Method of delivery and subjective distress: women's emotional responses to childbirth practices

Forty women who had given birth for the first time following full term-pregnancy participated in a study concerning distress in response to one of four obstetric procedures: spontaneous vaginal delivery; induced vaginal delivery; instrumental vaginal delivery; or, emergency caesarean section. During their sixth week post-delivery, they completed questionnaires and supplied biographical data. Those who had undergone instrumental delivery (as assisted by episiotomy) described the birth of their child as significantly more distressing, themselves as being more at risk of injury and dissatisfied with the efficacy of pain relief during labour than women in the other three obstetric groups. By comparison, those who had an emergency caesarean section retrospectively reported little psychological distress or perceived risk of serious injury and significantly greater satisfaction with pain relief. Thus, it would appear that the well-being of women who experience an instrumental delivery is in need of additional support. Further prospective research is needed with a larger study population to confirm or otherwise the observations made in this initial investigation.