Vergleich der perioperativen Lebensqualität nach vaginaler Entbindung unter Epiduralanästhesie und abdominaloperativer Entbindung unter Spinalanästhesiein der Geburtshilfe anhand des PPP33-Fragebogens

The rate of c-section as a birth mode has shown a continuous rise for the past couple of years throughout the US and most of the western world, where it has reached about 30%. This phenomenon has unsettled a debate over women’s right to demand a c-section. This study evaluates patient satisfaction and qualtity of life in patiens giving birth at the John Sealy Hospital der University of Texas Medical Branch in Galveston, Texas. Within a two-months period a total of 642 patients after delivery took the questionnaire. 358 patients having had csecions under spinal anesthesia were compared to 284 patients after vaginal birth under epidural anesthesia. Quality of life was measured on the basis of the PPP33-Questionnaire featuring a 4-point Likert-scale. Patients answered 33 questions on information, fear, pain, autonomy, physical discomfort, recovery, communication and hotel services, as well as 5 additional questions regarding local anesthesia. Women after c-section reached lower scores in perioperative quality of life than women after vaginal birth. Differences could be seen in the categories fear, autonomy and physical discomfort. Patients after c-section more frequently reported to suffer from restlessness and fear prior to birth. Another advantage for vaginal delivery was the quicker recovery of patient autonomy and mobility in this group. There was no significant difference regarding pain. Postpartum discomfort regarding micturition, digestion, nausea and vomiting was more severe after c-section as birth mode. There was a significantly higher total score of 87% for vaginal delivery than for c-section (84%). As expected mother’s postpartum quality of life after birth under regional anesthesia was better after vaginal delivery than delivery by csection. The apparent loss of quality of life should be taken into account by women requesting a c-section for non-medical reasons.