Background <p>Pain is a risk factor for postpartum depression. This study aimed to determine the relationship between remifentanil analgesia and postpartum depression, as well as the birth experience among Iranian women.</p> Methods <p>This observational study was conducted on 200 mothers who underwent vaginal birth at Taleghani Hospital in Tabriz, Iran, in 2023-4. The Edinburgh Postnatal Depression Scale and the Childbirth Experience Questionnaire were used to assess the outcomes. To compare the childbirth experience and postpartum depression between the exposure group (receiving remifentanil) and the non-exposure group, independent t-tests and Mann-Whitney U tests were employed, respectively.</p> Results <p>The mean postpartum depression score in the remifentanil analgesia group was statistically significantly lower than that in the non-analgesia group (<i>p</i> = 0.002). The mean total childbirth experience score in the exposure group was statistically significantly higher than in the non-exposure group (<i>p</i> &lt; 0.001). Additionally, a comparison of the subdomains of childbirth experience between the two groups showed that the mean scores for own capacity (<i>p</i> &lt; 0.001), perceived safety (<i>p</i> &lt; 0.001), and participation (<i>p</i> &lt; 0.001) were statistically significantly higher in the remifentanil group compared to the non-analgesia group. However, there was no statistically significant difference between the two groups regarding the professional support subdomain (<i>p</i> = 0.434).</p> Conclusion <p>These findings underscore the significance of using remifentanil analgesia as a potential approach for preventing postpartum depression and creating a positive childbirth experience. It is recommended that clinical trials be conducted to obtain more precise results.</p>