Assessment of Postpartum Depression in women who had Cesarean and Normal Vaginal Deliveries

Postpartum depression (PPD) is one of the least vocalized topics surrounding pregnancy and motherhood. It is a major depressive disorder which occurs within the first 4 weeks after delivery and can extend up to a year postpartum. It is characterized by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) by 5 or more of the following symptoms: Sleep disturbances (insomnia/hypersomnia), fatigue, decreased concentration, agitation or impairment of psychomotor function, changes in appetite, a sense of despair or guilt, and suicidal ideation. Women with PPD are met with intense emotional & psychological changes which may affect their ability to cope with stressors and their relationship with their newborn. The social stigma associated with depression often hinders new mothers from getting professional assistance. Various predisposing factors have been researched throughout the years, however, studies that correlate the mode of depression to PPD have shown conflicting evidence.

The primary objective of this study was to assess and evaluate postpartum depression in women who have undergone recent deliveries. The secondary objective was to compare PPD in different modes of delivery (cesarean and vaginal), and women's age groups, and compare based on the gender of the baby.

The research employs a prospective, observational design. We approached women admitted post-delivery in the Obstetrics & Gynecology department at Vivekananda General Hospital, Hubli (a city in the south Indian state of Karnataka). 210 subjects who underwent delivery via a normal vaginal delivery (NVD) or a lower segment cesarean section (LSCS) were assessed for PPD utilizing the Edinburgh Postnatal Depression Scale (EPDS). We obtained the data from the women's case files and their verbal answers to the face-to-face questioning. Data were collected for 6 months, from November 2021 to April 2022. An EPDS score of ≥7 out of 30 indicated postpartum depression. It was categorized as mild (7-13), moderate (14-19), and severe (19-30) depression. Participants were divided into 3 groups based on age: Lower (18-22 years), Median (23-27 years), and Higher (28-32 years) age groups. Data were analyzed using Pearson’s Chi-Square correlation.

Out of 210 women, 157 had PPD, giving it an incidence of 74.7% in 6 months. Delivery by LSCS was more likely than NVD to cause PPD, X² (3, N = 210) = 11.6, p = .009. The participants ranged in age from 19 to 33 years. Most women who were identified as depressed were on the younger side, X² (6, N = 210) = 18.04, p = .006). Mothers of female infants were more likely to experience depression, X² (3, N = 210) = 9.35, p = .025. Mild depression was the most frequently occurring severity.

PPD negatively affects mothers as well as children. Screening and education can be encouraged during postpartum health-care visits or child-care visits to improve the detection of PPD and help provide better care for the affected women, which in turn improves child development.