gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Request for caesarean section ? should it be combined with anxiety and depression?


Author(s): Agnieszka Bąk, Jadwiga Biela-Mazur, Kamila Dudzik

Introduction. The number of pregnancies terminated by a Cesarean section (CS) has been rising in Poland for many years. This increase is particularly evident in the group of operations conducted for indications other than obstetric. One of the causes of this situation can be the lack of legal possibility to conclude pregnancy with a CS due to psychological reasons (so-called “CS on request”). A request for a CS may result from tocophobia or anxiety-depressive disorders. The aim of the study was to evaluate the level of anxiety-depressive disorders among women who opt for ‘a CS on demand.’ Material and methods. An Internet survey was based on a proprietary diagnostic questionnaire, containing questions about anxiety associated with pregnancy and birth, and the Hospital Anxiety and Depression Scale. Calculations were done in Microsoft Excel 2007 with statistical significance of p <0.05. Results. 1,005 women participated in the study. Their mean age was 27 years. 58% of respondents think that CS should be available on request. In 25% of supporters of ‘a CS on request,’ HADS-A indicated symptoms of anxiety; among opponents, it was 17% (p< 0.05). Signs of depression were observed in 12% of supporters and 6% of opponents (p < 0.05). Conclusions. Women who opt for “a CS on demand” are characterized by a higher level of anxiety-depressive symptoms. In women who want to terminate their pregnancy by a CS with no medical indications, symptoms suggesting anxiety and depressive disorders should be sought and psychological or psychiatric consultation should be considered.