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We read with concern the article “Exposure to General Anesthesia for Cesarean Delivery and Odds of Severe Postpartum Depression Requiring Hospitalization” by Guglielminotti and Li. 1 Using New York State hospital data from 2006 to 2013, the authors reported an association between general anesthesia (GA) during cesarean delivery (CD) and increased risk of postpartum depression (PPD) requiring hospitalization. Based on this association, the authors concluded that “these preliminary findings underscore the need to avoid the use of GA for CD whenever possible.” This conclusion implies a causality that may incorrectly sway anesthesiologists to avoid GA for CD, when indicated, and create unnecessary lay public fear of GA in this setting. Indeed, within days of publication, multiple major news outlets published articles with titles such as “General Anesthesia Increases the Risk of Postpartum Depression.” 2

We …