An exploratory study of the effect of labor pain management on postpartum depression among Chinese women

Ginekol Pol. 2018;89(11):627-636. doi: 10.5603/GP.a2018.0107.

Abstract

Objectives: The purpose of this study was to investigate the effects of pain relief during labor on the occurrence of potential postpartum depression in early postpartum among Chinese women.

Material and methods: A quasi-experimental study used, with a convenience sample of 565 women who delivered at the Women's Hospital, School of Medicine. Three types of pain relief were administered based on the women's preference (doula, n = 301; transcutaneous electrical nerve stimulation, n = 51; epidural analgesia, n = 213). Pain scores of participants were assessed using a 10-point visual analog scale during labor. The Edinburgh Postnatal Depression Scale was administered in person and by phone at three days and two to four weeks after delivery, respectively. All data were analyzed using SPSS 20.0.

Results: Visual analog scale pain scores in the epidural analgesia group decreased significantly during labor compared to those of the other two groups. The occurrence of potential postpartum depression at three days was 6.6% in the epidural analgesia group, 1.3% in the doula group, and 2% in the transcutaneous electrical nerve stimulation group (P = 0.04). Furthermore, potential postpartum depression occurred at two to four weeks after childbirth in 16% (34/213) of the participants in the epidural analgesia group, 7.3% (22/301) of those who received doula support, and in 7.8% (4/51) of those in the transcutaneous electrical nerve stimulation group (P = 0.006).

Conclusions: The results indicated that epidural analgesia was an effective pain relief method during labor. However, it did not reduce the occurrence of potential postpartum depression and was associated with higher postnatal depression scores.

Keywords: edinburgh postpartum depression scale; labour analgesia; labour pain management; postpartum depression.

MeSH terms

  • Adult
  • Analgesia, Epidural / statistics & numerical data*
  • Analgesia, Obstetrical / statistics & numerical data*
  • China / epidemiology
  • Depression, Postpartum / epidemiology*
  • Doulas*
  • Female
  • Humans
  • Labor Pain / therapy*
  • Pain Management
  • Pain Measurement
  • Pregnancy
  • Transcutaneous Electric Nerve Stimulation / statistics & numerical data*
  • Young Adult