A WA-based study has found current procedural norms and supports are flawed for women undergoing medically necessary elective caesarean sections.
Conducted by Curtin University, Nottingham University (UK) and Griffith University, the study followed 28 women ranging in age from 23 to 41 with varying education and income backgrounds.
While all approached the day as ‘special’, women overwhelmingly reported feelings of irrelevance, invisibility and disconnection following birth.
“Women felt they were just another case on the operating list. There was also stress involved in wanting to be a good patient, but wanting to be involved, as well as a sense of being unable to be their baby’s mum,” says Curtin’s Dr Yvonne Hauck.
Women reported a lack of instruction and assurance on how to behave during the procedure. In the most extreme cases, fear coupled with the desire to be ‘a good patient’ led to ‘a submerged state’ of involuntary paralysis.
Researchers suggest this is trauma-induced peritraumatic dissociation, a condition linked to post-traumatic stress symptoms.
Separation of mother and child in the operating room was another issue.
Women reported feelings of ecstatic joy, love and protectiveness at birth were affected by being made to wait several minutes as the baby was examined out of sight, even when there was no obvious distress.
One mother described an ‘almost animal’ physical yearning to see and hold her child, a desire further impaired by children being taken to the postnatal ward soon after birth.
“On average, families were reunited an hour after birth, by which time new mothers reported their initial very strong feelings of connection and concern for the baby had dissipated almost completely,” says Dr Hauck.
“Women clearly articulated they felt differently towards their newborn.”
This damaging of the mothering instinct is consistent with studies which state bonding and firm maternal behaviour require constant contact between mother and child for several hours immediately after birth.
Bystrova et al found skin-to-skin contact of 25 to 120 minutes led to far greater maternal sensitivity even one year later.
“At birth, ensuring a well baby is handed directly to their mother, and babies needing medical support are attended to within the mother’s view, would negate the sense of loss women feel when their meeting with the child is delayed, even for a few minutes,” says Dr Hauck.
“Babies should remain in their mother’s arms wherever possible.”
“Off everyone’s radar: Australian women’s experiences of medically necessary elective caesarean section” by Drs Sara Bayes, Yvonne Hauck and Jenny Fenwick was published in Midwifery.