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Postpartum Depression May Be Linked To Pain After Childbirth

The excitement of a couple’s pregnancy can make many expectant parents overlook some of the challenges they may face when it’s time for baby’s arrival. We know that labor and delivery can be quite painful for some women, and often, postpartum pain can range from mild to severe.

Often, new moms don’t expect to feel the level of pain they experience after childbirth. Depending on the delivery process, some women may experience soreness, bruising, after-pain, cramps, and if they experience tearing or an episiotomy, stitches. Women recovering for a C-section may also experience after-pain, vaginal discharge, and recovering from the surgery itself.

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Now, studies show how necessary it is to provide extra care to help moms recover after giving birth. According to new research, postpartum depression (PPD) can be linked to mother's pain after childbirth.

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Childbirth pain has been linked to PPD, however the culprit may be the pain experienced by the mother following childbirth, rather than during the labor and delivery process, suggests new research presented at the ANESTHESIOLOGY® 2018 annual meeting

This is the first study to differentiate postpartum pain from labor and delivery pain and identify it as a significant risk factor for PPD.

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"For many years, we have been concerned about how to manage labor pain, but recovery pain after labor and delivery often is overlooked," said Jie Zhou, M.D., M.B.A., lead author of the study and assistant professor of anesthesia at Brigham and Women's Hospital and Harvard Medical School, Boston.

"Our research suggests we need to focus more on helping new mothers manage pain after the baby is born."

Credit: iStock / Camrocker

The study reviewed pain scores (from the start of labor to hospital discharge) for 4,327 first-time mothers delivering a single child vaginally or by C-section at Brigham and Women's Hospital. They compared pain scores to the mothers' Edinburgh postnatal depression scale (EPDS) scores one week after delivery.

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PPD was significantly associated with higher postpartum pain scores. Mothers with PPD complained more about pain during recovery, and often needed additional pain medication. Women in the PPD group were more likely to have delivered by C-section, and also had more reports of inadequate postpartum pain control.

Previous research has demonstrated the pain associated with giving birth may increase the risk of postpartum depression, but has not specified which part of the labor process (e.g., before, during or after delivery) may be the source of the problem.

Postpartum depression affects about 1 in 9 women, according to the Centers for Disease Control and Prevention (CDC). Symptoms of PPD include extreme sadness, low energy, anxiety, crying episodes, irritability and changes in sleep or eating patterns.

"While ibuprofen and similar pain medications are considered adequate for pain control after childbirth, clearly some women need additional help managing pain," said Dr. Zhou. "We need to do a better job identifying who is at risk for postpartum pain and ensure they have adequate postpartum care."

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