Relation between labour pain relief methods, postpartum depression, satisfaction with labour and labour analgesia for primiparous parturients

Background and Goal of Study: Childbirth is associated with severe pain and intensive stress for most women. Women underestimate the pain of childbirth, especially primiparas. Unsatisf ying birth experiences are associated with the occurrence of postpartum depression. Pain relieving during childbirth is not as significant in ensuring a positive birth experience, but labour analgesia may decrease postpartum depression by af fecting the feeling of powerlessness. Our primary objective was to assess the relation between labour analgesia, satisfaction with labour and labour analgesia and the postpartum depression. Materials and methods: An observational prospective cohort study was carried at 2014 11 - 2015 09 in a teaching hospital. To evaluate the satisfaction the New Mother Quality of Care questionnaire (NEMOQC) was used. To estimate postpartum depression level Edinburgh Postnatal Depression Scale (EPDS) was used at <72 h and 4 weeks (contacted by phone) af ter birth. Results and discussion: 264 primiparas af ter vaginal delivery fit the inclusion criteria. 245 were included, 19 didn’t answer all questionnaires. The response rate was 92.8%. Epidural analgesia was used for 100 (40.8%) of parturients, 50 (20.4%) used nitrous oxide and 95 (38.8%) didn’t use analgesia. Postpartum depression was in 10.2% (N=25) cases within 72 hours, and in 12.1% (N=29) 4 weeks af ter delivery.184 Obstetric Anaesthesiology N2O vs without analgesia Epidural vs without analgesia OR 95% CI p OR 95% CI p Satisfaction with labour analgesia 3,467 1,706-7,045 0,001 3,424 1,896-6,183 <0,001 Satisfaction with labour 0,547 0,250-1,199 0,132 0,414 0,215-0,795 0,008 Postpartum depression <72 h 1,000 0,323-3,101 1,000 1,071 0,425-2,704 0,884 Postpartum depression after 4 weeks 1,272 0,644-2,512 0,489 0,155 0,052-0,253