Persistent pain after caesarean and vaginal delivery: Experience at a public tertiary hospital, Benin city, Nigeria

Background: Recent observation has revealed that persistent pain (PP) might follow both vaginal delivery (VD) and cesarean delivery. The present study sought to examine the development of PP following delivery in Nigerian women.Methods: Questionnaires were administered to all consenting women at their 6-week post-delivery visit to hospital to ask about persistence of abdominal scar, pelvic, or perineal pain. They were subsequently called on phone to enquire about the duration of previously documented pain, or the persistence of pain at 6 months and 1 year post-delivery. Information on the frequency and intensity of pain, the impact on daily activities, as well as the quality of life was also sought. Chi-square test or Fisher's exact test was done for differences in proportion, prevalence ratio (PR) and cross tabulation was done for association using SPSS 20.0 and GraphPad Instat 3.Results: Cesarean section (CS) was associated with higher prevalence of PP at 6 weeks postpartum than VD {(37/88, 42%) and (26/144, 18%), respectively; PR 2.1, 95% CI: 1.2--3.7, P = 0.01)}. The majority (93.7%) had mild to moderate pain. PP was associated with previous pain problem (PR 2.3, 95% CI: 1.2--4.5; P = 0.02). The women with PP recalled more severe peripartum pain (P = 0.01), and primiparity was highly predictive of PP (0.001).Conclusion: PP is more common after 6 weeks of CS than VD, but pain beyond 6 months appears rare. PP is associated with poorly managed chronic pain and severe peripartum pain especially in primiparas. We advocate a deliberate attempt to screen for and treat pain on an individualized basis.