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Postpartum Post-Traumatic Stress Symptoms Following Cesarean Section—the Mediating Effect of Sense of Control

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Abstract

Our aim is to clarify the differences in post-traumatic symptom levels between women who had emergency cesarean sections (C-sections) and women who had elective ones and investigate the function of sense of control in post-traumatic symptoms development. On the fourth day after the C-section, participants were recruited and completed a demographic and background questionnaire. Six to eight weeks later, they received continuation questionnaires. A total of 161 women who underwent Cesarean-sections participated in the study’s final sample. Women above the age of 18, who gave birth by elective or emergency cesarean-sections were included. Post-traumatic symptoms were measured by the post-traumatic stress disorder checklist for DSM-5 (PCL-5), and sense of control was measured by the Support and Control in Birth (SCIB) questionnaire. Demographic and background data were also taken. The relationship between the type of cesarean section and the post-traumatic symptom levels was fully mediated by the sense of internal control. Women who underwent emergency cesarean-sections experienced lower levels of internal control than women who had elective ones, which in turn, correlated negatively with post-traumatic symptom levels. The mediation model explained 38.5% of the variance in post-traumatic symptoms levels. An internal sense of control is important in reducing post-traumatic symptoms, especially among women undergoing emergency cesarean-sections. The medical team should develop an awareness of the importance of gaining an internal sense of control by including the antenatal woman in decision-making as much as possible. By explaining and normalizing physical and mental feelings, physicians can possibly reduce the prevalence and severity of postpartum post-traumatic symptoms.

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Acknowledgements

We wish to thank the Zefat academic college for the support in this research project.

Funding

This study was funded by the research committee of the Zefat academic college, Israel.

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Authors and Affiliations

  1. Zefat Academic College, 11 Jerusalem St., Zefat, Israel

    Yeela Tomsis & Salam Hadid

  2. Galillee Medical Center, 89 Nahariya-Cabri, Nahariyya, Israel

    Esther Perez, Limor sharabi, Moshit Shaked, Shani Haze & Salam Hadid

Authors
  1. Yeela Tomsis
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  2. Esther Perez
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  3. Limor sharabi
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  4. Moshit Shaked
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  6. Salam Hadid
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Contributions

Conceptualization: Yeela Tomsis, Salam Hadid; Material preparation and data collection: Esther Perez, Limor sharabi, Moshit Shaked, Shani Haze; Formal analysis and investigation: Yeela Tomsis; Writing—original draft preparation: Yeela Tomsis; Writing—review and editing: Salam Hadid; Funding acquisition: Salam Hadid; Supervision: Yeela Tomsis, Salam Hadid.

Corresponding author

Correspondence to Yeela Tomsis.

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Ethical Approval and Consent to Participate

We confirm that informed consent to participate in this study was given by the participants orally and in writing. We confirm that any aspect of the work covered in this manuscript that has involved humans has been conducted with the ethical approval of institutional ethical review board of the Galillee medical center on March 27, 2017 (no. NHR-0050–17) and the approval of the institutional ethical review board on May 18, 2017 (no. 3–2017) of Zefat Academic College, Israel.

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The authors declare that they have no conflict of interest.

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Tomsis, Y., Perez, E., sharabi, L. et al. Postpartum Post-Traumatic Stress Symptoms Following Cesarean Section—the Mediating Effect of Sense of Control. Psychiatr Q 92, 1839–1853 (2021). https://doi.org/10.1007/s11126-021-09949-0

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