Women who suffer from poorly managed pain after childbirth are more prone to postpartum depression.
Contrary to popular belief, pain should not only be managed during childbirth, but also after delivery. Women who are not well supported at this level are more likely to suffer from postpartum depression, according to a new study.
“For many years, we’ve been concerned about how to manage labor pain, but recovery pain is often overlooked,” says Jie Zhou, director of research and professor of anesthesia at Harvard Medical School (Boston ). “Our results indicate that we also need to help mothers deal with pain after the baby is born,” he says.
More depressions postpartum with caesareans
Her team analyzed the postpartum pain levels of 4,327 new mothers who gave birth vaginally or by caesarean section between June 1, 2015 and December 31, 2017. One week after delivery, they compared these pain levels to the possible developments of postnatal depression in mothers.
They found that postpartum depression was significantly associated with higher levels of postpartum pain. Mothers with postpartum depression often needed additional painkillers right after pregnancy. Additionally, women with postpartum depression were more likely to have delivered by caesarean section, which often leads to more painful recoveries.
Previous research had already shown that the pain of childbirth could increase the risk of postpartum depression, but had not specified which part of the labor process could be the source of the problem.
“Some women need extra help to manage the pain”
“Although ibuprofen and similar analgesics are considered adequate for postpartum pain control, it is clear that some women need additional help with pain management,” the researchers note. “We need to better identify women at risk of postpartum pain and ensure they receive adequate postpartum care,” they conclude.
The researchers also noted that postpartum depression was higher in women who were overweight or obese, who had a torn perineum, and who had a history of depression, anxiety, or chronic pain.
Postpartum depression is the most common postnatal psychiatric disorder and affects 10 to 15% of mothers. Its diagnosis is based on the criteria of a major depressive episode, with the specificity of an onset of symptoms within 4 or 6 weeks after delivery. However, studies recognize a later onset (up to a year after childbirth). The most common symptoms are difficulty falling asleep, hyperactive behavior, difficulty concentrating, irritability, anxiety and permanent fatigue. Disorders of mother-baby interaction may also occur.
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