POSTPARTUM DEPRESSION AND BIRTH EXPERIENCES: THE ROLE OF DELIVERY MODE AND EPIDURAL ANALGESIA IN THE DEVELOPMENT OF POSTPARTUM DEPRESSION

Abstract

Aim of the study. This systematic review aims to assess the impact of delivery mode, interventions, and epidural analgesia on the development of postpartum depression (PPD). Methods. A systematic literature review was conducted using the PubMed, ScienceDirect, and Wiley online library databases. Eight publications were included in the review based on PRISMA selection criteria. Results. Six studies analysed the influence of delivery mode on the development of PPD. All publications consistently agreed that emergency caesarean section (CS) carries the highest risk for PPD, while vaginal delivery without induction reduces this risk. The results for patients who had planned CS were mixed: women without previous psychiatric disorders had an increased risk of PPD after elective CS. In contrast, for those who had been diagnosed with depression or anxiety disorders before delivery, elective CS lowered the risk of PPD. Two studies found that epidural analgesia reduces the risk of PPD. Conclusions. Vaginal delivery without induction or instrument use, along with epidural analgesia for pain relief, is associated with the lowest risk of PPD among women without prie-existant psychiatrical disorders. For women who had been  diagnosed with depression before delivery, elective CS is associated with the lowest risk of PPD. Emergency CS poses the highest risk for this mental health disorder.