- Pain associated with childbirth may increase the risk of postpartum depression in the woman without clearly specifying whether it was pain during labor or after delivery
- Poorly controlled pain following delivery of the baby is associated with a significant increase in the risk of postpartum depression
- Better pain management measures following delivery are necessary to reduce the risk of postpartum depression
Better management of pain following delivery can reduce the risk of postpartum depression and associated complications in the woman, according to a study at the Brigham and Women's Hospital and Harvard Medical School, Boston. The findings of the study were presented at the ANESTHESIOLOGY 2018 annual meeting
"For many years, we have been concerned about how to manage labor pain
, but recovery pain after labor and delivery is often overlooked," said Jie Zhou, M.D., M.B.A., lead author of the study and assistant professor of anesthesia at Brigham and Women's Hospital and Harvard Medical School, Boston. "Our research suggests that we need to focus more on helping new mothers manage pain after the baby is born."
Effect of Post Delivery Pain in Causing Postpartum Depression
The study team analyzed pain scores from the start of labor to hospital discharge at Brigham and Women's Hospital in about 4,327 first-time mothers delivering a single child either by normal vaginal delivery or by cesarean delivery (C-section)
between June 1, 2015 and Dec. 31, 2017
‘Managing a woman’s pain following delivery is important to reduce the risk of postpartum depression, which could cause poor bonding with baby and lower rates of breastfeeding.’
Pain scores of the mothers one week after delivery were compared to the Edinburgh postnatal depression scale (EPDS).
It was found that:
- Postpartum depression in women was significantly associated with bigger pain scores following delivery
- Women with postpartum blues showed more pain-related complaints after childbirth and often needed additional pain medication to control pain
- Women with postpartum depression were more likely to have delivered by C-section.
- Reports of inadequate pain relief following delivery was higher in women with postpartum depression
The findings of the study suggest that better pain management in women following delivery may help to reduce the risk of postpartum depression or blues.
Dr Zhou explained, "While ibuprofen
and similar pain medications are considered adequate for pain control after childbirth, clearly some women need additional help managing pain. We need to do a better job identifying who is at risk for postpartum pain and ensure they have adequate postpartum care."
About Postpartum Depression or Blues
Some women suffer from a depressed mood or postpartum blues after childbirth. Symptoms of postpartum depression are feeling very sad or low, anxiety, crying episodes, extremely low energy levels, irritability and altered sleeping and eating patterns.
According to the Centers for Disease Control and Prevention (CDC) it can affect about 1 in 9 women
. Postpartum depression may result in lower rates of breastfeeding and poor bonding with the baby.
Several factors have been found to be associated with postpartum depression. Studies have demonstrated a higher incidence among women who were overweight or obese, perineal tear (area around the vagina) during delivery, women whose babies had low birth weight
and had lower Apgar scores
(a scoring system used to assess the health status of newborns one minute and five minutes after birth) and women with a history of depression, anxiety or chronic pain. References :
- Postpartum depression - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918890/)
- Postpartum depression and birth experiences - (https://sophia.stkate.edu/cgi/viewcontent.cgi?article=1581&context=msw_papers)