Double duty: does epidural labor analgesia reduce both pain and postpartum depression?

Abstract

Nearly one-third of pregnant women in the United States undergo cesarean delivery.1 Effective analgesia is crucial to maximize the mother’s comfort, increase her mobility, and support lactation and emotional attachment to her newborn. The incidence of severe acute postpartum pain is approximately 11%.2 Chronic pain incidence varies by study and ranges from 1% to 4% to 10% after vaginal delivery and 6% to 18% after cesarean delivery.3,4 Chronic pain frequently co-occurs with depression. Eisenach et al.2 evaluated whether mode of delivery or acute postpartum pain was associated with persistent pain and depression 8 weeks after childbirth in a multicenter, prospective, longitudinal cohort study (n = 1288). The prevalence of severe acute pain within 36 hours of birth was 10.9%. Women with severe acute pain had a 2.5-fold increased risk of persistent pain and a 3-fold increased risk for postpartum depression compared with those with mild postpartum pain.