A comprehensive description of postpartum pain after cesarean delivery

J Obstet Gynecol Neonatal Nurs. 2014 Nov-Dec;43(6):729-41. doi: 10.1111/1552-6909.12483. Epub 2014 Aug 14.

Abstract

Objective: To describe women's experiences with the perception of, evaluation of, and response to postpartum pain after cesarean delivery through the sensory, affective, cognitive, and behavioral dimensions of pain. The secondary aim of this research was to differentiate pain described with nociceptive and neuropathic pain descriptors.

Design: Longitudinal, concurrent mixed methods design.

Setting: Large, university-based, midwestern medical center.

Participants: Convenience sample of 30 low-risk women scheduled for cesarean deliveries.

Methods: The PAINReportIt, a computerized version of the McGill Pain Questionnaire, was administered in person to participants at two visits: between 24 and 48 hours postcesarean delivery and at 6 weeks postpartum. Descriptive statistics, t tests, and χ(2) tests were calculated from these data and pain descriptor selections were compared with established nociceptive and neuropathic pain descriptor lists.

Results: Pain was reported in all dimensions at both visits. The abdomen was most frequently selected for pain location; mean intensity was 2.75/10 at the first visit, 1.1/10 at the 6-week visit. Pain in the sensory and cognitive dimensions decreased significantly between visits. Affective dimension pain decreased, but the difference was not significant. Participants reported activities that increased and decreased pain in the behavioral dimension. Pain descriptors indicative of nociceptive (e.g., tender, sore) and neuropathic (e.g. aching) pain were selected at both visits.

Conclusion: Postpartum pain after cesarean delivery is multidimensional and has been described with words indicative of nociceptive and neuropathic pain. Nurses should complete a thorough and comprehensive pain assessment throughout the postpartum for patients experiencing cesarean deliveries.

Keywords: Cesarean delivery; McGill Pain Questionnaire; PAINReportIt; Postpartum pain.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Female
  • Humans
  • Longitudinal Studies
  • Neurologic Examination / methods
  • Nursing Process
  • Pain Measurement* / methods
  • Pain Measurement* / psychology
  • Pain Perception / physiology*
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / nursing
  • Pain, Postoperative* / physiopathology
  • Pain, Postoperative* / psychology
  • Postpartum Period* / physiology
  • Postpartum Period* / psychology
  • Pregnancy
  • Surveys and Questionnaires
  • Time Factors