Post-natal psychopathology and bonding with the infant among first-time mothers undergoing a caesarian section and vaginal delivery: Sense of coherence and social support as moderators

Abstract

Objective: To investigate the protective role of sense of coherence (SOC) and perceived social support in the effect of emergency/elective caesarian section on post-natal psychological symptoms and impairment in mother–infant bonding.

Design: Thirty-seven women delivering via an emergency C-section, 21 via elective C-section and 38 through a vaginal delivery were assessed six weeks post-partum (Time 1) as to their post-traumatic stress disorder (PTSD) and depressive symptoms, impairment in bonding and SOC and social support. Symptoms and bonding difficulties were assessed again six weeks later (Time 2). Main and interactive effects of mode of delivery and the protective factors were examined.

Main Outcome Measures: Post-natal depressive and PTSD symptoms and mother–infant bonding.

Results: An emergency C-section mode of delivery predicted an increase in PTSD symptoms in Time 2, but only among women with low levels of Time-1 social support. Time-1 SOC predicted a decrease in post-natal PTSD and depression.

Conclusions: Social support might buffer against the potentially traumatic effect of an emergency C-section. SOC appears to constitute a powerful dimension of post-natal resilience.

Keywords:

• caesarian section
• trauma
• post-partum depression
• PTSD
• sense of coherence
• social support