Primiparae's well-being before and after birth and relationship with preferred and actual mode of birth in Germany and the USA

Abstract

The purpose of this study was to evaluate which mode of birth first-time mothers in Germany and in the USA prefer and how this desire is related to maternal well-being and sense of coherence. The paper describes emotional well-being postpartum in relationship to mode of birth. For data collection a prospective cohort study was conducted in both countries. A self-administered questionnaire including validated instruments (WHO-5 Well-Being Index, Sense of Coherence Scale and Edinburgh Postnatal Depression Scale) was used. Results showed that only a few of the pregnant women in Germany and the USA preferred to deliver by caesarean section. There was a relationship between women's well-being, women's sense of coherence and the preferred mode of birth. The majority of women who wanted a caesarean section delivered in this way. No relationship was found between women's well-being and the type of birth experienced. Well-being in both samples generally decreased after giving birth, but there was a difference between German and American first-time mothers on the postpartum well-being and depression scores. German mothers had a higher postnatal quality of life and lower postnatal depression scores. To give families the opportunity for a healthy start, midwives and obstetricians should try to enhance women's well-being and they should give some thought to health professionals' decision-making processes. Expanded postpartum care might have an impact on women's depression scores.