How an Epidural May Lower Postpartum Depression Risk

Source: Time

Pain during childbirth can be excruciating for some women—and its harmful effects may reach beyond the delivery room. A small new study suggests that getting a pain-relieving epidural injection during labor may lower the risk of developing postpartum depression.

“Labor pain matters more than just for the birth experience,” said lead author Dr. Grace Lim, director of obstetric anesthesiology at Magee Women’s Hospital of the University of Pittsburgh Medical Center, in a press release. “It may be psychologically harmful for some women and play a significant role in the development of postpartum depression.”

Overall, 61% of U.S. women get an epidural while giving birth, and the injections can be controversial. This is in part due to an ongoing debate over whether they are linked to more Caesarean sections or have other negative effects for mom and baby; some women who plan an unmedicated birth feel guilty if they end up opting for this type of pain relief. The new research suggests that epidurals may have benefits beyond pain relief.

For the study, which was presented at the American Society for Anesthesiologists’ annual meeting, Dr. Lim and her colleagues reviewed the medical records of 201 women who received an epidural while in labor, and who rated their pain on a scale from 0 to 10 throughout the entire birth process. From these numbers, the researchers calculated the percent by which the women’s pain improved after the epidural.

Six weeks after their babies were born, the new moms also completed a questionnaire used to assess whether a woman may have, or may be at risk for, postpartum depression.

The researchers controlled for factors already known to increase the risk for postpartum depression (including pre-existing depression and anxiety, as well as post-delivery pain caused by tissue trauma). After accounting for these factors, the results showed that in some women, labor pain alone was a significant risk factor: The lower their pain-improvement scores (suggesting that the epidural had not provided substantial relief) the higher their depression-scale scores.

In other words, “we found that certain women who experience good pain relief from epidural analgesia are less likely to exhibit depressive symptomsin the postpartum period,” said Dr. Lim. The researchers conclude that alleviating labor pain might help reduce the risk for postpartum depression in some women. (The study still needs to be published in a peer-reviewed medical journal, which is key to confirming the results.)

However, the researchers acknowledge that a woman’s labor experience is just one of many factors that contributes to her how she feels after giving birth. “Postpartum depression can develop from a number of things including hormonal changes, psychological adjustment to motherhood, social support, and a history of psychiatric disorders,” said Dr. Lim.

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