Communication surrounding cesarean delivery: A secondary analysis on a qualitative study evaluating women's experiences of perceived preparedness, agency, and psychological well-being

Background Cesarean delivery is associated with an elevated risk of perinatal mood, anxiety, and trauma symptoms. Though anesthetic and surgical techniques are well studied, less attention has been given to how perioperative communication, including consultation with an anesthesiology provider, shapes patient experience and psychological outcomes. Methods We conducted a secondary qualitative analysis of focus group transcripts originally collected during the development of an intervention to prevent postpartum mental health challenges following cesarean delivery. Twenty-two participants with lived experience of cesarean delivery discussed communication with their obstetric, anesthesia, and perioperative care teams. Transcripts were reanalyzed using a qualitative approach focused on communication-related themes. Results Three domains emerged: communication gaps, communication content, and communication impact. Participants described limited preparation for the possibility of cesarean delivery, insufficient information about intraoperative sensations and recovery, lack of partner inclusion, and few opportunities for postoperative debriefing. Anticipatory guidance that helped patients form a mental map of the procedure and real-time explanations using shared decision-making with the anesthesiology team were some of the most valued communication experiences and were described as fostering agency. Communication gaps were perceived by participants as shaping their psychological well-being, trust in the medical teams, sense of control, physical recovery, and early parent–infant bonding. Conclusions Perioperative communication perceived by participants to be a central, modifiable factor shaping psychological experience surrounding the delivery. Trauma-informed, anticipatory, and real-time communication, involving all medical service lines, represents a critical opportunity to improve patient-centered care and may help mitigate perinatal mood and anxiety disorders.