If you are planning a cesarean birth, you may have seen headlines this month linking ketamine to lower postpartum depression scores. The research is real and worth knowing about, but it is early and covers only a narrow slice of the postpartum period, so it helps to read it closely.
A meta-analysis of six randomized trials involving 1,832 women found that new mothers who received ketamine or esketamine during or right after an elective C-section had modestly lower depression screening scores in the first two weeks after birth. The findings were presented at the ANESTHESIOLOGY 2026 annual meeting in San Diego, and the American Society of Anesthesiologists released them in a news release on October 17.
Below, we walk through what the study measured, what it left open, and what expecting parents can do now.
What did the C-section ketamine study find?
The researchers pooled randomized controlled trials published from January 2015 through September 2025. Each trial compared women who received ketamine or esketamine around the time of surgery with women who received neither.
Two terms help here:
- Ketamine is an anesthetic used in operating rooms for decades. At certain doses it also has rapid antidepressant effects.
- Esketamine is one of the two mirror-image forms that make up the ketamine molecule. It is the active ingredient in Spravato, a nasal spray approved for depression.
Women who received either drug had lower scores on a depression screening questionnaire between day 3 and day 14 after surgery. The pooled effect was a standardized mean difference of -0.36, which the authors described as a small-to-moderate, statistically significant reduction. In plain terms, the ketamine groups reported somewhat fewer symptoms on average. The study does not show that fewer women went on to develop depression.
Lead author Peter Hsin, a medical student at FIU Herbert Wertheim College of Medicine, put it carefully: “it is too early to say that ketamine prevents clinically diagnosed postpartum depression.”
Researchers are interested in this question for a reason. According to the society, postpartum depression affects about one in five women after childbirth, and C-section births are associated with a higher risk of depressive symptoms. Many people already receive anesthesia during a cesarean, so researchers want to know whether that moment could also support mental health.
What does a screening score tell you, and why does day 14 matter?
The trials used the Edinburgh Postnatal Depression Scale, a 10-question tool that remains widely used to screen new mothers. A higher score means more symptoms and can prompt a fuller evaluation. A screening score is not a diagnosis.
Timing is the bigger limit. Symptoms were tracked only through day 14. That window overlaps with the “baby blues,” the short-lived tearfulness, mood swings and worry that many new parents feel in the first days after birth. Baby blues usually ease on their own within about two weeks.
Postpartum depression, by contrast, can begin weeks or months after delivery. The National Institute of Mental Health’s guidance on perinatal depression describes symptoms that can appear during pregnancy or anytime in the year after birth. A lower score in week one or two may reflect a gentler early adjustment, a true protective effect, or both. This study cannot tell those apart.
What the findings leave open
Pooling trials adds statistical power, but the result depends on how similar those trials were. According to the society’s release, several details were not reported:
- Dosing, and whether ketamine was given during surgery or afterward
- Side effect rates in the women who received it
- Separate results for ketamine and esketamine
- Confidence intervals, which show how precise an estimate is
The work is conference data and has not yet appeared as a full peer-reviewed paper. Meeting releases can also include numbers updated after the abstract was submitted.
Earlier research points in a similar direction. A randomized trial published in The BMJ in 2024 found that a single low dose of esketamine after delivery, given to mothers who had depressive symptoms during pregnancy, was linked to fewer major depressive episodes at six weeks. That trial focused on a higher-risk group and a longer window, which is the kind of evidence the new meta-analysis cannot provide on its own.
The University at Buffalo’s Department of Anesthesiology plans a prospective randomized study to test whether ketamine during a C-section reduces how often postpartum depression occurs and how severe it becomes, according to co-author Dr. Rose Berkun of the University at Buffalo. Hsin said larger studies with longer follow-up are needed to find the best dose and timing.
How is ketamine in surgery different from ketamine therapy?
The word “ketamine” covers very different experiences. In an operating room, an anesthesiologist gives it as part of anesthesia or pain control, usually once, alongside other medications. The person’s attention is on giving birth, and there is no preparation or follow-up focused on mood.
Ketamine used as a mental health treatment is built differently. Here is how a therapeutic series typically works at Nushama:
- Medical assessment. We review medical history and current medications to confirm ketamine is appropriate. Pre-treatment testing can include urine and blood tests, blood pressure and an EKG.
- Preparation. Members set an intention for each journey and learn what to expect. Our guide on how to prepare for your first ketamine treatment covers this step.
- IV ketamine sessions. IV ketamine means the medicine is delivered through a vein, so clinicians can adjust or stop the dose quickly. Nushama physicians typically administer 6 infusions over a 3 to 6 week period, up to 2 per week, while doctors and nurses monitor vital signs throughout.
- Integration. Integration is the work of turning insights from a session into changes in daily life. Licensed therapists or trained integration coaches support members after each journey.
During a session, many people feel some dissociation, a sense of distance from their body or surroundings that fades as the medicine wears off. Researchers think ketamine may also support neuroplasticity, the brain’s ability to form new connections, which is one reason early research on ketamine and the brain after stress draws so much interest. You can read more in our overview of how ketamine affects the mind and body.
We share this to give context for the headline, not to suggest the C-section study supports any particular treatment. Our view is that medicine works best as a catalyst within a fuller plan, a point we explore in ketamine-assisted therapy as a powerful tool, but not a cure-all.
Safety considerations for new mothers
Ketamine and esketamine carry real risks. According to the FDA’s current prescribing information for Spravato (see the FDA), the label warns of sedation, dissociation, respiratory depression, increased blood pressure, and potential for abuse and misuse. Doses used in surgery differ from treatment doses, but these effects are why careful study matters before routine use around childbirth.
A few points deserve a direct conversation with your clinicians:
- Blood pressure. Ketamine can raise blood pressure. Anyone with preeclampsia, postpartum hypertension, or certain heart or blood vessel conditions needs careful medical review.
- Mental health history. A personal or family history of psychosis or bipolar disorder changes the risk picture.
- Breastfeeding. If you are nursing, plan any ketamine or esketamine treatment with your care team in advance.
- Recovery and support at home. Ketamine and esketamine can affect alertness after a session, so ask your clinic how long to wait before driving and plan for help with the baby that day.
Spravato has not been studied or approved specifically for postpartum depression. A new mother may still be evaluated for it if her depression meets its existing criteria. Our plain-English guide to Spravato eligibility in Aventura, Florida explains who qualifies and how the REMS safety program works. If you have questions about ketamine’s legal status, see ketamine, FDA approval, and off-label use.
What can expecting parents do now?
For now, the study points to an option still under research, not something to request at delivery. Several steps can help today:
- Ask about screening. The American College of Obstetricians and Gynecologists recommends screening for depression and anxiety during pregnancy and after birth using a validated tool. Ask your obstetrician when yours will happen.
- Share your history early. If you have lived with depression or anxiety before, have limited support at home, or had a difficult pregnancy, tell your obstetrician and anesthesiologist before your delivery date.
- Know the treatments that already exist. Therapy, antidepressants and peer support programs help many people. In 2023, the FDA approved zuranolone as the first oral medication specifically for postpartum depression.
- Give your partner a role. Partners and family can watch for signs that last beyond two weeks, such as persistent sadness, hopelessness, severe anxiety, trouble bonding with the baby, or pulling away from loved ones.
Postpartum depression can also affect fathers and adoptive parents. Our page on ketamine for postpartum depression explains the condition in more depth and how we approach care.
If you are worried about whether ketamine is safe or addictive, our article debunking common ketamine myths addresses those questions plainly.
If you need support right now
Thoughts of harming yourself or your baby are an emergency. Call 911, or call or text the 988 Suicide & Crisis Lifeline.
The National Maternal Mental Health Hotline, run by the Health Resources and Services Administration, is free, confidential, and available 24 hours a day at 1-833-TLC-MAMA (1-833-852-6262). You can call or text in English or Spanish.
How we read research like this
We welcome studies that take postpartum mental health seriously. This meta-analysis offers a hopeful signal, and the trial planned in Buffalo may tell us much more. Until then, we suggest reading it as evidence that ketamine around a C-section may ease early symptoms, with the larger questions about lasting benefit, dose and safety still open.
If depression has lingered for weeks or months after birth and the first treatments you tried haven’t been enough, IV ketamine or Spravato may be worth discussing with a clinician. Our team in New York can review your history, your recovery and your life with a newborn, and help you decide whether either option fits. When you’re ready, book a consultation to start that conversation at your own pace.