PSYCHOSOCIAL IMPACT OF CESAREAN-SECTION ON THE FAMILY - A LITERATURE-REVIEW

This paper reviews the literature linking cesarean section with maternal, paternal and infant/child/familial psychosocial impact. Cesarean section is discussed as both major surgery, with concomitant physical and psychosocial ramifications, and as an increasingly and routinely utilized method of birthing. Also considered are factors associated with the current high cesarean birthrate, as well as socio-cultural based factors contributing to varying parental conceptualizations and expectations of birthing. Empirical research published during the past 14 years associates cesarean section with adverse maternal and paternal psychosocial outcome and with possible negative consequences for the infant/child. Weaknesses/flaws of psychosocial impact studies are discussed, including timing and location of data collection, sample bias, and the difficulties of analyzing vast arrays of complex variables. Enumeration of both physical/environmental variables and psychosocial/cultural variables of maternal psychosocial impact are included. A number of these variables form a profile of a woman at relatively high risk of adverse psychosocial outcome. This profile is useful in identification of approaches and strategies for the prevention of adverse psychosocial outcome as well as in the identification of women who might benefit from focused perinatal psychotherapeutic services. The importance of psychotherapeutic services for cesarean families, including local, national and international cesarean support networks, is discussed. Emphasis is given to the importance of increased awareness of psychosocial issues and of current research on the part of medical care providers and health policy experts.