The impact of general anaesthetic caesarean section on parental mental health & infant bonding: A scoping review

Background

Women and birthing people who undergo caesarean section with general anaesthesia are in a state of controlled unconsciousness, meaning they do not experience the birth of their infant and are often unable to engage in early bonding interactions with their newborn. The impact of this on postnatal parental mental health and infant bonding is unknown.

Aim

This review aimed to establish what is known regarding the psychological impact of GACS, with or without Intensive Care Unit (ICU) admission, on parental mental health and infant bonding.

Methods

A scoping review was conducted following Arksey & O’Malley’s Five-Stage Methodological Framework in combination with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Databases including Maternity & Infant Care, MEDLINE & EMBASE (OVID), PUBMED, CINHAL were searched using MeSH terms, subject headings and keywords. Full text articles published up to May 2024 were included with no date restrictions.

Results

Five studies were identified: two focused on maternal mental health, one on childbirth experience, one on mother-infant bonding and one on father/partner experiences. No studies were identified specifically exploring ICU admissions following GACS. Findings indicated an increased risk of postpartum depression, birth dissatisfaction and impaired maternal-infant bonding for GACS compared to neuraxial anaesthesia groups. Additionally, the presence of fathers in the operating theatre during emergency GACS did not lead to adverse mental health outcomes three months postnatally.

Conclusion

Further research is required to better understand the psychological implications of GACS, particularly the impact on parental mental health and infant bonding.