The maternal childbirth experience more than a decade after delivery - 30/08/17
, Kelly M. Townsend, MS b, Alexandra C. Walton, BS a, Joan L. Blomquist, MD c, Victoria L. Handa, MD, MHS aAbstract |
Background |
Maternal satisfaction with the birth experience is multidimensional and influenced by many factors, including mode of delivery. To date, few studies have investigated maternal satisfaction outside of the immediate postpartum period.
Objective |
This study investigated whether differences in satisfaction based on mode of delivery are observed more than a decade after delivery.
Study Design |
This was a planned, supplementary analysis of data collected for the Mothers’ Outcomes after Delivery study, a longitudinal cohort study of pelvic floor disorders in parous women and their association with mode of delivery. Obstetric and demographic data were obtained through patient surveys and obstetrical chart review. Maternal satisfaction with childbirth experience was assessed via the Salmon questionnaire, administered to Mothers’ Outcomes after Delivery study participants >10 years from their first delivery. This validated questionnaire yields 3 scores: fulfillment, distress, and difficulty. These 3 scores were compared by mode of delivery (cesarean prior to labor, cesarean during labor, spontaneous vaginal delivery, and operative vaginal delivery). In addition, the impact of race, age, education level, parity, episiotomy, labor induction, and duration of second stage of labor on maternal satisfaction were examined.
Results |
Among 576 women, 10.1-17.5 years from delivery, significant differences in satisfaction scores were noted by delivery mode. Salmon scale scores differed between women delivering by cesarean and those delivering vaginally: women delivering vaginally reported greater fulfillment (0.40 [–0.37 to 0.92] vs 0.15 [–0.88 to 0.66], P < .001) and less distress (–0.34 [–0.88 to 0.38] vs 0.20 [–0.70 to 0.93], P < .001) than those who delivered by cesarean. Women who delivered by cesarean prior to labor reported the greatest median fulfillment scores and the lowest median difficulty scores. Median distress scores were lowest among those who delivered by spontaneous vaginal birth. Among women who underwent cesarean delivery, labor induction and prolonged second stage were associated with higher difficulty scores. These factors did not affect satisfaction scores among women who delivered vaginally. Among women who delivered vaginally, operative vaginal delivery was associated with less favorable scores across all 3 scores.
Conclusion |
Maternal satisfaction with childbirth is influenced by mode of delivery. The birth experience leaves an impression on women more than a decade after delivery.
Le texte complet de cet article est disponible en PDF.Key words : childbirth experience, maternal perception of childbirth, mode of delivery, patient satisfaction, Salmon questionnaire
Plan
| Support provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD056275). |
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| The authors report no conflict of interest. |
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| Cite this article as: Bossano CM, Townsend KM, Walton AC, et al. The maternal childbirth experience more than a decade after delivery. Am J Obstet Gynecol 2017;217:342.e1-8. |
Vol 217 - N° 3
P. 342.e1-342.e8 - septembre 2017 Retour au numéro
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