Epidural During Childbirth Can Cut Postpartum Depression Risk

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Women who receive an epidural during childbirth can significantly lower their risk of postpartum depression, according to new research.

Study participants whose pain was managed during labor had a 14-percent rate of depression at six weeks after delivery, compared to a nearly 35-percent rate of depression for those who did not have the pain relief. The study also found that women who attended childbirth classes during pregnancy and those who breastfed after labor lowered their risk of postpartum depression. Breastfeeding was more common in the group who had an epidural for pain (70 percent) compared to those who did not (50 percent).

The study, which will be published in the August issue of “Anesthesia & Analgesia,” involved 214 women, half of whom were given an epidural to reduce their pain during the vaginal delivery of their child. The other 107 participants were not given any pain medication during delivery. The mental statuses of all study participants were examined three days after delivery and again six weeks after delivery using an established postnatal depression scale.

"It’s a huge omission that there has been almost nothing in postpartum depression research about pain during labor and delivery and postpartum depression," Katherine Wisner, M.D., a Northwestern Medicine® perinatal psychiatrist, said in a press release. "There is a well-known relationship between acute and chronic pain and depression."

Up to 80-percent of new mothers experience some degree of emotional distress after childbirth. It is common for women to have a range of emotions, including weepiness, anxiety, and mood swings. However, if these symptoms last longer than two weeks and become more severe, postpartum depression (PPD) could be the reason. PPD is a type of clinical depression with symptoms such as fatigue or exhaustion, changes in appetite or eating habits, loss of interest in activities you usually enjoy, and physical pain, including, headaches, stomachaches, or backaches. According to the American Psychological Association, between 9 and 16 percent of women will experience PPD, which can have significant consequences for both the new mother and family.

According to Wisner, managing acute postpartum pain supports the new mother’s ability to emotionally attach and care for her infant. “Pain control gets the mother off to a good beginning rather than starting off defeated and exhausted,” she said. “Whether it’s vaginal or cesarean section delivery, pain control postpartum is an issue for all new mothers. There is no way to have a delivery without pain. The objective here is to avoid severe pain. Controlling that delivery pain so a woman can comfortably develop as a mother is something that makes a lot of sense.”

Wisner recommends that women who experience chronic pain one to two months after delivery be screened for depression.