Feb. 24, 2005 -- A pregnant woman's risk of depression after giving birth isn't affected by the way her baby is delivered, say U.K. researchers.
"There is no reason for women at risk of postnatal depression to be managed differently with regard to mode of delivery," they write in BMJ Online First.
The finding comes from a study of more than 14,600 women who gave birth between April 1991 and December 1992. The type of delivery -- vaginal, planned cesarean section, or emergency caesarean section -- and the women's history of depression were noted. The women also completed a depression questionnaire eight weeks after giving birth.
About 80% of the women had a spontaneous vaginal delivery and 11% had an assisted vaginal delivery using medical instruments. Emergency cesarean sections (C-sections) were performed on 5% of participants, and 3.6% had a planned C-section.
Past studies have suggested a link between emergency C-sections and postnatal depression. Other work has indicated that elective C-sections may lower postnatal depression risk, say the researchers, who included Roshni Patel, clinical academic training fellow at the University of Bristol's obstetrics and gynecology department.
But that's not what Patel's team found. Their results showed that the type of delivery didn't affect postnatal depression risk.
In women who had planned a vaginal delivery, those who delivered by either vaginal delivery or emergency C-section had similar risks of postpartum depression.
"Women who plan vaginal delivery and require emergency caesarean section or assisted vaginal delivery can be reassured that three is no reason to believe that they are at increased risk of postnatal depression," says the study.
Neither having a history of depression nor depression during pregnancy was linked to emergency C-sections.
"Elective caesarean section does not protect against postnatal depression," write the researchers.
Women, Motherhood, and Depression
Depression is widespread in the U.S., affecting more than 9% of the adult population in any given year, says the National Institute for Mental Health (NIMH). About twice as many women as men have depression, says the NIMH.
While motherhood and pregnancy are often joyful, these women are not immune to depression. "Many women are particularly vulnerable after the birth of a baby," says the NIMH's booklet, Depression. "The hormonal and physical changes, as well as the added responsibility of a new life, can be factors."
It's estimated that as many as one in five pregnant women are depressed, but few get help. That's according to a study of more than 3,400 pregnant Michigan women published in the May 2003 Journal of Women's Health.
It's essential to treat depression whenever it strikes. A wide range of help is available, including medications, therapy, and lifestyle changes. Mental health is within reach and professional help is available for anyone with depression, whether or not they're pregnant or mothers.
Depression doesn't just hurt women's well-being. It can also affect their children.
"Infants of depressed mothers have been found to perform less well on object concept tasks and be more insecurely attached to their mothers," write Patel and colleagues. They also list other potential problems for the kids of depressed moms, including "higher rates of intellectual deficits at 4 years of age, behavioral disturbances up to 5 years, and increased rates of special education needs at 11 years."
Other studies have tracked the dangers of depression during pregnancy. Depressed pregnant women have been found to be more likely to have premature babies and lower-birth-weight babies. They may also be more likely to have complications such as preeclampsia, a pregnancy-related condition that causes high blood pressure and affects the mother's kidneys, liver, brain, and placenta.
The study suggests that pregnant women don't have to worry that the way their baby is delivered could increase postpartum depression risk. But mothers-to-be and new moms owe it to themselves and their families to notice and treat depression whenever it surfaces.