Controlling women's pain levels during childbirth and the post-delivery period may reduce the risk of new mums suffering from postnatal depression (PND), according to a new study.
Researchers found that 14 per cent of women who had an epidural for pain relief during labour reported suffering depression six weeks after the birth of their baby, compared with 34.6 per cent for women who had no pain relief during childbirth.
The Chinese study, which analysed data from 214 women, also found that breastfeeding was more common in the group who had an epidural for their pain (70 per cent) compared to those who did not (50 per cent).
Writing about the findings in the current issue of Anesthesia and Analgesia journal, perinatal psychiatrist Katherine Wisner described the findings as "exciting" and said the information could be particularly helpful for women who are already at risk of postnatal depression.
"It's a huge omission that there has been almost nothing in postpartum depression research about pain during labour and delivery and postpartum depression. There is a well-known relationship between acute and chronic pain and depression," said Wisner, who is a professor of psychiatry and behavioural sciences and gynecology at Chicago's Northwestern University Feinberg School of Medicine.
"Maximising pain control in labour and delivery with your obstetrician and anesthesia team might help reduce the risk of postpartum depression."
While biological and emotional factors are known to contribute to postnatal depression, Wisner said chronic pain might also play a part by hindering a mother's ability to emotionally attach to her new baby.
The incidence of severe acute postpartum pain is approximately 11 per cent, Wisner says. While the rate of chronic pain varies between studies, it ranges from 1 to 10 per cent for vaginal delivery and 6 to 18 per cent following a caesarean.
Wisner says a woman who has chronic pain one to two months after delivery should be screened for depression.
"Pain control gets the mother off to a good beginning, rather than starting off defeated and exhausted," Wisner said. "Whether it's vaginal or caesarean section delivery, pain control postpartum is an issue for all new mothers. There is no way to have a delivery without pain; the objective here is to avoid severe pain.
"Controlling that delivery pain so a woman can comfortably develop as a mother is something that makes a lot of sense."
According to the Black Dog Institute, depression during pregnancy or the postnatal period affects between 15 and 20 per cent of women in Australia. About three per cent suffer severe depression in the early months after their baby's birth.
Common symptoms of PND include loss of enjoyment in usual activities, loss of self-esteem and confidence, loss of appetite and weight (or weight gain), difficulty with sleep, a sense of hopelessness and being a failure, suicidal thoughts, panic attacks and loss of libido.
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