Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #119028

Anna Sanderson, SNM, MPH¹, Mary Barger, CNM, MPH², Eugene R. Declercq, PhD³, Milton Kotelchuck², and Beate Schuecking, MD⁴. (1) Boston University School of Public Health, 71 Birch Drive, Concord, MA 01742, 978-371-9747, ccrimmins@asph.org, (2) School of Public Health, Dept. of Maternal and Child Health, Boston University, 715 Albany St, Boston, MA 02118, (3) Maternal and Child Health Department, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, (4) Dept. Health and Illness Research, Osnabrueck University, Albrechtstr. 28, Osnabrueck, Germany

Background: The effect of unexpected operative birth on maternal depression scores among primigravidas is examined in this cohort study. Methods: Time series design and secondary data analysis of a larger multi-national convenience cohort study. Healthy women expecting vaginal births were recruited during pregnancy from hospital clinics, birth center and childbirth classes. A self-administered prenatal questionnaire was given to primigravid, English speaking women. A postpartum questionnaire was mailed 6 weeks after estimated birth date. Fifty-five women completed both questionnaires, which contained the Edinburgh Depression (EPDS) scale. Results: The overall rate of depression from prenatal and postpartum was the same, 16%. There were no significant differences in mean or rate of depression scores by cesarean or operative birth compared to spontaneous birth. Most women's (75%) prenatal to postpartum EPDS scores changed very little. Eighteen percent experienced moderate changes (5-10 points); half improved and half worsened, though they did not meet criteria for depression. Four subjects had major changes in scores: 1 improved and 3 became depressed; therefore, the true rate of postpartum depression was 5%. Conclusion: Findings support recent literature showing that postpartum depression may only reflect the high rate of depression in reproductive age women. The study would have needed 245 subjects to find a significant difference in depression by mode of birth given the baseline depression rate of 16% and a cesarean rate of 20%.

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