Bonding is NOT impaired with planned cesarean delivery

The publicity that Swain et al's research (in which just 12 women were analyzed following their cesarean delivery) is simply incredible. Compare it if you will to the Birth Trauma Association's research earlier this year, which discovered that women are less likely to die following a planned cesarean delivery than following any other birth type. As Maureen Treadwell said on Channel Five News last week, "We bury all the positive news about cesareans and hype the bad news ."

If you want to better understand the implications and more importantly, limitations of this research, a good place to start is the NHS' Behind the Headlines online explanation.

It concludes that:
"Mothers undergoing elective or emergency caesarean sections should not be led to believe that they will be any less able to bond with their baby or respond to their baby’s needs than a mother who has undergone a natural delivery."
Here's why:
"As this was a very small study, it is highly possible that any differences found are due to chance only. The brain responses occurred when listening to a recording of a baby crying during a nappy change, not to a real-life baby and it is unclear whether the changes seen on the brain scan would have any effect on the mother or baby's experience of bonding."
In fact:
"The researchers found that there was no difference in the emotional scores given between the women in response to either their own baby's cry, another baby's cry or control noise between vaginal delivery and caesarean delivery mothers. There was also no difference within each woman in her response to her own baby's cry or another baby's cry. In both groups of mothers, there was a greater emotional response to the baby cries than to a control noise. "

The Problem with Media Reports

As is so often the case, media coverage of studies like this end up muddying the waters even further due to an evident lack of understanding of the differences between planned and emergency cesarean outcome risks. For example, the two reputable news sources below each expand further on the story by reminding the reader of an existing link between cesareans and postpartum or postnatal depression (PND).

This connection is wholly inaccurate however, as the link with PND has been associated with emergency surgery (usually the outcome of an originally planned vaginal delivery) and unwanted cesareans. It is not relevant to planned procedures where the mother herself has 'elected' to have surgery. Once again, this illustrates the problem with reporting on a vast array of mixed cesarean delivery data. Journalists need to be careful (particularly when criticizing maternal request) that any research quoted is relevant to the story context.

11 Sep 08, HealthDayNews: Natural Childbirth Moms More Attuned to Babies' Cry Finding may help shed light on postpartum depression in those choosing Caesareans
03 Sep 08, BBC news online: Natural birth 'may aid baby bond' The procedure has been linked to an increased risk of post-natal depression