The women and their birth partners were questioned before, during
and after the delivery about their fears, expectations and experiences.
The women were also assessed for their pain levels at different
stages of the procedure and immediately afterwards.
The study revealed that those women who had negative birth expectations
before the operation had the most fear experiences during the delivery,
which in turn was related to greater post-operative pain.
It also showed that women are most afraid during the application
of the nerve block used to numb the lower part of the body, rather
than the initial incision as the researchers expected.
"Maternal fear fluctuates during a caesarean section but it
can be influenced by the psychosocial factors around them, including
their birth partner," said Dr Keogh.
"Anecdotally a number of birth partners told us that they
had little choice in attending the caesarean operation and felt
ill prepared.
"Birth partners can have potentially beneficial effects on
maternal birth experiences. Rather than removing them from the operating
theatre altogether, it would be better to target the emotional wellbeing
of the birth partner to help reduce the anxiety and fear experienced
by the mother.
"Since anxiety can increase recovery times, it would be useful
to study whether increased maternal fear during the procedure has
an impact on mothers, such as longer-term recovery from surgery
as well as other related factors such as breast feeding and parent-child
bonding."
http://pregnancyandbaby.com/read/articles/5912.htm
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