Good news for women who don't enjoy pain: a new study suggests that pain relief during labor, such as an epidural, may help prevent postpartum depression. This benefit is in addition to an epidural's intended effect of taking the edge off of one of the most painful things a person could possibly experience, which is also nice. According to TIME, just 61 percent of U.S. women get an epidural during labor; some avoid them over concerns that pain relief could impede labor or lead to an unplanned C-section, while others view pain relief as "unnatural."
The study, presented by Grace Lim, M.D. at the 2016 American Society of Anesthesiologists meeting, controlled for known risk factors for postpartum depression and concluded that labor pain alone also contributed a "significant risk." After assessing the labor pain of 201 women on a scale of 0 to 10 and comparing it with their depression risk six weeks postpartum, researchers found that the better controlled their pain was, the lower their depression risk scores. They noted that some women are "more likely to experience severe labor pain," and more research is needed to identify those who are at an increased risk for such pain, who would therefore see a greater benefit from pain relief.
It's not particularly surprising that a painful, traumatic labor experience could lead to postpartum depression, but it's certainly not the only cause. According to the CDC, up to one in nine women experience depression before, during, or after pregnancy, and the strongest contributing factors are a past history of psychological problems and a lack of social support. Pregnant women should discuss their risks for depression with their health care provider.
As for the down side to epidurals, it turns out that those concerns aren't very well-founded. According to a Slate article that examined several studies, today's epidurals contain a much lower concentration of local anesthetic than those in the past, and they don't prevent a woman's ability to push like they used to. As for the idea that epidurals lead to C-sections, studies have found a correlation between the two, but there's no evidence that epidurals actually cause C-sections. Unfortunately, there's no ethical way to accurately study the link, because that would mean withholding pain relief from women who requested it, which is, of course, evil.
For those worried that medicated births are "unnatural" and therefore bad, I'd point out that prenatal vitamins and car seats are also "unnatural," but nobody's arguing that utilizing those makes you a bad mother. The ultimate goal for any birth plan should be that both the baby and the mother are as safe and comfortable as possible, and an epidural can have lasting benefits for the whole family.