EFFECT OF PRENATAL PREHABILITATION ON PERIOPERATIVE STRESS AND POSTPARTUM PSYCHOLOGICAL OUTCOMES IN ELECTIVE CESAREAN DELIVERIES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background:

Cesarean deliveries are associated with increased risk of postpartum mood disorders and perioperative psychological stress. Prehabilitation, though effective in surgical populations, remains underutilized in obstetric settings.

Objective:

To assess the feasibility and preliminary efficacy of a structured prenatal psychological prehabilitation program in reducing perioperative stress and postpartum depression/anxiety in women undergoing elective cesarean section.

Methods:

This randomized controlled pilot study included 30 pregnant women (≥28 weeks gestation) scheduled for elective cesarean section. Participants were randomized into Group A (n = 15, prehabilitation intervention) or Group B (n = 15, routine antenatal care). The intervention consisted of six weekly sessions involving mindfulness, stress-coping strategies, and emotional preparedness. Psychological outcomes were assessed at baseline, pre-surgery, and 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), and Perceived Stress Scale (PSS). Descriptive and inferential statistics were used for analysis.

Results:

Women receiving prehabilitation showed lower perioperative stress levels and significantly improved EPDS and STAI scores postnatally compared to controls (p < 0.05). No adverse effects were reported, and intervention adherence was high.

Conclusion:

Prenatal psychological prehabilitation appears feasible and potentially effective in improving emotional outcomes in cesarean deliveries. These pilot findings support the need for larger, definitive trials and suggest a role for integrating psychological preparation into routine antenatal care.