Mothers who undergo Caesarean sections may bond less well with their babies immediately after birth, concludes a study of 12 women published this week.
But the researchers stress that because the study is so small, and the differences not 鈥渨hopping鈥�, women contemplating C-sections shouldn鈥檛 panic.
鈥淚 don鈥檛 want to come across as scolding people who have Caesareans,鈥� says James Swain of Yale University, leader of the study team. 鈥淚t鈥檚 better for some women to have a Caesarean section when relaxed than to suffer the stress of awaiting a vaginal delivery,鈥� he says.
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Swain also revealed that an as-yet unpublished follow-up of the same women a few months later suggests that the differences seen shortly after birth had largely disappeared.
In the study published this week, half the women had Caesareans and half gave birth naturally.
Love hormone
Three to four weeks after they had given birth, the women had magnetic resonance imaging (MRI) brain scans while they listened to recordings of their own baby crying, a different baby crying, or an artificial sound similar to a baby crying.
The scans revealed that when they heard their own baby crying, women who had given birth via Caesarean had lower levels of activity than mothers who had undergone natural births in parts of the brain linked with empathy, drive and motivation.
One possible explanation, say the researchers, is that women having Caesareans miss out on the hormonal 鈥減riming鈥� for motherhood thought to happen when women deliver naturally through the vagina.
As the baby descends, oxytocin 鈥� sometimes called the 鈥渓ove hormone鈥� 鈥� is released and is thought to prime the mother for behaviour that helps forge an instant bond with the baby, such as cuddling, kissing and feeding.
Experiments in mice genetically engineered to lack the ability to make oxytocin and other maternal hormones have demonstrated that mothers are less attentive than normal to newly born pups and have lower levels of nesting and grooming behaviour.
Early warning
Likewise, says Swain, it may be that women undergoing Caesareans are 鈥渘eurohormonally deprived鈥�, and thus less primed neurologically and emotionally to bond properly with their babies. It鈥檚 also possible that this deprivation can lead to postnatal depression, although Swain says that the evidence for this in Caesarean women is inconclusive.
He stresses that the brain activity differences observed in the new study are significant, but not huge. 鈥淚t鈥檚 not double or triple the activity in the relevant areas, only a few percent, maybe 5%,鈥� he says. Also, the relevant areas were not totally switched off in any of the women, just slightly less active.
鈥淭his is very preliminary, and women shouldn鈥檛 feel guilty if they have reasons to want a Caesarean,鈥� says Swain.
One aim of such work is to see if brain imaging following Caesareans can be used to identify mothers who might have especially low maternal 鈥減riming鈥� in the relevant brain areas. In such cases, it might be possible to help the women develop their maternal bonding, and to try and stave off any tendencies towards depression.
Journal reference: (DOI: 10.1111.j.1469-6710.2008.01963.x)
