Research sheds new light on postpartum depression

It is a crushing reality for many women: depression after the birth of their baby‚ when the community expects them to be delighted at the arrival of the new bundle‚ or to simply “cope” if they are struggling.

Many international researchers have looked into this issue‚ and pain during childbirth has often been named as one of the culprits. A woman who experiences pain during labour and delivery is said to be at far higher risk of experiencing what’s known as postpartum depression.

But now‚ some new groundbreaking research has shed light on a whole new culprit. Researchers at Harvard Medical School have found that pain experienced after rather than during the birth is an even bigger risk factor.

This is the first study which differentiates pain experienced after childbirth to that experienced during labour and delivery. Lead author on the study‚ Jie Zhou‚ said: “For many years‚ we have been concerned about how to manage labour pain‚ but recovery pain after labour and delivery often is overlooked‚ and our research suggests we need to focus more on helping new mothers manage pain after the baby is born.”

The study looked at around 4‚500 first-time mothers giving birth over a two-and-a-half year period and not only found higher levels of depression among those who experienced pain after the birth‚ but also higher levels of pain among those who had a caesarian section compared to a vaginal birth. Those who had a caesarian section reported higher levels of inadequate pain management after the birth‚ and were thus at even higher risk than their vaginal-birth counterparts.

In the South African context‚ where 30% of women living in adversity experience a mental illness during or after pregnancy‚ research of this nature has particular significance as postpartum physical pain is just one of several other even higher risk factors.

According to the Perinatal Mental Health Project (PMHP) at the University of Cape Town‚ of the clients that the organisation sees‚ 60% lack primary support from a partner or family‚ 40% experience problems in their social environment (for example‚ violence‚ housing problems‚ financial issues‚ to name but a few)‚ and around 80% have more than one presenting problem.

Roseanne Turner‚ a training consultant at the PMHP‚ told TimesLIVE that‚ while postpartum pain might be a contributing factor‚ “in South Africa it is more likely to be related to an undetected common mental health disorder (anxiety and depression) during pregnancy”.

She said that to tackle this‚ “we need to screen all pregnant women and provide integrated care to those at risk”.

She added that the department of health in the Western Cape was starting to “evaluate all pregnant women for risk factors and screen for anxiety and depression”.

As for the physical pain after giving birth‚ Zhou said: “While ibuprofen and similar pain medications are considered adequate for pain control after childbirth‚ clearly some women need additional help managing pain. We need to do a better job identifying who is at risk for postpartum pain and ensure they have adequate postpartum care.”