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Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem.<\/jats:p>\n                  <jats:p>Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.<\/jats:p>","DOI":"10.3109\/00048679709062687","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T11:23:37Z","timestamp":1201173817000},"page":"728-738","source":"Crossref","is-referenced-by-count":124,"title":["Adverse Psychological Impact of Operative Obstetric Interventions: A Prospective Longitudinal Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Jane","family":"Fisher","sequence":"first","affiliation":[{"name":"Key Centre Por Women's Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 211 Grattan Street, Carlton, 3053, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Astbury","sequence":"additional","affiliation":[{"name":"Key Centre Por Women's Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 211 Grattan Street, Carlton, 3053, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre tor the Study of Sexually Tranmnisslble Diseases, La Trobe University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1997,10,1]]},"reference":[{"key":"bibr1-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1984.tb01460.x"},{"key":"bibr2-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198702123160706"},{"key":"bibr3-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.1989.tb00901.x"},{"key":"bibr4-00048679709062687","first-page":"1182","volume-title":"Effective care in pregnancy and childbirth","author":"Lomas J","year":"1989"},{"key":"bibr5-00048679709062687","volume-title":"Caesarean births in Australia, 1985\u20131990","author":"Lancaster PAL","year":"1993"},{"key":"bibr6-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(94)70217-9"},{"key":"bibr7-00048679709062687","volume-title":"Australia's mothers and babies 1993","author":"Lancaster PL","year":"1996"},{"key":"bibr8-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1992.tb13867.x"},{"key":"bibr9-00048679709062687","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.1993.tb00600.x"},{"key":"bibr10-00048679709062687","first-page":"157","volume-title":"Clinics in developmental medicine no. 64: benefits and hazards of the new obstetrics","author":"Chard T","year":"1977"},{"key":"bibr11-00048679709062687","first-page":"34","volume-title":"Clinics in developmental medicine no. 64: benefits and hazards of the new obstetrics","author":"Chalmers I","year":"1977"},{"key":"bibr12-00048679709062687","volume-title":"Birth rights, birth rites: childbirth alternatives for Australian parents","author":"Lumley J","year":"1980"},{"key":"bibr13-00048679709062687","volume-title":"Report of the working party to investigate variations in caesarean section rates in Australia","author":"Lumley J","year":"1984"},{"key":"bibr14-00048679709062687","volume-title":"Clinics in developmental medicine nos. 123\/124. 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