Post by gibbinator on Jul 24, 2014 11:38:22 GMT -5
I can definitely see how a woman who expected to get pain relief and didn't for whatever reason (epi didn't work, no time to place it etc), would be more likely to feel traumatized after a painful birth experience and I imagine all those stress hormones could contribute to ppd in some way. Certainly a lot more factors need to be taken into consideration before making a blanket statement that epis reduce ppd
Anecdote, I intended to have an epi free birth (though quite happy to use other pain management options), eventually got one that didn't have time to kick in, and no ppd.
For me, I think part of it was the crash. I'd been thinking about and planning the birth the entire pregnancy, and it was amazing and I felt so powerful and great. Then it's over and you're stuck with a little human who screams all the time and you're sleep deprived and by comparison, that really sucked. Kind of like post-wedding blues.
Post by dancingirl21 on Jul 24, 2014 12:17:16 GMT -5
This is interesting. I'm curious how BF plays into this as well.
I had an epidural, EFF and did not have PPD. H was also home for 2.5 weeks after baby was born. For me, having him there and the ability to feed J (who was a preemie and eating always) was nice so that I could sleep.
I can see how it would be really overwhelming doing most of it on your own and think possibly that plays into PPD.
I had a failed epidural, lots of PP pain, and struggles BF. I didn't have PPD, but stayed on my low dose antidepressant so I'm sure that helped. The first several days were so difficult when he screamed and screamed because my milk hadn't come in and he was starving were really hard and I cried constantly, but once we supplemented it got better.
In my case, I strongly disagree that not having pain control starts the mother off feeling "defeated and exhausted". I felt empowered, and was up walking around soon after labor. Granted, everyone's experience is completely different.
This is how I felt. I was on a complete high after giving birth med-free. No PPD.
I also had to deliver my retained placenta approx. 10 weeks later med-free. That hurt like a mofo and I didn't get the fun of holding a baby at the end of the process, but I still wouldn't say it left me feeling defeated and exhausted.
For me, I think part of it was the crash. I'd been thinking about and planning the birth the entire pregnancy, and it was amazing and I felt so powerful and great. Then it's over and you're stuck with a little human who screams all the time and you're sleep deprived and by comparison, that really sucked.
Nailed it.
And all the while people are telling you to treasure this time, isn't it wonderful, etc.
(What I wanted to say: No, I do not treasure having my lady bits in stitches, my nipples scabbed over, and a hemmy out my ass, thanks. Yeah, DD is great. Now go away so I can nap.)
For me, I think part of it was the crash. I'd been thinking about and planning the birth the entire pregnancy, and it was amazing and I felt so powerful and great. Then it's over and you're stuck with a little human who screams all the time and you're sleep deprived and by comparison, that really sucked. Kind of like post-wedding blues.
I think this makes a ton of sense. It's definitely the let down of all the energy and adrenaline you've been building up to the BIG MOMENT and then when it's over, you realize you've been holding your breath the whole time or something…and it's like, shit, now what do I do???
I had an epi (a freaking great one; felt nothing) and no PPD. Just typical baby blues.
But I feel like recovery still sucked and I wasn't a very happy person for the first 3 weeks after delivery. It was still hard.
In my case, I strongly disagree that not having pain control starts the mother off feeling "defeated and exhausted". I felt empowered, and was up walking around soon after labor. Granted, everyone's experience is completely different.
This is how I felt. I was on a complete high after giving birth med-free. No PPD.
I also had to deliver my retained placenta approx. 10 weeks later med-free. That hurt like a mofo and I didn't get the fun of holding a baby at the end of the process, but I still wouldn't say it left me feeling defeated and exhausted.
10 weeks?! That seems really late. Is that common? Did you know something was wrong that entire time or did you suddenly not feel well?
curbsideprophet- I kept bleeding and bleeding, but my doctors thought it was because I wasn't taking it easy enough. I was eventually referred for an u/s and then it took some time to get on the schedule to remove the placenta. I could be off by a week or so total. It's all kind of hazy in my memory now, but basically, it sucked.
I had two great epidural births and one really painful, largely unmedicated birth (worthless epidural inserted seconds before I was holding the baby--my bad) and no PPD with any of them. If anything, I had the hardest time regulating my emotions after DS1 but I think that is largely because he was my first, and I was overwhelmed, and also because I had the toughest recovery with him. I found tearing the shit out of my vagina and perineum and the associated pain to be more depressing than any other aspect of childbirth.
Two med free births, huge high after both of them and no PPD.
But the very rough recovery after DS2 (tear that took six months to heal and mild prolapse) gave me my lowest points in the 0-6 months period. Thinking I would never have pain free sex again was devastating. **Eventually everything resolved and I'm now pregnant with baby #3.
curbsideprophet- I kept bleeding and bleeding, but my doctors thought it was because I wasn't taking it easy enough. I was eventually referred for an u/s and then it took some time to get on the schedule to remove the placenta. I could be off by a week or so total. It's all kind of hazy in my memory now, but basically, it sucked.
Thanks for explaining. That does not sound like fun. I am 6 weeks pp and thought i could basically stop worry about things like that so i was a little freaked at the thought. I have pretty much stopped bleeding so I am just going to assume I do not have this problem.
I had PPD with both births. Factors fro. Epidural to my home life where drastically different and that remained the same. I had tons of support and never had to be the primary parent to E. Still managed to be knocked over by PPD.
I didn't read the article, but did it say anything about getting pitocin after birth? I was on SUCH a high afterwards... not sure if it was just bc of HOLDING A BABY, or that, but I felt amazing.
I BFed as well, and honestly as much as it sucked, it did give me something to keep going
I don't think the article mentioned pitocin at all.
The full text article in Anesthesia and Analgesia does mention pitocin. The authors theorize that part of the decrease in PPD with the epidural was a higher rate/use of pitocin, as oxytocin is a natural mood enhancer. They obviously couldn't control for who received pitocin and at what dose though.
Post by fortmyersbride on Jul 24, 2014 21:17:58 GMT -5
I read the article in Anesthesia and Analgesia. As the Yahoo summary says, it was done by psychiatrists and is this group's initial attempt at trying to qualify an association between pain control and PPD.
In recent years, preemptive analgesia has become a huge focus in our field. Many studies have shown that in the area of surgery, placing nerve blocks preemptively (preoperatively) decreases the incidence of chronic post-surgical pain and related depression. So from a preemptive analgesia stand-point, the correlations in this study make sense. The study also touches on pre-op and post-op epidurals helping to decrease the risk in c/s pts as well.
Whether future studies can further go on to prove causation is difficult to say, as PPD is multifactorial and in general, well-controlled studies in pregnancy and L&D are difficult to carry out from an ethical stand-point.
My anecdote - had the epidural (actually had two, because the first failed), and although I haven't gotten a PPD diagnosis, I'm meeting with a therapist this weekend, as DH and I are pretty sure there's something going on.
I think Brie is right about the crash. I've also had issues with family and support. My MIL has been amazing, a lot more than I thought, and my mom, who I thought would be really helpful, has definitely not been.