Mothers who have epidural could be ‘less likely to suffer postnatal depression’

October 27, 2016

Scientists looked at women’s labour pains using a score of 0 to 10
Found women who endured less pain were less likely to suffer PND
Suggested painful labour could cause psychological damage to women

Kate Pickles For Mailonline

and
Ben Spencer Medical Correspondent For The Daily Mail

Published:
09:45 EST, 26 October 2016

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Updated:
19:51 EST, 26 October 2016

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Controlling pain during childbirth could reduce the risk of mothers suffering from post-natal depression.

A new study shows that giving pain relief may actually protect new mothers from the baby blues.

An estimated 140,000 women giving birth each year in the UK are thought to suffer depression, anxiety or other mental health problems during pregnancy or in the months after birth.

But researchers suggest effective pain relief – in the form of an injection in the back that numbs the nerves and stops you feeling pain – could reduce this.

Researchers looked at the medical records of 201 women who had an epidural and had their pain assessed on a 0 to 10 scale during labour.

They calculated the per cent improvement in pain (PIP) throughout labour after a woman had an epidural.

Effective pain relief, such as an epidural, could reduce the risk of postnatal depression, a new study has found (file image)

Depression risk was assessed using the Edinburgh Postnatal Depression Scale (EPDS) six weeks after childbirth.

After factoring in other possible risks of postnatal depression, researchers found the higher the PIP scores, the lower the EPDS scores.

Dr Grace Lim, director of obstetric anaesthesiology at Magee Women’s Hospital of the University of Pittsburgh Medical Centre, said it showed how labour pains could have a long-term effect on some women.

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‘Labour pain matters more than just for the birth experience,’ she said.

‘It may be psychologically harmful for some women and play a significant role in the development of postpartum depression.

‘We found that certain women who experience good pain relief from epidural analgesia are less likely to exhibit depressive symptoms in the postpartum period.’

Therefore alleviating this pain might help reduce the risk for postpartum depression, she said.

But she said more research was needed to identify which women are more likely to experience severe labour pain.

Roughly one in three women giving birth in England have an epidural, but experts say some women feel under pressure to have a ‘natural’ birth free from pain relief.

A study shows that giving pain relief may actually protect new mothers from the baby blues (file image)

Dr Liz McDonald, chair of the perinatal faculty at the Royal College of Psychiatrists, said last night: ‘Women are under societal pressure to have a natural birth, particularly for their first child.

‘Women with a certain temperament tend to blame themselves for anything that has gone wrong during the pregnancy.

‘If they feel a lot of pain, if they feel out of control, they may feel they have failed.’

She said that for some women, that may trigger a form of post-traumatic stress disorder later on.

Edward Morris, of the Royal College of Obstetricians and Gynaecologists, added: ‘Childbirth can be painful and unpredictable so it is important that women are informed about all methods of pain relief to allow them to make an informed choice about what they would like to use in labour.

‘The decision to have an epidural anaesthetic should lie with the woman, in consultation with a midwife, obstetrician or anaesthetist where possible, who can explain the advantages and disadvantages.’

He added: ‘While a very painful and prolonged labour may be a factor in some women developing postpartum depression, a larger, more robust study is needed into whether an epidural anaesthetic decreases the likelihood of this.’

But Professor Stuart Derbyshire, of the National University of Singapore, said the study was too small to show anything meaningful.

He added: ‘The risk of causal relationship cannot be established – it’s just as likely that being at reduced risk of postpartum depression reduces labour pain.

‘In other words, it is just as possible that being prone to depression causes increased labour pain as it is that having increased labour pain causes subsequent depression.’

The preliminary study was presented at the American Society of Anesthesiologists annual meeting.