Chronic pain after cesarean delivery linked to poorer quality of life for months and years after giving birth
A new synthesis of global evidence, published in Anaesthesia finds that chronic postsurgical pain after cesarean delivery is associated with substantial impairment in women's quality of life and everyday functioning in the months and years after giving birth.
A new global review of research on chronic pain following cesarean delivery has found that long-term pain significantly worsens new mothers' quality of life and everyday functioning for months and years postpartum. Led by Dr. Sarah Ciechanowicz from University College London Hospitals NHS Foundation Trust, the study analyzed data from 30 studies involving 28,295 women across 22 countries, and discovered that persistent pain lasting longer than three months is associated with substantial impairment in physical activity, work, walking, mood, sleep, and in some cases, sexual function.
At three months postpartum, over half of women with chronic pain reported interference with general activity, mood, walking, work, and sleep. By six months, interference with mood and sleep persisted in 53% of women, and by 12 months, mood-related interference affected around two-thirds of women, while sleep disruption was reported by half of them.
Fatigue was also a common issue, with around two-thirds of women reporting extreme tiredness at both six and 12 months after giving birth. Depression was also a concern, with rates of postpartum depression ranging from 7% to 46% in the first year after giving birth, with women experiencing chronic pain having roughly five times higher odds of significant depressive symptoms at three and six months postpartum.
Beyond one year, chronic pain continued to affect activities, sleep, and mood in some women, with around 5% to 24% of women reporting that sexual intercourse exacerbated their pain, with rates persisting up to four years after delivery. The researchers emphasize the importance of early identification of at-risk women and comprehensive management of chronic pain to improve longer-term recovery and reduce the socioeconomic burden of prolonged recovery, reduced capacity to work, and repeated healthcare visits.
However, they also acknowledge limitations in the evidence due to the predominantly observational nature of the studies, high risk of bias, and inconsistent use of quality-of-life measures.
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