New Study Finds General Anesthesia During A C-Section May Increase Chance Of Postpartum Depression

Supermajority Education Fund

February 17, 2020

Pregnant patients who receive general anesthesia during c-sections may be at an increased risk of developing postpartum depression, according to a new study from Columbia University’s Mailman School of Public Health. The study found that patients who had general anesthesia during their c-section deliveries were 54 percent more likely to develop postpartum depression severe enough to require hospitalization, and were 91 percent more likely to experience thoughts of suicidal thoughts or self-inflicted injury.

Researchers analyzed over 428,000 discharge records for women who had c-sections in New York hospitals. Of those, eight percent, or 34,356 cases, had general anesthesia (as opposed to an epidural) during their surgeries. Though that number is relatively small, of that group, three percent (or 1,158 patients) were hospitalized for severe postpartum depression. 

The report’s authors stress, however, that more research needs to be done to determine whether this positive association indicates a causal relationship. They also caution that the use of general anesthesia may sometimes be unavoidable. 

“General anesthesia for a cesarean section can be medically necessary in some situations (for example, if the fetus is in distress),” said Dr. Jean Guglielminotti, the study’s lead author, told Supermajority News. “In these emergent situations, the benefits of general anesthesia outweigh its risks.”

Guglielminotti also noted that “general anesthesia is associated with more severe and more prolonged postpartum pain compared with regional anesthesia,” which could play some role in the postpartum association. General anesthesia, he added, also often leads to a delay in when a parent can start breastfeeding and begin sharing skin-to-skin contact with their newborn.

To protect patients and their babies in the future, Guglielminotti urges healthcare providers to be watchful for signs of postpartum depression early on, especially when it comes to those who received general anesthesia. 

“Clinicians should avoid using general anesthesia for cesarean delivery whenever possible and provide mental health screening, counseling, and other follow-up services to all the women who undergo cesarean delivery under general anesthesia,” he said.

Postpartum depression is the most common side effect for patients who give birth;  one in five patients develop the condition post-pregnancy. More attention and research has been devoted to both diagnosing and treating the condition in recent years, including several cities across the country, creating programs to help parents in the weeks after they give birth