Postpartum Depression Link to Post-Birth Pain

New research has indicated that post-birth pain could be the defining factor in the development of postpartum depression.

Although it has long been accepted that pain during childbirth was one of the major determiners of whether a new mother developed postpartum depression, the study, which was carried out by scientists at Harvard Medical School, is the first to differentiate postpartum pain from that of labour and delivery.

“For many years, we have been concerned about how to manage labour pain, but recovery pain after labour and delivery often is overlooked,” commented Dr Jie Zhou, the study’s lead author and assistant professor of anaesthesia at Brigham and Women’s Hospital and Harvard Medical School, Boston. “Our research suggests we need to focus more on helping new mothers manage pain after the baby is born.”

According to the NHS, around 15% of women experience postnatal depression, with symptoms ranging from feelings of fatigue and sadness to feelings of anxiety, irritability and disrupted sleep patterns.

In a study involving more than 1000 women’s birth experience, Dr Zhou’s found postnatal depression to be much more prevalent in women who recorded higher postpartum pain scores. Typically, these mothers requested more help for their pain and were more likely to be prescribed pain medication. They were also more likely to report being unsatisfied with the level of relief provided by their medication. Interestingly, those with postpartum depression were also more likely to have given birth by C-section.

One significant factor in the onset of postpartum depression was whether a woman had suffered a torn perineum. Women who were obese or who had previously suffered from poor mental health were also more likely to develop the condition, as were those who were mothers of smaller babies with lower Apgar scores.

The study has the potential to improve postnatal depression rates as it would indicate that more effective postpartum pain relief could lead to better outcomes.

NICE currently advises that healthcare professionals identify which mothers are at heightened risk of postpartum depression and to help mothers develop awareness of what they can do to protect their postnatal mental health.

Furthermore, at around two weeks post-birth, women are assessed to check for symptoms. In the event of symptoms, ‘talking’ therapies are recommended as first-line treatment, with anti-depression treatment an alternative for acute and persistent cases.

For more information, you can read Dr Sylvia Garry’s article on postnatal depression.