Charité Caesarean Birth Improves Birth Experience in Planned and Unplanned Caesarean Sections While Maintaining Maternal and Neonatal Safety: A Prospective Cohort Study

Abstract

Charité Caesarean Birth Improves Birth Experience in Planned and Unplanned Caesarean Sections While Maintaining Maternal and Neonatal Safety: A Prospective Cohort Study Laura Radtke1,§ , Ricarda Dukatz1 , Carolin Biele1 , Alexander Paping1 , Khaled Sameez1 , Christine Klapp1 , Wolfgang Henrich1 , Anna M Dückelmann1,* 1Department of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany *Correspondence: anna-maria.dueckelmann@charite.de (Anna M Dückelmann) §Current address: Department of Gynaecology, Agaplesion Diakonieklinikum Hamburg, 20259 Hamburg, Germany. Academic Editor: Kimitoshi Imai Submitted: 14 February 2022 Revised: 18 March 2022 Accepted: 24 March 2022 Published: 1 June 2022 Abstract Background: In this study, we aimed to assess the safety of a modified caesarean delivery (Charité caesarean birth) in an extended frame of indications, and to examine its impact on parents’ birth experience and long-term effects. Methods: This prospective cohort study was performed from January to June 2019. A standardized questionnaire was given to all women who gave birth as an inpatient delivery. Eight months after hospital discharge, all women who gave consent were sent a follow-up questionnaire including questions on current feelings, breast feeding, bonding, and support system, as well as a screening for postnatal depression. Indications for caesarean delivery included preterm birth, fetal malpresentation, fetal malformation, twin pregnancy, and maternal pre-existing conditions. Results: The study cohort included 110 women. The mode of delivery was spontaneous in 49%, per vacuum extraction in 15%, conventional caesarean section in 7%, and Charité caesarean birth in 29%. The groups with Charité versus conventional caesarean delivery did not significantly differ in neonatal admission rates, umbilical cord parameters, maternal blood loss, or duration of surgery. Compared to conventional caesarean delivery, women who underwent a Charité caesarean delivery were significantly more satisfied with their birth experience. At follow-up, the mode of delivery was not associated with significant differences in postnatal depression, breast feeding, or bonding parameters. Conclusions: Outside of emergency situations, Charité caesarean birth improves patients’ well-being, without increased maternal and neonatal morbidity. Keywords: birth experience; breast feeding; caesarean section; early-skin-to-skin contact; bonding; follow-up