Role of pelvic sensory signalling during delivery in postpartum mental health

Abstract

Background: Animal research demonstrates that pelvic sensory signalling at parturition initiates behavioural and emotional changes that are protective for mother and offspring. In contrast, research with humans has found no effect of caesarean delivery (i.e. procedure that blocks pelvic signalling) on mother's mental health. The lack of effect may reflect little consideration for the use of epidurals, another intervention that blocks pelvic signalling. The following study examines whether blocking pelvic signalling during delivery predicts postpartum depression symptomatology. Method: Longitudinal mental health data were collected prospectively from 142 primiparous women who had a caesarean delivery and/or received epidural anaesthesia (Intervention) or delivered vaginally without anaesthesia (No‐Intervention). Measurements began in late pregnancy and continued through the first postpartum year. Results: Intervention mothers reported more depressive symptoms at the end of the first postpartum year compared to those in the No‐Intervention group. This effect was independent of socio‐cultural factors known to predict levels of depressive symptoms. Conclusion: These results suggest that pelvic sensory signalling may help to prepare women for the postpartum period. Considering there are many factors influencing the mental health of mothers, the present finding suggest that populations vulnerable to postpartum depression should consider a delivery without intervention, when medically permissible.

Keywords:

• postpartum depressive symptoms
• depression
• hierarchical linear modelling
• pelvic sensory signalling

Acknowledgements

We would like to thank all mothers who participated in this study, the research assistants for their technical support, and Baystate Medical Center for their continued commitment to research. This research was supported by the National Institute of Mental Health (R01‐MH5677 to Maureen Perry‐Jenkins).