Investigation of the relationship of delivery expectation and delivery method preference reasons with depression and anxiety in pregnant women admitted to van yyu faculty of medicine

Aim: The purpose of this study is to determine the relationship between delivery method preference reasons with depression and anxiety, to solve the problems of pregnant women in this regard, to create awareness in the healthcare workers and the society, as a result, to ensure the health of the mother and her baby, and to contribute to the national economy by preventing unnecessary cesarean delivery. Materials and Methods: Our study is a cross-sectional descriptive study to determine the relationship of depression and anxiety with birth expectancy and delivery method preferences of pregnants who admitted to Van YYU Medical Faculty Gynecology and Obstetrics Outpatient Clinic between 1 October 2018 and 1 January 2019. The universe of our study consists of pregnant women between the ages of 18-49 who did not give birth by cesarean section before. Pregnant women who did not want to participate in the interview were not evaluated. The data were collected by interviewing face to face by filling the questionnaire forms with pregnant women who were taken into consideration. These questionnaire forms consist of 4 surveys, namely Sociodemographic scale, Wijma Delivery Expectancy/Experience Questionnaire, Beck Depression and Beck Anxiety Inventory. The data were evaluated using the IBM SPSS Statistics 18 program as number, percentage, mean, standard deviation, smallest, largest, and chi-square test and one-way variance analysis were used while performing statistical analysis. p <0.05 value was considered statistically significant. Results: The average age of the pregnant women participating in our study was 26.9 ± 5.9, 50.3% (n = 100) of which were between 18-25, 42.7% (n = 85) were between 26-35 years, 7% (n = 14) were between 36-49 years old. The average Wijma Delivery Expectancy/Experience Questionnaire (W‐DEQ) score of the pregnant women between the ages of 18-25 was 60.4, the average W‐DEQ score of the pregnant women between the ages of 26-35 was 57.9, the average W‐DEQ score of the pregnant women VI between the ages of 36-49 was 61.7, and the delivery fears of all age groups were moderate. Average Beck Depression Score of pregnant women according to age range: It was observed that there was near-moderate depression with 16.8 points for age of 18-25, mild depression with 12.7 points for age of 26-35, and moderate depression with 22.6 points for age of 36-49 years. Average Beck Anxiety Score according to the age range of pregnant women: 18-25 years old has moderate anxiety with 19.1 points, 26-35 years 15.6 points with mild anxiety, 36-49 years 20.6 points with moderate anxiety findings. Birth fears (W‐DEQ score: 77.45), depression levels (Beck depression score: 22.01) and anxiety levels (Beck anxiety score: 22.5) of those who prefer delivery by Cesarean section were higher than who want normal vaginal delivery (W-DEQ score: 54.9, Beck depression score: 12.1, Beck anxiety score: 16.5). Of the pregnant women with a low W-DEQ level (n = 34); 61.8% (n = 21) had minimal depression, 20.6% (n = 7) had mild depression, 17.6% (n = 6) had moderate depression. There were no pregnant women with severe depression in this group. 33.3% (n = 28) of pregnant women with moderate W-DEQ level (n = 84) had minimal depression, 34.5% (n = 29) had mild depression, 21.4% (n = 18) had moderate depression, 10.7% (n = 9) had severe depression. Of the pregnant women with severe W-DEQ level (n = 57), 24.6% (n = 14) had minimal depression, 33.3% (n = 19) had mild depression, 26.3% (n = 15) had moderate depression and 15.8% (n = 9) had severe depression. The comparison of the anxiety status of the pregnant women participating in the study is as follows: 32.4% (n = 11) of pregnant women with a low W-DEQ level (n = 34) had minimal, 47.1% (n = 16) had mild, 17.6% (n = 6) had moderate, and 2.9% (n = 1) had severe anxiety symptoms. Of the pregnant women with moderate W-DEQ level (n = 84), 14.3% (n = 12) had minimal, 33.3% (n = 28) had mild, 34.5% (n = 29) had moderate, 17.9% (n = 15) had severe anxiety symptoms. 5.3% (n = 3) of the pregnant women with severe W-DEQ level (n = 57) had minimal, 33.3% (n = 19) had mild, 38.6% (n = 22) had moderate, 22.8% (n = 13) had severe anxiety symptoms. Of the pregnant women with clinically severe W-DEQ level (n = 24), 4.2% (n = 1) had minimal, 16.7% (n = 4) had mild, 25.0% (n = 6) had moderate, 54.2% (n = 13) had severe anxiety symptoms. Conclusion: Increasing Caesarean section rates have become a major problem in the world and in our country. Uncovering the reasons of Caesarean section preference for delivery and taking the necessary measures for this will greatly reduce this problem. VII In our study, we examined whether depression and anxiety is effective in women's birth method preference. Our study showed that high levels of depression and anxiety in pregnant women increase the fear of delivery. Pregnant women who have a high fear of birth prefer Cesarean section rather than normal vaginal delivery. Therefore, every pregnant woman should be examined for depression, anxiety and fear of birth, and necessary medical support should be provided. As a result, Cesarean section tendencies out of indication will decrease in pregnant women whose fear of birth, depression and anxiety decrease. In addition, an underlying depression should be examined in pregnant women stating that they prefer Cesarean section and necessary medical care and support should be provided.