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Can an epidural prevent postpartum depression?

Claire Zulkey wonders when she'll ever get used to the idea that she has two boys. She is the author of two books for young people, An Off Year and Best Frenemies. She and her filmmaker husband live in Evanston, IL. You can find out more...

Early research shows that pain relief during labor may prevent postpartum depression

I started having the flashbacks just hours after my first child was born. I hadn’t slept in days and was so relieved that the fear, pain and tension of my surprise 37-week induction was behind me that I should have passed right out like my husband dozing on the hospital cot next to me. But I couldn’t sleep because I kept reliving the experience, from that first horrifying cervical check to the vomiting and fever to the realization that my epidural hadn’t taken that well to watching my husband cry from the stress of seeing me in so much pain.

The flashbacks didn’t stop after I left the hospital, either. For months, it seemed like I couldn’t get to sleep until I had successfully relived every single stop along the five-day journey from my hospital admittance to getting discharged from the hospital.

My experience (while anecdotal) made me nod in recognition when I saw the American Society of Anesthesiologists' recently released preliminary research that for some women, epidural anesthesia may reduce the likelihood of postpartum depression.

More: 10 things you should know about getting your first epidural

In the study, researchers reviewed the medical records of 201 women who had epidurals and assessed their pain during labor. Researchers found that the higher the “improvement in pain” scores, the lower the women’s risk of depression six weeks after childbirth.

“Labor pain matters more than just for the birth experience. It may be psychologically harmful for some women and play a significant role in the development of postpartum depression,” says Dr. Grace Lim, director of obstetric anesthesiology at Magee-Womens Hospital of the University of Pittsburgh Medical Center and lead investigator on the study. However, more research needs to be done to determine which women are more likely to experience severe labor pain and who would most benefit from pain-control strategies to reduce the impact of pain on postpartum recovery.

All I can say is that with my second child, while experience and a “broken-in” body helped, so did better pain control — unlike with my first epidural, the second time, I couldn’t tell at all when I was undergoing contractions (which is not a complaint). All I know is that my second delivery engendered a lot less fear, a lot less pain and no flashbacks whatsoever.

Obviously, everyone’s childbirth journey is different and no one should ever be shamed for her choices when it comes to labor and delivery. Epidural or unmedicated, no childbirth process is a walk in the park. However, this new study may show what many women already know — that the effects of childbirth, especially the pain and fear, linger long after the child has been born. Mitigating those effects isn’t necessarily just about pain relief in the moment, but down the line as well.

More: Yes, I had an epidural. No, my childbirth wasn't pain-free

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