Background & Aims
Pregnancy and labour often entail pain and tissue damage, which may lead to the development of chronic pain (1-3). Globally, chronic pain, defined as pain that persists after three months (4), is a leading cause of lasting suffering and disability (5). It often leads to reduced quality of life and an increased need for healthcare. Individuals with chronic pain are at risk of developing complications, including physical, psychological, and cognitive dysfunctions, such as depression, anxiety, sleeping problems and fatigue (6). If pain is not timely diagnosed and adequately treated it can become a chronic condition (7). The aim of this thesis was to describe the prevalence and characteristics of chronic pain related to childbirth. Further aims were to explore women’s experiences of pain and its consequences as well as information and support from healthcare professionals.
Methods
Data were obtained through two self-administered questionnaires and the patient record system, Obstetrix as well as interviews. The first questionnaire was distributed 24-36 hours after labour, to women who had given birth at one of seven hospitals located in the capital of Sweden, and in two medium sized cities (n=1507), between April and December 2015. The second questionnaire was sent by post eight months after childbirth. Data from 1,171 women, who answered the second questionnaire, were analysed using descriptive statistics. The 20 face-to-face, semi-structured, interviews were conducted between June and November 2016, recorded and transcribed verbatim. The data were processed and analysed using inductive content analysis.
Results
The results showed that 17% of the women reported chronic pain related to childbirth. Approximately 80% rated their worst pain as moderate or severe and more than 40% of the women experienced pain constantly or daily. The pain severely reduced women´s ability to perform physical and social activities, negatively impacted psychological well-being and self-image, as well as their roles as partners and mothers. Although pain and its consequences had a profound negative impact on several aspects of women’s lives, they did not receive adequate information or support from healthcare. In consequence, women did not know when and where to seek help and half of them did not consult healthcare professionals. When women turned to healthcare, their pain was often not identified, assessed, or treated but instead ignored or trivialized. The women felt abandoned after childbirth and forced to manage the condition on their own.
Conclusions
Despite the relatively high prevalence of chronic pain related to childbirth and its profound consequences, the women were not informed about risks of developing chronic pain and the pain was not recognized, assessed, or treated. Together this may contribute to women’s suffering as well as an increased risk of development and maintenance of chronic pain.
References
1. Bergström C, Persson M, Nergård KA, Mogren I. Prevalence and predictors of persistent pelvic girdle pain 12 years postpartum. BMC Musculoskelet Disord. 2017 Dec;18(1):399Bijl RC, Freeman LM, Weijenborg PT, Middeldorp JM, Dahan A, van Dorp EL. A retrospective study on persistent pain after childbirth in the Netherlands. J Pain Res 2016;9:1–8.
2. Hannah ME, Whyte H, Hannah WJ, Hewson S, Amankwah K, Cheng M, et al. Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: The international randomized Term Breech Trial. Am J Obstet Gynecol. 2004 Sep;191(3):917–27.
3. Weibel S, Neubert K, Jelting Y, Meissner W, Wöckel A, Roewer N, et al. Incidence and severity of chronic pain after caesarean section: A systematic review with meta-analysis. Eur J Anaesthesiol 2016;33:853–65.
4. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019 Jan;160(1):19–27.
5. Goldberg DS, McGee SJ. Pain as a global public health priority. BMC Public Health. 2011 Dec;11(1):770.
6. Fine PG. Long-Term Consequences of Chronic Pain: Mounting Evidence for Pain as a Neurological Disease and Parallels with Other Chronic Disease States. Pain Med. 2011 Jul;12(7):996–1004. 6.
7. McGreevy K, Bottros MM, Raja SN. Preventing chronic pain following acute pain: Risk factors, preventive strategies, and their efficacy. Eur J Pain Suppl. 2011 Nov;5(S2):365–76.
Presenting Author
Beata Molin
Poster Authors
Beata Molin
BSc
Red Cross University
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Obstetric and Labor Pain