Can Having an Epidural Reduce Your Risk for Postpartum Depression?

Small studies say yes, but the evidence isn’t strong

You likely know that having epidural anesthesia can help block the worst of your discomfort during labor and delivery of your baby. But can getting that pain relief improve your mental state after your baby’s born?

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Two small, recent studies show evidence of that, finding that women who have an epidural may have a lower risk of postpartum depression than those who don’t.

A 2014 study found that 14 percent of women who had epidurals reported having postpartum depression, as opposed to almost 35 percent who didn’t receive the treatment.

And, in 2016, researchers presented findings at the American Society for Anesthesiologists annual meeting that show women who had less pain during labor had lower rates of depression afterward.

But the studies were small — only about 200 women participated in each one. They also excluded important factors like whether participants had a history of depression — a major risk factor for postpartum depression.

OB/Gyn Vicki Reed, MD, answered our questions about what these studies might mean and how to identify and manage postpartum depression.

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Q: How strong is research on epidurals reducing postpartum depression?

A: Some new moms get the baby blues. And, in about 10 percent of women, it will develop into postpartum depression.

Does getting an epidural decrease that? It’s hard to say and I don’t think there is enough medical literature to support that.

In fact, a 2015 study in Clinical Lactation looking at more than 6,000 mothers found that epidurals increased risk for postpartum depression. What we really need to do is help women recognize postpartum depression and get the help they need to manage symptoms.

Q: Who is at risk for postpartum depression?

A: There are so many unknown variables that may cause it. But we do know of some factors that increase risk:

  • A history of depression or any kind of psychiatric issue.
  • A premature baby or a newborn who needs care in the neonatal intensive care unit.
  • Lack of a good support system at home.

Q: What symptoms should you watch for?

A: It’s normal to have ups and downs after you have a baby. But if you are feeling down more than up, that is a problem. Other symptoms include:

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  • Not bonding with your baby or having no interest in bonding.
  • Wanting to be by yourself most of the time.
  • Sleeping so much that it interferes with your daily activities.
  • Not enjoying things you normally would.
  • Frequent or constant crying.
  • Thoughts of harming the baby or yourself. If you are having these thoughts, go to the emergency department immediately.

Q: How can you manage postpartum depression?

A: One very important component is screening. Many doctors screen before and after delivery, but we do it during pregnancy at 28 weeks. Screening early allows you to establish a plan and begin treatment early.

Treatment may include meeting with counselors or participating in a postpartum mom group. These groups can guide you to psychiatric help or counseling. Many women also do yoga or rely on family for support and assistance.

Some women who have had depression opt to take medication immediately after delivery as a preventive measure.

The most important thing to know is don’t ignore or worry about being judged if you’re depressed after childbirth.

And don’t dismiss it — pay attention to what people around you are saying.

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