Authors: Ganamo GG et al.
Source: BMC Anesthesiology. Published June 1, 2026.
Summary:
This open-access cross-sectional study examined how common preoperative anxiety is among obstetric patients scheduled for elective cesarean section under spinal anesthesia and identified factors associated with higher anxiety risk.
The study was conducted at two specialized hospitals in Addis Ababa, Ethiopia, from October 2024 to January 2025. Pregnant women age 18 or older who were scheduled for elective cesarean section under spinal anesthesia were included. Anxiety was measured using the State-Trait Anxiety Inventory, or STAI.
The authors found that clinically significant preoperative anxiety was very common, affecting 54% of patients. Several independent predictors were identified. These included younger maternal age under 25 years, lower educational level, previous negative surgical experience, lack of preoperative counseling, and poor social support.
The strongest modifiable risk factor was lack of preoperative counseling, which was associated with more than three times higher odds of anxiety. Poor social support was also an important predictor. These findings suggest that anxiety before cesarean delivery is not just a patient-specific issue but may be improved through better communication, counseling, and support systems.
Clinical importance:
This article is important for anesthesia providers because spinal anesthesia for cesarean section requires patient cooperation and reassurance. High anxiety can make positioning, neuraxial placement, intraoperative communication, and maternal experience more difficult.
The study also highlights that many risk factors are modifiable. A standardized preoperative anesthesia consultation, clear explanation of spinal anesthesia, reassurance about intraoperative sensations, and involvement of family or support networks may reduce anxiety, especially in resource-limited settings.
Bottom line:
Preoperative anxiety is highly prevalent among obstetric patients undergoing cesarean section under spinal anesthesia, affecting more than half of patients in this study. Younger age, lower education, prior negative surgical experience, lack of counseling, and poor social support increased the risk. The most practical takeaway is that better preoperative counseling and support may significantly reduce anxiety before cesarean delivery.
Thank you to BMC Anesthesiology for publishing this important open-access study on preoperative anxiety in obstetric anesthesia.