Maternal health after childbirth: results of an Australian population based survey

OBJECTIVE: To describe the prevalence of maternal physical and emotional health problems six to seven months after birth. DESIGN: Statewide postal survey, incorporating the Edinburgh Postnatal Depression Scale, distributed to women six to seven months after childbirth. PARTICIPANTS: All women who gave birth in a two-week period in Victoria, Australia in September 1993 except those who had a stillbirth or known neonatal death. RESULTS: The response rate was 62.5% (n = 1336). Respondents were representative of the total sample in terms of mode of delivery, parity and infant birthweight; young women, single women and women of nonEnglish speaking background were under-represented. One or more health problems in the first six postnatal months were reported by 94% of the women; a quarter had not talked to a health professional about their own health since the birth. Of women reporting health problems, 49% would have liked more help or advice. The most common health problems were tiredness (69%), backache (43.5%), sexual problems (26.3%), haemorrhoids (24.6%) and perineal pain (21%); 16.9% of women scored as depressed. Compared with spontaneous vaginal births, women having forceps or ventouse extraction had increased odds for perineal pain (OR 4.69 95% CI 3.2-6.8), sexual problems (OR 2.06 95% CI 1.4-3.0), and urinary incontinence (OR 1.81 95% CI 1.1-2.9). These differences remained significant after adjusting for infant birthweight, length of labour and degree of perineal trauma. CONCLUSION: Physical and emotional health problems are common after childbirth, and are frequently not reported to health professionals despite the fact that many women would like more advice and assistance in dealing with them.