Chronic pain after childbirth.

PURPOSE OF REVIEW: Although childbirth is considered a natural event, some deliveries may necessitate instrumentation or surgical intervention. In contrast with trauma or surgery, persistent pain after delivery has received little attention until recently, despite the large number of individuals potentially at risk. RECENT
FINDINGS: Excluding pre-existing pain or pain that developed during pregnancy, prospective studies show a surprisingly low prevalence of persistent pain after childbirth, much lower than the prevalence reported in retrospective studies and that of persistent postsurgical pain in a general population for similar procedures. The nature of persistent pain itself remains poorly characterized; the chronic pain following caesarean delivery appears to be predominantly neuropathic, but the intensity is generally lower than usually reported for other types of chronic neuropathic pain. Finally, the type of delivery and the degree of tissue trauma do not seem to impact the risk of developing persistent pain. It is unclear whether individual factors place specific women at a risk for persistent pain. Experimental study suggests that protective mechanisms against the development of neuropathic pain may be active during the puerperium, but whether these mechanisms exist following human childbirth remains unknown.
SUMMARY: Some recent findings on the development of persistent pain after childbirth are intriguing and might open the way to interesting perspectives for the treatment of persistent pain caused by trauma or surgery.