What I Learned About Epidurals and Postpartum Anxiety
What I Learned About Epidurals and Postpartum Anxiety
One of the biggest reasons I wanted to skip the epidural during my second birth was everything I learned from my first. What started as a simple induction quickly turned into a cascade of interventions—first Cytotec, then a Foley bulb, and eventually a C-section after my labor stalled and my baby’s heart rate was dropping.
If you want to read more about that experience, I’ve shared more of my story here:
👉 The Truth About Cytotec for Labor Induction (From a Mom Who’s Been There)
👉 Foley Bulb for Labor: Pros, Cons & What It Felt Like
Epidurals often include a mix of pain-numbing medication and a small amount of an opioid—typically fentanyl. Research shows that fentanyl can cross into the brain and, in small amounts, even reach the baby through the blood-brain barrier, the body’s natural filter between the bloodstream and the brain.¹ ²
That didn’t sit right with me. After going through intense postpartum anxiety with my first, and only learning all this after the fact, I didn’t want to risk anything—especially not something that could mess with my baby, my hormones or my brain. This time, I really wanted my body and mind to work together during birth, not feel disconnected again.
Some studies say there’s no clear link between epidurals and postpartum depression or anxiety,³ ⁴ but others suggest there could be a connection depending on factors like your mental health before birth, how your labor goes, or how much control you feel during the process.⁵ ⁶ ⁷ So while it’s not completely black and white, I knew the importance of feeling in control over my labor this time. I also knew how sensitive my body and mind had been last time—and I wanted to reduce any chance of that intense, fearful postpartum anxiety again.
There are also a few ways epidurals can practically affect your birth experience, which can also absolutely influence your mental health afterward:
Longer pushing stage and more assisted deliveries: Older studies show that epidurals can sometimes slow labor or make it harder to push effectively, slightly increasing the odds of vacuum or forceps deliveries.⁸ Feeling powerless or pressured during this stage can affect how you remember your birth.
Epidural-related fever: About 15–25% of women with epidurals develop what’s called epidural-related maternal fever.⁹ This often leads to extra monitoring, antibiotics, or separation from baby—adding more stress in an already intense moment.
Pain and control both matter: Studies show that unmanaged pain can raise the risk of postpartum depression, but so can feeling out of control or disconnected from your body.¹⁰ It’s about finding the balance that protects your peace.
For me, it wasn’t about “avoiding pain.” It was about protecting my mental health and giving my body the best chance to function the way it was designed to. I had to have my body and mind connected this time- that made me feel safe and in control and able to move at the pace that my baby and body were ready to move.
What I Wanted Instead
I didn’t just want to “get through” labor. I wanted to actually experience it—to stay connected and trust the process. Since my first birth was a cascade of interventions, this time I just wanted to have the chance to try.
I wanted:
To be present for every moment—not zoned out or detached.
To trust that my body could birth my baby.
To reduce the chance of needing more interventions.
To protect my mental health by feeling connected instead of powerless.
When I researched natural birth and the mind-body connection, it made so much sense. The same hormones that help you labor (like oxytocin and endorphins) also help you bond and recover emotionally afterward. I wanted those natural processes to flow as smoothly as possible.
And something I noticed firsthand—contractions feel totally different when your labor starts naturally compared to being induced. My induced contractions during my first birth were sharp, stacked, and overwhelming. But my second, natural labor built up gradually in waves that were intense but more manageable.
My Second Birth: Completely Different
Laboring without an epidural was hard—I won’t sugarcoat it. There were definitely moments I thought, “will I be in labor for the next 10 days?”
But I kept coming back to my “why” and kept praying for God to strengthen me and leaned on my husband, doula and midwife. And when my baby was finally born—through a successful, unmedicated VBAC—it felt nothing like my first experience. I could feel my body working. I knew what was happening. I felt strong, grounded, and alert. I got up to go pee like 2 hours after having delivered her and it was a day and night difference in recovery from an unmedicated standpoint (and also from a vaginal versus c-section recovery standpoint - we will get to this another time).
Recovery wasn’t perfect, but my mind felt clearer. I didn’t have that same anxious fog I had the first time. My body and brain finally felt like they were on the same page. I remember even laying on the bed with my baby on my chest and the oxytocin and adrenaline I had kept me awake in a peaceful daze for like 48 hours. It was the closest to Heaven I’ve ever felt.
If you want to see what that kind of natural birth actually looks like, I share it here: What Does a Natural Birth Actually Look Like?
And if you’re curious how I prepared for it, here’s my post: How I Prepped My Body and Mind for a Natural Birth.
What I’ve Learned Since
I’m not saying epidurals are “bad.” They can be a huge blessing in certain situations, and some women have beautiful experiences with them.
But here’s what the research and my experience have taught me:
Some studies show no clear link between epidurals and postpartum depression or anxiety.³ ⁴
Other research finds that in certain groups—especially moms with previous anxiety or high-stress births—there may be a connection.⁵ ⁶ ⁷
The biggest predictors of postpartum mental health seem to be how in control, supported, and safe you feel during birth.¹⁰
For me, saying no to the epidural was less about being “tough” and more about being intentional. My first birth showed me that emotional health matters just as much as physical recovery. Protecting my peace meant doing things differently.
If you’ve ever struggled with anxiety, trauma, or feeling disconnected after birth, it might be worth exploring how your birth experience—whether it’s induced, medicated, or natural—can influence your postpartum emotions too.
There’s no one “right” way. But asking yourself these questions can help:
How do I want to feel during birth?
What helps me feel safe and connected?
What might affect my mental health afterward?
Final Thoughts
Every birth is personal. Every mom deserves to feel safe, supported, and informed—epidural or not.
For me, skipping it was a step toward healing and confidence. It gave me a clearer head, a calmer recovery, and a deeper trust in my body.
If you’ve ever wondered how birth choices might affect your postpartum emotions, you’re not alone. Keep learning, keep asking questions, and most of all—trust your instincts.
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Are you interested in learning more about vaginal birth after cesarean or unmedicated birth?
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Sources
Beilin, Y., et al. (2005). Effect of labor epidural analgesia with and without fentanyl on infant breastfeeding: A prospective, randomized, double-blind study. Anesthesiology, 103(6), 1211–1217. PubMed
Chaves, C. (2017). Opioids and the blood–brain barrier: A dynamic interaction. Frontiers in Pharmacology, 8, 921. PMC
Almeida, M., et al. (2020). The association between labor epidural analgesia and postpartum depression: A systematic review and meta-analysis. BMC Women’s Health, 20(1), 64.
Munro, A., et al. (2021). The association between labor epidural analgesia and postpartum depressive symptoms: A longitudinal cohort study. Canadian Journal of Anesthesia, 68(8), 1136–1146.
Parise, D. C., et al. (2021). Childbirth pain and postpartum depression: Does labor epidural analgesia decrease this risk? Journal of Pain Research, 14, 115–125.
Tan, C. W., et al. (2020). Investigating the association between labor epidural and postpartum depression at three months: A prospective study. Anesthesia & Analgesia, 131(6), 1878–1885.
Eckerdal, P., et al. (2018). Mood disorders in the postpartum period and the role of pain and labor management: A population-based study. Birth, 45(4), 458–465.
Anim-Somuah, M., et al. (2018). Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database of Systematic Reviews, (5).
Patel, S., et al. (2023). Epidural-related maternal fever: Incidence, mechanisms, and clinical implications. American Journal of Obstetrics & Gynecology, 228(2), 132–140.
Ding, T., et al. (2014). Epidural labor analgesia is associated with a decreased risk of postpartum depression: A prospective cohort study. Anesthesia & Analgesia, 119(2), 383–392.
