Depression and anxiety in pregnant women may be connected to the type of delivery they have, new research by the University of Michigan suggests.

The findings appeared in the journal Health Affairs. Perinatal mood and anxiety disorders have already been associated with adverse pregnancy outcomes like low birth weight and preterm birth. The study is among the largest to document a link between predated mood and anxiety disorders and first-time C-sections among low-risk pregnant women.

Reducing the rate of first-time caesarean sections is a Healthy People 2030 goal in the US endorsed by numerous public health and professional societies.