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New research suggests that persistent pain after childbirth can predict postpartum depression – even if the labor and delivery of the woman is not particularly painful.
Doctors have long observed that the pain associated with childbirth was related to depression afterwards, but they were not about to specify which period of pain was most closely associated with pain. potentially debilitating mental health condition.
Researchers at Harvard Medical School and Brigham and Women's Hospital found that it was the post-delivery period that deserved special attention.
They advise doctors to ensure that women are not sent home to suffering to protect their physical and mental health.
Ensuring that women better manage pain after childbirth – particularly via caesarean section – can reduce the risk of postpartum depression, according to a new study
In the United States, about one in nine women suffers from postpartum depression.
The symptoms of the disorder can appear at any time during the first year of a newborn's life and last for weeks or even months, although the trajectory is different for everyone.
In some ways, postpartum depression is similar to other forms of mood disorder, with symptoms such as general sadness and fatigue, but it can also make women feel violent towards themselves and others. their newborn baby.
The disorder can impair a woman's and her child's ability to bond, which harms their health for both.
Postpartum depression is partly caused by the dramatic hormonal changes that women experience during and after pregnancy, but compounded by the emotional ups and downs and exhaustion of a new baby's care.
In addition, physicians believe that other factors, including the extent of physical pain inflicted on a woman, help determine whether she will develop postpartum depression.
The authors of the new study found that this is especially true if a woman is suffering a lot during her recovery after childbirth.
Complications such as tears or wounds left by a caesarean section have a greater impact than expected.
Until now, it was thought that only pain during delivery was related to the disease, but it now seems that the dominant factor is the pain that new mothers experience when they leave the room. # 39; s birth.
Assistant Professor Dr. Jie Zhou, head of study at Brigham and Women's Hospital and Harvard Medical School in Boston, said, "For many years we have been concerned how to manage the pain of work.
"But the pain associated with recovery after work and delivery is often overlooked.
"Our research suggests that we need to focus more on helping new mothers manage pain after the baby is born."
In the new study, Dr. Zhou's research group looked at pain scores from early postpartum to hospital discharge, in more than 4,300 new mothers who gave birth naturally or by caesarean section.
Scientists compared the results to scores from the Edinburgh Postnatal Depression Scale (EPDS) used by mothers in screening for postpartum depression one week after delivery.
The results showed strong links between depression and higher postnatal pain scores.
Mothers with postpartum depression had more pain complaints during their convalescence and often needed additional pain medications.
These women were also more likely to have delivered by caesarean section. This meant that doctors had to cut through layers of their abdominal muscles and uterus to surgically remove the baby.
Although they are safe, these procedures are much more invasive and may result in longer and more painful recovery.
Still, women who had a caesarean section were more likely to report poor pain control after work.
Although clinical recommendations indicate that ibuprofen is expected to relieve postpartum pain, previous research suggests that about half of American women with caesarean sections are also prescribed opioid analgesics.
This practice is risky because drugs are powerful and addictive. Still, the new study found that many Caesarean patients were still suffering too much, which increased the risk of depression.
The authors of the study stated that much more needed to be done to mitigate these and other risks of postpartum depression.
A number of factors, in addition to cesarean and postnatal pain, may contribute to the postpartum, but researchers found that it was more common in overweight or obese women.
It was also more prevalent among women who were crying during delivery, who had a history of depression, anxiety or chronic pain and whose babies were smaller and had lower physical health scores. a few minutes after birth.
"Although Ibuprofen and Analgesic Analgesics are considered adequate for pain relief after childbirth, some women clearly need additional help to manage pain."
"We need to better identify people who are at risk for postpartum pain and ensure that they receive adequate care after birth."
The results were presented by the American Society of Anesthesiologists in San Francisco.
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