Is caesarean section linked to postnatal depression?

Operative delivery and postnatal depression: a cohort study BMJ Online First

Elective caesarean section does not protect women from postnatal depression, according to a study published on bmj.com today. Furthermore, neither emergency caesarean section nor assisted vaginal delivery (use of forceps or vacuum extraction) is associated with an increased risk of postnatal depression.

These findings challenge the theory that women at risk of postnatal depression should be managed differently, and should also help women make informed decisions about childbirth. Over 14,000 pregnant women completed a questionnaire eight weeks after giving birth to a single infant at full term. Postnatal depression was also assessed using a recognised scale. There was no evidence that elective caesarean section altered the odds of postnatal depression compared with planned vaginal delivery.

Among planned vaginal deliveries there was similarly little evidence of a difference between women who had an operative delivery and those who had spontaneous vaginal delivery. There is no reason for women with a history of depression or those at high risk of depression to be managed differently with regard to mode of delivery, say the authors. Even if emergency caesarean section or assisted vaginal delivery is required, women can be reassured that there is no reason to believe that they are more likely to experience postnatal depression.