As discussed in previous articles, mental health is defined as a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.
One in five women worldwide experience challenges with their mental health during pregnancy, during the delivery, in the post-partum period and even beyond. Up to 30% of births worldwide occur through caesarean section or C/sections.
While this procedure is often life-saving for both mum and baby, C/sections come with unique challenges that can influence a woman’s mental well-being.
Why do C/Sections affect women’s mental health?
- A sense of loss of control, particularly if the c/section is unplanned. C/sections represent a more medicalised mode of delivery with greater reliance on the medical care team
- Feeling like one missed the birth particularly with c/sections done under general anaesthesia
- Trauma, particularly with emergency c/sections. Emergency c/sections can increase the risk of post-partum depression by up to 15% and up to 17% of women who have emergency c/sections may develop post-traumatic stress disorder following the experience
- Pain following the procedure, which can take weeks to fully subside, can affect a woman’s mental wellbeing
- Slower recovery and return to normal functioning compared to vaginal delivery can also have an impact on mental wellbeing of mothers
- Body image challenges post c/section: women may struggle with a changing body post c/section and the slower return to a pre-pregnancy state and this may impact one’s mental wellbeing
- Societal misconceptions that a c/section is an easier birth experience and that women who deliver through c/section didn’t experience a real birth which can be discouraging and upsetting to a mother after a major surgical procedure. These misconceptions can affect a woman self esteem, sense of self worth and confidence as a mother
What mental health conditions can affect women after a C/Section?
- Post partum depression: Are you feeling sad or irritable since your c/section? Are you constantly tired even with adequate rest? Do you find yourself crying often? Do you feel guilty or ashamed about the challenges you faced during your delivery or about how you are taking care of your baby? Are you struggling with your self esteem and sense of self- worth? Are you struggling with a loss of hope and thinking about hurting yourself or your baby?
- Post partum anxiety: Are you feeling overwhelmed? Do you find yourself almost constantly worrying about your baby’s health and development, yourself, your family? Are you struggling to sleep? Are you struggling with palpitations, muscle tension, shaking hands?
- Post traumatic stress disorder: Do you experience nightmares about the delivery process; Are you feeling on edge constantly, are you easily startled? Are you feeling emotionally numb since the delivery? Do you feel unsafe? Are you still struggling with anger towards yourself or the medical team concerning your delivery process? Do you find yourself avoiding the hospital or health workers? Do you struggle to talk about the delivery experience?
Emotional healing post C/Section
- Be aware of the difficult emotions you may be experiencing post-delivery, acknowledge them as valid, be open and vulnerable to trusted friends, family or to a mental health professional. Talk about your frustrations, fears and concerns.
- Seek out and gracefully receive practical support. Physical recovery post c/section can take much longer than a vaginal delivery and practical physical support with care for the baby and household and other responsibilities may be needed for some months following delivery.
- Get medical support for pain, constipation or any other post c/section challenges that are commonly faced which can significantly affect your mental wellbeing.
- Make time to reflect on the birth experience you had and how it has changed you, coming to terms with the reality of what you experienced versus what you had planned or expected. Reflect on what you have learnt from the experience, what strengths you exhibited during this experience and how you can build on this going forward.
If you think that you or a woman that you know maybe struggling with a mental health problem after a delivery by caesarean section, please contact your nearest health care provider and get help.
*Dr Chido Rwafa-Madzvamutse is a consultant psychiatrist. Feedback on WhatsApp: +263777727332