Cesarean effects on adolescents' birth experiences: counterfactual analysis

Abstract Introduction The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. Objective To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. Methods Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. Results We found that the mediating effect of delivery mode depended on the adolescent's depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. Conclusion Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.

Effect of Birth Experience on Cognitive Function

PURPOSE: This study aimed to investigate whether birth experience affects short-term memory (1,2-back task) by examining parturient and non-parturient women. METHODS: A total of 31 women were enrolled in this study, of which 16 were parturient women who had given birth within the past 2 years (mean age: 33.9±2.2 years) and 15 were non-parturient (mean age: 31.4±2.1 years). The mean age did not significantly differ between the two groups, so the effects of age were eliminated. To match the level of education between the two groups, college graduation was an inclusion criterion. A 1,2-back task consisting of six alphabets from A–F was created using the SuperLab software. For each task, there were 100 stimuli (alphabets) and 30 answers. The participants practiced the task prior to the main experiment to ensure that they adequately understood the procedure. RESULTS: The correct answer rates in the 1-back and 2-back tasks were 93.56±22.23% and 76.89±21.98%, respectively, in the non-parturient group and 95±10.04% and 80.83±13.67%, respectively, in the parturient group. The reaction time in the 1-back and 2-back tasks were 650.57±173.77 ms and 736.77±138.35 ms, respectively, in the non-parturient group and 621.91±81.90 ms and 737.5±195.99 ms, respectively, in the parturient group. There were no significant differences in the answer rates between the two groups, suggesting that parturition did not have a significant impact on the 1,2-back task performance. CONCLUSION: Birth experience does not significantly impair cognitive function. However, the findings of this pilot study are not highly reliable because of the limitations of the small sample size, degree of load, various types of working memory, and impact of hormones.

La experiencia del parto: dar a luz en el Hospital San Agustín de Valparaíso (1894-1902) / The experience of childbirth: give birth at the San Agustín Hospital of Valparaíso (1894-1902)

En el presente escrito abordaremos la experiencia del parto vivenciada por una importante cantidad de mujeres que optaron, en un determinado momento del estado de gravidez o ya iniciado el ‘trabajo de parto’, ‘dar a luz’ en el Hospital Materno-Infantil San Agustín de Valparaíso, dejando atrás la ayuda prestada por la ‘empírica’ partera; portadora de un acervo sociocultural aceptado y respaldado aún por las autoridades e instituciones del período. Más que ahondar en detalles relativos al contexto epocal, nos centraremos en mostrar los resultados alcanzados a partir del análisis de la información suministrada por las fuentes estudiadas (Boletines Clínicos y Estadísticos de la Maternidad). Resultados que nos hablarán del estado físico presentado por los recién nacidos, La cantidad de embarazos y partos experimentados por las gestantes antes de la actual atención, las ciudades de procedencia de las parturientas, entre otras consideraciones de índole descriptiva. Es así como las fi chas clínicas nos remitirán a la asistencia médica de más de 5.000 mujeres que decidieron aceptar un tipo de ayuda profesional que solo se encontraba cuando se recurría a una sala de maternidad como la construida en el San Agustín al fi nalizar la década de 1880, en los inicios de la medicalización del parto.

In this paper we will address the experience of childbirth experienced by a signifi cant number of women who chose to, at one point of the pregnancy state or already started the ‘labor, ‘give birth’ at the San Agustín maternal and child Hospital of Valparaíso, leaving behind support provided by the “empirical” midwife; bearer of a socio-cultural heritage accepted and still endorsed by the authorities and institutions of the period. Rather than delve into details of the epochal context, we will focus on showing the results obtained from the analysis of information provided by the studied sources (Clinical and Statistical Bulletins of Motherhood). Results that will show us the physical condition presented by the newborn, number of pregnancies and births experienced by pregnant women before the current attention, precedence of the parturients, among others descriptive considerations. That is how the medical records will send us to the medical care of over 5000 women that accepted, one kind of professional help, found only when it involved a maternity ward as the built in San Agustín at the end of 1880, at the beginning of the medicalization of childbirth.