Postpartum Post-Traumatic Stress Symptoms Following Cesarean Section-the Mediating Effect of Sense of Control

Abstract

Our aim is to clarify the differences in post-traumatic symptom levels between women who had emergency cesarean sections (C-sections) and women who had elective ones and investigate the function of sense of control in post-traumatic symptoms development. On the fourth day after the C-section, participants were recruited and completed a demographic and background questionnaire. Six to eight weeks later, they received continuation questionnaires. A total of 161 women who underwent Cesarean-sections participated in the study's final sample. Women above the age of 18, who gave birth by elective or emergency cesarean-sections were included. Post-traumatic symptoms were measured by the post-traumatic stress disorder checklist for DSM-5 (PCL-5), and sense of control was measured by the Support and Control in Birth (SCIB) questionnaire. Demographic and background data were also taken. The relationship between the type of cesarean section and the post-traumatic symptom levels was fully mediated by the sense of internal control. Women who underwent emergency cesarean-sections experienced lower levels of internal control than women who had elective ones, which in turn, correlated negatively with post-traumatic symptom levels. The mediation model explained 38.5% of the variance in post-traumatic symptoms levels. An internal sense of control is important in reducing post-traumatic symptoms, especially among women undergoing emergency cesarean-sections. The medical team should develop an awareness of the importance of gaining an internal sense of control by including the antenatal woman in decision-making as much as possible. By explaining and normalizing physical and mental feelings, physicians can possibly reduce the prevalence and severity of postpartum post-traumatic symptoms.

Keywords: Cesarean section; Post-traumatic stress disorder; Postpartum period; Sense of control.