Cellphone Access for Lowered Maternal Anxiety and Stress in Cesarean Sections

Cesarean section performed under regional (spinal) anesthesia allows the mother to remain awake throughout the procedure, which can be associated with heightened anxiety, stress, and feelings of loss of control. While medical and surgical outcomes of cesarean delivery have been extensively studied, less attention has been given to modifiable, non-pharmacologic factors that may improve the psychological experience of the mother during surgery.

Personal mobile phones are an integral part of daily life and serve as a means of emotional support, reassurance, and connection. Allowing mothers to use their cellphones during cesarean section-such as communicating with family members, or engaging in video calls-may help reduce intraoperative anxiety and enhance maternal satisfaction. Despite this, many operating rooms maintain strict policies prohibiting cellphone use, largely based on tradition rather than evidence regarding patient-centered outcomes.

The CALMAS-CS Trial is a prospective, randomized, parallel-group study designed to evaluate the psychological impact of unrestricted personal cellphone use during elective cesarean section under spinal anesthesia. Participants are randomly assigned to either an intervention group, in which personal cellphone use is permitted throughout the procedure, or a control group, which follows standard operating room policy prohibiting cellphone use. All participants receive identical surgical, anesthetic, and perioperative care; the only difference between groups is access to personal cellphone use during surgery.

Maternal anxiety is assessed at predefined perioperative timepoints using validated instruments, including the State-Trait Anxiety Inventory and a visual analogue scale for anxiety. Maternal satisfaction with the cesarean experience is evaluated postoperatively using a structured questionnaire. In addition, the study explores the psychological impact on next of kin by assessing their stress levels and perceived involvement when remote communication during surgery is permitted.

This trial focuses on a low-risk, non-pharmacologic intervention that does not interfere with standard medical care. By systematically evaluating the psychological effects of cellphone access during cesarean delivery, the study aims to generate evidence that may inform future institutional policies and contribute to more patient-centered obstetric care. The findings may have implications for improving maternal experience, family engagement, and overall satisfaction with planned cesarean delivery.

Inclusion criteria

• Low-risk pregnant patients scheduled for Cesarean section under spinal anesthesia, who are literate and able to provide an informed consent.

Exclusion criteria

• Patients undergoing normal vaginal deliveries.
• Patients who underwent emergency Cesarean sections.
• Non-Lebanese patients.
• High-risk pregnancies, as determined by medical assessment.
• Patients diagnosed with pre-existing anxiety disorders.
• Patients for whom spinal anesthesia was difficult to perform (requiring more than two attempts for successful administration).
• Patients receiving sedation during the procedure.