Does Cesarean Section Increase the Risk of Postpartum Depression? A Systematic Literature Review



Alrika Febi Yuarsyah (Universitas Airlangga) Orcid ID Google Scholar or Scopus ID
Budi Utomo (Universitas Airlangga)
Izzati Dwi (Universitas Airlangga)


Background: Postpartum depression (PPD) is a psychological disorder experienced by mothers at 4 weeks to 6 months postpartum. One of the risk factors for postpartum depression is the type of delivery. The mode of delivery in its effect on postpartum depression has been studied extensively with conflicting results whether vaginal delivery or cesarean section (CS) that can affect postpartum depression (Rauh et al., 2012). Methods: This is a systematic literature review with a research question using PICO standard namely "What is the correlation between mode of delivery and postpartum depression?". 325 literature were obtained from five different databases. The screening was carried out according to PRISMA flowchart and bringing in a total of 21 literature to be reviewed. Results: Most of the literature reported that mothers with CS have higher EPDS scores than mothers with vaginal delivery. One literature stated that mothers with CS were more protected and less prone to PPD, and other studies stated that the method of delivery was not associated with PPD. Conclusion: Delivery mode is associated with postpartum depression in most studies. Mothers with CS are more at risk of exposure to PPD than mothers with vaginal delivery


Delivery Mode, Cesarean Section, Vaginal Delivery, Postpartum Depression, Systematic Literature Review

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American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Association, 2013

Alharbi, A. A., and Abdulghani, H. M. “Risk Factors Associated with Postpartum Depression in the Saudi Population”. Neuropsychiatric Disease and Treatment, Vol. X, 2014, pp. 311–316.

Al Nasr, R. S. Altharwi, K. Derbah, M. S. Gharibo, S. O. Fallatah, S. A. Alotaibi, S. G. Almutairi, K. A. Asdaq, S. M. B. “Prevalence and Predictors of Postpartum Depression in Riyadh, Saudi Arabia: a Cross Sectional Study”. PLoS ONE, Vol. XV, No. II, 2020, pp. 1–13

Cirik, D. A. Yerebasmaz, N. Kotan, V. O. Salihoglu, K. N. Akpinar, F. Yalvac, S. Kandemir, O. “The Impact of Prenatal Psychologic and Obstetric Parameters on Postpartum Depression in Late-Term Pregnancies: a Preliminary Study”. Taiwanese Journal of Obstetrics & Gynecology, Vol. LV, 2016, pp. 374-378

Deng, A. Xiong, R. Jiang, T. Luo, Y. Chen, W. “Prevalence and Risk Factors of Postpartum Depression in a Population Based Sample of Women in Tangxia Community, Guangzhou”. Asian Pacific Journal of Tropical Medicine, 2014, pp. 244-249

Duma, N. and Madiba, T. “The Prevalence of Peripartum Depression and Its Relationship to Mode of Delivery and other Factors Among Mothers in Ixopo, Kwazulu-Natal, South Africa”. South African Journal of Psychology, Vol. L, No. IV, 2020, pp. 530–539

Eckerdal, P. Georgakis, M. K. Kollia, N. Wikstrom, A. Högberg, U.Sialkidou, A. “Delineating the Association Between Mode of Delivery and Postpartum Depression Symptoms: a Longitudinal Study”. Acta Obstetricica et Gynecologica Scandinavica, Vol. XCVII, No. III, 2018, pp. 301-311

Habibzadeh, A. Habibzadeh, Z. “Evaluation of Effective Factors and its Prevalence on Postpartum Depression Among Women in the City of Qom, Iran”. International Journal of Women's Health and Reproduction Sciences, vol. IV, no. I, 2016, pp. 23-28

Indriasari, S. “Tingkat Depresi pada Ibu Postpartum di Puskesmas Moro-krembangan Surabaya”. Dunia keperawatan, Vo. V, No. I, 2017, pp. 43–49

Kaya, L., & Çiğdem, Z. “The Relationship Between Mode of Delivery and Postpartum Depression”. Journal of Education and Health Promotion, Vol. VIII, No. V, 2019, pp. 1–6

Kim, Y. Dee, V. “Sociodemographic and Obstetric Factors Related to Symptoms of Postpartum Depression in Hispanic Women in Rural California”. Journal of Obstetric, Gynecologic & Neonatal Nursing, Vol. XLIV, 2018

Mathisen, S. E. Glavin, K. Lien, L. Lagerløv, P. “Prevalence and Risk Factors for Postpartum Depressive Symptoms in Argentina: a Cross- Sectional Study”. International Journal of Women’s Health, Vol. V, 2013, pp. 787–793

Meky, H. K., Shaaban, M. M., Ahmed, M. R., & Mohammed, T. Y. “Prevalence of Postpartum Depression Regarding Mode of Delivery: a Cross-Sectional Study”. The Journal of Maternal-Fetal & Neonatal Medicine, Vol. XXXIII, No. XIX, 2020, pp.3300–3307

Nelson, D. B. Freeman, M. P. Johnson, N. L. McIntire D. D. Leveno, K. J. “A Prospective Study of Postpartum Depression in 17 648 Parturients”. J Matern Fetal Neonatal Med, Vol. XXVI, No. XII, 2013, pp. 1155–1161

Norhayati, M. N., Hazlina, N., Asrenee, A. R., and Emilin ,W. “The Magnitude and Risk Factors of Postpartum Symptoms: a Literature Review”. Journal of Affective Disorders; 175, 2015, pp. 34–52.

Padila. Keperawatan Maternitas. Yogyakarta: Nuha Medika, 2014

Rauh, C., Beetz, A., Burger, P., Engel, A., Häberle, L., Fasching, P. A., Kornhuber, J., Beckmann, M. W., Goecke, T.W., and Faschingbauer, F. “Delivery Mode and the Course of Pre- and Postpartum Depression”. Arch Gynecol Obstet, Vol. CCLXXXVI, No. VI, 2012, pp. 1407–1412.

Sadat, Z., Kafaei Atrian, M., Masoudi Alavi, N., Abbaszadeh, F., Karimian, Z., & Taherian, A. “Effect of Mode of Delivery on Postpartum Depression in Iranian Women”. The journal of Obstetrics and Gynaecology Research, Vol. XL, No. I, 2014, pp. 172–177.

Smorti, M. Ponti, L. Pancetti, F. “A Comprehensive Analysis of Post-partum Depression Risk Factors: the Role of Socio-demographic, Individual, Relational, and Delivery Characteristics”. Frontiers in Public Health, Vol. VII, 295, 2019, pp.1-9

Suhitaran, T. Pham, T. Chen, H. Assam, P. N. Sultana, R. Han, N. Tan, E. Sng, B. “Investigating Analgesic and Psychological Factors Associated with Risk of Postpartum Depression Development: a Case-control Study”. Neuropsychiatric Disease and Treatment, Vol. XII 2016, pp. 1333-1339

Syafrianti, N. “Perbedaan Kemungkinan Terjadinya Depresi Postpartum antara Primipara dengan Multipara di Puskesmas Lubuk Buaya dan Puskesmas Andalas Kota Padang’. Thesis. Faculty of Medicine, Universitas Andalas, Kota Padang , Indonesia, 2018

Sylvén, S. M. Thomopoulos, T. P. Kollia, N. Jonsson, M. Skalkidou, A. “Correlates of Postpartum Depression in First Time Mothers without Previous Psychiatric Contact”. European Psychiatry, Vol. XL, 2017, pp. 4-12

Taherifard, P., Delpisheh, A., Shirali, R., Afkhamzadeh, A., & Veisani, Y. “Socioeconomic, Psychiatric and Materiality Determinants and Risk of Postpartum Depression in Border City of Ilam, Western Iran”. Depression Research and Treatment, 2013, 653471.

Xie, R. H., Lei, J., Wang, S., Xie, H., Walker, M., & Wen, S. W. “Cesarean Section and Postpartum Depression in a Cohort of Chinese Women with a High Cesarean Delivery Rate”. Journal of Women's Health, Vol. XX, No. XII, 2011, pp.1881–1886.

Yokoyama, M. Tanaka, K. Sugiyama, T. Arakawa, M. Miyake, Y. “Cesarean Section is Associated with Increased Risk of Postpartum Depressive Symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study”. Journal of Affective Disorders, 278, 2021, pp. 497-501

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Undergraduate Program of Midwifery
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Faculty of Medicine, Universitas Andalas

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