An epidural could be the key to reducing PTSD in new mothers
Before I gave birth, I was sure it would be all-natural. For the sake of my baby, and my back, I decided to not take an epidural. The tune changed when the contractions attacked me like a lion, giving me no-where to run. Was this a smart decision to take the epidural, and do the short-term effects of it outweigh the other problems, like difficulties in breastfeeding, or lower back pain? According to a new study from Tel Aviv University, women who opt for the natural, pain-relief-free birth are at a much higher risk of developing full blown post-traumatic stress disorder (PTSD). It’s no trivial matter as PTSD is associated with serious health effects like depression and in the worst cases suicide. This news will no doubt get the La Leche League women fired up. Read on.
In the new study Prof. Rael Strous and colleagues found that about one third of all post-partum women develop PTSD, and among them a smaller percentage develop the full blown version of the condition. It usually develops in individuals who experience highly traumatizing situations such as terrorist attacks and car accidents, but symptoms can also come about after normal life events — including childbirth.
Looking deeper at the cases of women who developed PTSD, some 80 percent opted for natural childbirth without pain relief. Other significant factors that pointed to whether or not they’d develop the condition include the woman’s body image (including discomfort with being in an undressed state for the relatively prolonged period of labor and undergoing elective Caesarean sections), fear during labor, and complications in the present and earlier pregnancies and labors, the researchers found.
Published in IMAJ, the Israel Medical Association Journal, the researchers assess that the trauma is unlike others, in that it’s not unexpected. Still mothers feared their own safety as well as the health of their new babies.
In the study researchers interviewed 89 post-partum women between the ages of 20 and 40, first within 2 to 5 days after delivery and then again one month after delivery.
They discovered that of these participants, 25.9 percent displayed symptoms of post-trauma, 7.8 percent suffered from partial post-trauma, and 3.4 percent exhibited symptoms of full-blown PTSD. Symptoms included flashbacks of the labor, the avoidance of discussion of the event, physical reactions such as heart palpitations during such discussions, and a reluctance to consider having another child.
Is an epidural the key to stopping PTSD?
According to Strous, one of the most influential factors for developing PTSD or not was pain management during delivery. Of the women who experienced partial or full post-trauma symptoms, 80 percent had gone through a natural childbirth, without any form of pain relief.
“The less pain relief there was, the higher the woman’s chances of developing post-partum PTSD,” he said. Of the women who did not develop any PTSD symptoms, only 48 percent experienced a natural childbirth.
A full 80 percent of the PTSD group reported feeling discomfort with being unclothed, and 67 percent had previous pregnancies which they described as traumatic. Fear of the labor itself, both in terms of expected pain levels and danger to themselves and their children, was also influential.
The researchers discovered to their surprise that support during labor, in the form of a midwife or doula, had no lasting impact when it came to avoiding post-traumatic symptoms.
Factors such as socioeconomic and marital status, level of education, and religion also had no effect.
Reading the warning signs
There are some immediate steps medical professionals can take, Strous says, including better counselling about pain relief and making sure that patients’ bodies are properly covered during delivery: “Dignity is a factor that should be taken into account. It’s an issue of ethics and professionalism, and now we can see that it does have physical and psychological ramifications,” he says.
This research certainly makes me think again about going natural for the next birth. Or should I start smoking pot? (It’s supposed to be a good way to fight PTSD).
Image of epidural in process from Shutterstock