Persistent Postpartum Pain – A Somatic and Psychologic Perfect Storm

Abstract

Persistent postpartum pain is common and has a complex etiology. It has both somatic and psychosocial provoking factors and has both functional and psychological ramifications following childbirth. Pain that limits the functional capacity of a person who has the daunting task to take care of all the demands of managing a growing newborn and infant can have debilitating consequences for several people simultaneously. We will review the incidence of persistent postpartum pain, analyze the risk factors, and discuss obstetric, anesthetic, and psychological tools for prevention and management. Based on the current knowledge, early antenatal screening and management is described as the most likely measure to identify patients at risk for persistent postpartum pain. Such antenatal management should be based on the close collaboration between obstetricians, anesthesiologists, and psychologists to tailor peripartum pain management and psychological support-based individual needs.

Keywords:

• persistent pain
• postpartum
• risk factors
• analgesia
• labor
• delivery

Abbreviations

CD, Cesarean Delivery; CO, Cardiac Output; CPSP, Chronic Post-Surgical Pain; CTS, Carpal Tunnel Syndrome; EPDS, Edinburgh Postnatal Depression Score; ERAS, Enhanced Recovery After Surgery; GERD, Gastroesophageal Reflux Disease; NSAIDs, Non-Steroidal Anti-Inflammatory Drugs; PCS, Pain Catastrophizing Scale; PP, Postpartum Pain; PPD, Postpartum Depression; PPP, Persistent Postpartum Pain; PSS, Cohen’s Perceived Stress Scale; RAS, Renin-Angiotensin System; SF-MPQ-2, Short-Form McGill Pain Questionnaire-2; STAI, Spielberger’s State-Trait-Anxiety Inventory; SVR, Systemic Vascular Resistance; VD, Vaginal Delivery; VR, Virtual Reality.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There was no funding for this work.