Academic journal article Journal of Prenatal & Perinatal Psychology & Health

The Emotional Ramifications of Being Born in a Cesarean Delivery

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

The Emotional Ramifications of Being Born in a Cesarean Delivery

Article excerpt

Cesarean deliveries are the number one major surgery in the United States (Pfuntner, Wier, & Stocks, 2013) where the rate has gone from two to three percent in the 1970s (Verny & Weintraub, 2002) to 32.3% in 2014 (Betrán et al., 2016), exceeding the recommendation by the World Health Organization that cesarean deliveries should make up less than 15% of all births (World Health Organization, 2015). Around the world, rates of cesarean sections have been increasing steadily since 1990 in both developed and developing countries (Betrán et al., 2016; World Health Organization, 2015). Betrán and her colleagues (2016) found that between 1990 and 2014, the average global annual rate of increase in cesarean deliveries was 4.4%. Their study found Brazil and Dominican Republic to be the countries with the highest cesarean rates in 2014 with a 55.6% and 56.4% rate, respectively. A Brazilian retrospective cross-sectional study found an 84.3% cesarean section rate in a private maternity clinic in Brazil (Almeida, Bettiol, Barbieri, Silva, & Ribeiro, 2008).

Interest in the experience of childbirth has increased enormously in the United States since the 1970s. Much emphasis has been placed on having an optimal childbirth experience and on early parent-infant bonding (Affonso, 1981). Still, the process of birth has never been so medicalized as well as regulated by state legislation, insurance companies, and other bureaucratic systems (Noble, 1993). The emphasis in the obstetrical health team has long been on the physiological outcome of cesarean childbirth both for the mother and the newborn (Affonso, 1981) and studies have emphasized the high maternal and infant morbidity and mortality rates that are associated with cesarean delivery (Gregory, Jackson, Korst, & Fridman, 2012; Villar et al., 2007; Xie, Gaudet, Krewski, Graham, & Walker, 2015). Groups such as the VBAC (Vaginal Birth After Cesarean) movement and C - sect have, for several years, been addressing the mother's perspective and the question of the politics of too many cesareans (English, 1993). Though cesarean deliveries save the lives of mother and child, little attention and respect have been given to the baby and the baby's emotional well-being by the obstetric health team (Oliver, 2000). The aim of this article is to investigate whether being born in a cesarean delivery can emotionally and behaviorally impact the cesarean born throughout life, by reviewing the existing pre- and perinatal psychology literature and the current medical literature.

Literature Review

There are two major kinds of cesarean deliveries: those done before labor starts-which are referred to as elective cesarean deliveries, and those done after some labor, often in emergency conditions-which are referred to as emergency cesarean deliveries. Cesarean delivery on maternal request is a specific type of elective cesarean delivery performed for a singleton pregnancy on maternal request at term in the absence of any medical or obstetric indications (Golan, 2009; National Institutes of Health, 2006). Since the usual medical terms, elective cesarean and emergency cesarean, focus on the doctor's and the mother's experience, and this paper focuses on the child's experience, I will use Jane English's (1985) definitions of the two kinds of cesarean born: "non-labor cesarean" defines the child who is born in an elective cesarean and "labor cesarean" defines the child who is born in an emergency cesarean.

Evidence of birth memory, especially associated with trauma, has been reported frequently in the last seventy years (Noble, 1993) and the importance of the birth experience in formation of self-image and worldview has been documented in works by Feher and Grof (English, 1993). Freud was the first to propose that birth can be remembered and that it can influence personality (Feher, 1981; Verny & Weintraub, 2002) and Otto Rank believed all neurotic anxieties were repetition of the physiological phenomenon of birth (Feher, 1981). …

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