Beata Molin, Högskoleadjunkt, med.dr. leg. farmaceut, barnmorska, Röda Korsets Högskola

After childbirth, women are at risk of developing chronic pain from pain or injuries that they experience during pregnancy or labour. Knowledge about pain persisting after childbirth is limited, thus, the aim of this thesis was to evaluate how many women develop chronic pain related to pregnancy or labour and describe the characteristics of pain. Further aims were to investigate the impact of pain on women’s daily lives as well as their experiences of information and support from healthcare. Data were obtained through two questionnaires from 1,171 women as well as 20 interviews with women who reported chronic pain related to childbirth.

Eight months after giving birth, one in six women report chronic pain related to pregnancy or labour and one in five experience dyspareunia. Approximately 80% of the women rate their worst pain as moderate or severe and more than 40% experience pain constantly or daily. The pain severely reduces women´s ability to perform physical and social activities, negatively impacts psychological well-being and self-image, as well as their roles as partners and mothers. Although pain and its consequences have a profound negative impact on several aspects of women’s lives, they do not receive adequate information or support from healthcare. In consequence, women do not know when and where to seek help and half of them do not consult healthcare professionals. When women turn to healthcare, their pain is often not identified, assessed, or treated but instead ignored or trivialized. In consequence, the pain is often not identified, managed, or resolved. The women feel abandoned by maternal care after childbirth and forced to manage their condition on their own. There is an overall desire among women for information as well as for a well-defined and well-functioning chain of care with better accessibility and scope. Furthermore, they express a need for greater knowledge and competence among healthcare professionals about pain and its management.

The results suggest a review of the content and quality of current healthcare services for women after childbirth concerning pain management. Assessment of, and counselling on, pain should be included as standard during postpartum check-up visits in order to monitor the potential development of chronic pain and to ensure that the women receive the care they need. There is a need for well-functioning healthcare structures that enable the management of pain persisting after pregnancy or labor, to which women can turn or be referred to when they need help with their pain-related problems. As there are indications of lack of knowledge among healthcare professionals, there is also a need to investigate possible knowledge gaps regarding educational programs, continuing education as well as knowledge support, in the form of guidelines and recommendations at national level. This can be an important step toward better recovery after childbirth, reducing suffering, as well as preventing potential long-term health problems in a relatively young population.