Patient experiences of chronic postsurgical pain after caesarean delivery: findings from a prospective qualitative study.

BACKGROUND

Chronic postsurgical pain after caesarean delivery affects 10-20% of women at 3-6 months postpartum, yet its broader impact on recovery is underexplored. This study examined lived experiences of chronic postsurgical pain and identified key domains of impact.

METHODS

Twenty-four women with self-reported pain at 3-6 months after intrapartum or planned caesarean delivery were recruited from two prospective studies. Semi-structured interviews, conducted in English or Spanish via secure video call, were transcribed and analysed using inductive reflexive thematic analysis.

RESULTS

Patients described a multidimensional, interconnected symptom burden. Pain persisted or worsened unpredictably, interfering with mobility, infant care, and daily life. Poor sleep and fatigue compounded distress. Cognitive and affective disruptions, including anxiety and fear, were common. Many patients avoided opioid analgesics due to concerns about alertness or breastfeeding. Patients sometimes reported feeling dismissed or unsupported by healthcare professionals. Ten themes were identified: pain and sensory disruption; functional limitations and fatigue; interference with infant care and identity; psychological distress and cognitive load; sleep disruption; control and coping; intimacy and embodied recovery; healthcare gaps; peer and online normalisation; and reflections on future health.

CONCLUSIONS

Chronic pain after caesarean rarely occurs in isolation. Interacting symptoms across sleep, pain, emotional wellbeing, cognitive function, and energy domains shape women's lived experiences. These findings provide qualitative support for a multidomain, possibly syndromic pattern of postpartum pain and recovery.