Research in the postpartum period has been largely quantitative and focused on obstetric dysfunction, major depression and impact of epidural analgesia. The purpose of this study was to describe women's perception of postpartum pain and identify specific impediments to better pain management. AbstractIntroduction: During the postpartum period women do not usually have health issues reviewed until 6 weeks. The purpose of this qualitative study was to examine women's experiences in the postpartum period and identify specific impediments to better pain management.

Objective: Numerous studies have been trying to disentangle the complex pathophysiology of autism spectrum disorders (ASD). In our study, we explored the potential role of maternal serum (MS) alpha-fetoprotein (AFP) in the prediction and the pathophysiology of ASD.Methods: A total of 112 patients with ASD and 243 control subjects were included in a case-control study, using a historic birth cohort maintained at Statens Serum Institute. Measurements of MS-AFP were obtained from a multicentre screening program, whereas clinical data were obtained from nationwide registers. Association between MS-AFP and ASD status was analyzed using logistic regression models and nonparametric tests. Results:Crude, but not adjusted, estimates showed that MS-AFP levels were slightly, but significantly, higher in mothers of children with ASD, compared with their control subject counterparts. People with ASD had an odds ratio of 2.33, with 95% confidence intervals of 1.00 to 5.39, to have MS-AFP above 2.5 multiple of median. Excluding subjects with congenital malformation comorbidities did not alter the direction of our estimates (OR 2.60; 95% CI 1.04 to 6.51, P = 0.04). Conclusion:Biologic plausibility of its role in the pathophysiology of ASD makes AFP a good candidate for further larger-scale studies to confirm such an association and to determine whether this pattern is unique to ASD or related to other psychiatric disorders as well.Can J Psychiatry. 2011;56(12):727-734. Clinical Implications• People with ASD showed an increased risk of elevated MS-AFP levels regardless of their congenital malformation comorbidities.• Confirming the potential role of AFP in autism is feasibile and cost-effective because it is part of routine antenatal screening for neural tube defects in several countries.• Historic birth cohorts and nationwide biobanks provide precious resources for research in psychiatry. Limitations• Our study used Danish nationwide health registers, and no information on psychiatric symptomatology was present to validate the diagnoses.• Our study had a relatively small sample size.