Experiences of Emergency Cesarean Section: A Phenomenological Study of 53 Women

BACKGROUND: Childbirth by emergency cesarean section can be a traumatic experience, but since the result is often a healthy mother and baby, its seriousness is open to doubt. METHOD: Fifty-three women were interviewed approximately two days after emergency cesarean section to ascertain whether or not the trauma met the stressor criterion of posttraumatic stress disorder. A time-spatial model from disaster psychiatry was used to chart the women's thoughts and feelings during consecutive phases of the delivery process. The women's causal attributions of the event were also assessed. RESULTS: Generally speaking, the feeling of the women after they had arrived at the delivery ward changed from one of confidence and safety to one of fear. The decision to undertake a cesarean section brought a feeling of relief, but this was again replaced by fear as the operation approached. The women's thoughts centered around the impending delivery and operation until after the event, when the newborn baby occupied their attention and happiness predominated. In retrospect, 55 percent of the women experienced intense fear for their own life or that of their baby. Eight percent felt very badly treated by the delivery staff and were angry. Almost all the women had adequate knowledge of the reasons for the emergency cesarean section. One in four blamed themselves to some extent for the event. CONCLUSIONS: The stressor criterion of DSM IV is applicable to the trauma of emergency cesarean section. Even if and when a new mother is happy to meet her baby, negative feelings, such as fear, guilt, or anger, may dominate her memories of the birth.