Natural Childbirth Linked To Stronger Baby Bonding Than C-Sections
Main Category: Pregnancy / ObstetricsAlso Included In: Pediatrics / Children's Health; Psychology / Psychiatry
Article Date: 15 Sep 2008 - 3:00 PDT
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The bonds that tie a mother to her newborn may be stronger in women who deliver naturally than in those who deliver by cesarean section, according to a study published by Yale School of Medicine researchers in the October issue of Journal of Child Psychology and Psychiatry.
The researchers, led by Yale Child Study Center Assistant Professor James Swain, M.D., recruited two groups of parents from postpartum wards. One group of 12 mothers had cesarean sections and the other delivered naturally (vaginally). All women were interviewed and given brain scans two to three weeks after giving birth. During the brain scans, parents listened to recordings of their own baby's cry during the discomfort of a diaper change. The researchers then conducted interviews to assess the mothers' mood as well as their thoughts and parenting.
The team found that compared to mothers who delivered by cesarean section, those who delivered vaginally had greater activity in certain brain regions in response to their own baby's cry as measured by fMRI. These brain areas included cortical regions that regulate emotions and empathy, as well as deeper brain structures that contribute to motivation, and habitual thoughts and behaviors. The responses to their own baby's cry in some of these regions varied according to mood and anxiety.
Swain said that no parent in the small study developed clinical depression, making it hard to assess the significance of the findings without replication and follow-up studies. "I suspect that the parental brain is 'primed' by vaginal delivery and affected by neurohormonal factors such as oxytocin, a hormone linked to emotional connections and feelings of love," said Swain. "C-sections may alter these neurohormonal factors and increase the risk of problematic bonding and postpartum depression."
"These results provoke many questions and may help expectant mothers as they consider their options carefully," said Swain. "There are plenty of good reasons for cesarean sections, and we would not want our work to be misinterpreted as proving that mothers who opt for c-sections are destined for trouble. On the contrary, we hope to ultimately be in a position to identify and help new mothers with postpartum mental health problems, whatever the causes."
Swain is pursuing studies on populations at risk for postpartum mental health problems. He expects to undertake genetic studies in addition to brain imaging and interviews to improve basic understanding and to eventually translate the research into tailored treatments.
Other authors on the study include Esra Tasgin, Linda C. Mayes, Ruth Feldman, R. Todd Constable and James F. Leckman.
Citation: Journal of Child Psychology and Psychiatry 49(10) (October 2008)
YALE
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http://www.medicalnewstoday.com/releases/121466.php.
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Headline And Introduction Exaggerate The Facts
posted by Pauline M Hull on 16 Sep 2008 at 5:04 pmI would suggest that interested parties also read this more rational review of the research on the UK's National Health Service website, which highlights a number of limitations in this study and its subsequent conclusions.
http://www.nhs.uk/news/2008/09September/Pages/Bondingafterbirth.aspx
(Also see: http://www.electivecesarean.blogspot.com)
For example: '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.'
And: '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. '
It concludes: '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.'
Medical News Today's emphasis (in its headline and opening text) on the certainty of a link between impaired bonding and cesarean delivery is very disappointing given the actual facts. Women rely on news stories like this for facts and should not be faced with frightening (and to many, insulting) theories based on such a tiny study.
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