Caesarian Birth Not Linked to Postnatal Depression

Media release

Wednesday 18 July 2007

Caesarian Birth Not Linked to Post-Natal Depression

A systematic review of international studies by the University of Otago, Christchurch has shown that the evidence for a link between giving birth by caesarian section and post-natal depression, is unconvincing.

Dr Frances Carter and colleagues from the Department of Psychological Medicine conducted the review because concern has been expressed since the 1970s that having a caesarian section may place women at increased risk for developing depression after childbirth.

“The results of this review will be reassuring for women in New Zealand who may have a caesarean section,” says Dr Carter, “as they don’t indicate a clear link between caesarian births and later post-natal depression.”

Many studies have now examined this issue, and several of these studies have been large and well conducted. This issue is of relevance to many women, as having a baby by caesarian section is now relatively common in the developed world (greater then 20% over recent years), and post-natal depression affects around 10% of women.

The key findings of the review were that:

- most studies had not found a link between caesarian section and post-natal depression;

- the better the study, in terms of its methodology, the less likely the study was to find a link;

- when data from similar studies were pooled together and then analysed, a link was not found; and

- caesarian section did not seem to be a risk factor of special significance in comparison with other known risk factors.

Dr Carter says the impact of caesarian section on mood may depend on the context in which the caesarian section occurs, including cultural norms, preparedness and the social support available to women.

For example, the authors of a study conducted in Taiwan believe they did not find a link between caesarian section and post-natal depression because women in Taiwan are given greater social support if they have the procedure.

Another study found that women in an urban setting actually had lower rates of post-natal depression if they had given birth by caesarian section. Together, these studies suggest that adverse impacts of caesarian section may be mitigated, nullified, or even reversed in certain contexts.

It is important to note that this review looked specifically at caesarian section and post-natal depression. The link between caesarian section and anxiety disorders, such as post-traumatic stress disorder, was not examined.

The study also examines the evidence for the link for women in general. This finding does not rule out the possibility that for individual women, their caesarian experience may have been relevant in the development of post-natal depression.

Finally, it is not clear if women who are already vulnerable for some other reason (e.g., they have a personal history of depression) may be at increased risk of post-natal depression if they have a caesarian section, as studies have not been done examining this.

ENDS

www.chmeds.ac.nz

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