Persistent Postpartum Pain – A Somatic and Psychologic Perfect Storm

Balazs Horvath,1,2 Benjamin Kloesel,3 Sarah N Cross4 1Department of Anesthesiology, St. Vincent’s Medical Center, Bridgeport, CT, USA; 2Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN, USA; 3Department of Anesthesiology, Children’s Minnesota Hospital, Minneapolis, MN, USA; 4Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USACorrespondence: Balazs HorvathDepartment of Anesthesiology, St. Vincent’s Medical Center, Bridgeport, CT, USA, Tel +612 624-9990, Email bhorvath@umn.eduAbstract: 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