FACTORS ASSOCIATED WITH MOTHERS SELECTING GENERAL-ANESTHESIA FOR LOWER SEGMENT CESAREAN-SECTION

The objective of the study was to investigate the sociodemographic and psychological factors which are associated with choice or refusal of regional anesthesia for lower segment Caesarean section. A semi-struct ured questionnaire was administered preoperatively to consecutive wome n presenting for elective operation at two hospital sites in the same health authority. The questionnaires were administered to 39 pregnant women by two anesthetists, one at each site. Sociodemographic and past and present obstetric and anesthetic details were obtained. The Hospi tal Anxiety and Depression scale and the FEAR questionnaire were used with an additional visual analog scale to assess fearfulness associate d with the proposed operation. A 'panic checklist' of ten items was al so constructed to identify procedures associated with feelings of pani c. Ten women requested general anesthesia. These women had a similar l evel of anxiety to the others, but were significantly move depressed h ad had more pregnancies overall and more without live babies. There we re also more aspects of the procedure at which they thought they might panic. Women who have suffered the loss of a conception with its asso ciated grief and often obstetric intervention are more reluctant to be conscious during an operative delivery for a subsequent baby. Prevent ive measures should be considered at the time of fetal loss to avoid t his. However, preoperatively a simple visual analog scale for fearfuln ess would identify these women so that any unresolved fears could rece ive full psychological assessment.