Nature and characteristics of after pain among postnatal mothers admitted in a tertiary care hospital in South India

Abstract

Background: All postnatal mothers experience pain in some form or the another. Crampy pain in the abdomen known as after pain is a determinant of the uterine involution which is more evident clinically in the first four days postpartum. The present study emerged with a view to study the nature and characteristics of after pain among postnatal mothers at a tertiary care hospital in South India. Methods: A prospective survey design was used for the study. Quota sampling was used to select 100 postnatal mothers, 50 mothers who had caesarean section and 50 mothers who had vaginal delivery. The mothers were enrolled for the study consecutively in 12-24 hours postpartum till the required sample size was obtained in both the groups. A demographic proforma was designed to collect the background information. The characteristics of after pain were assessed using numerical pain rating scale every 24 hours in the first three postpartum days. Results:The mean scores of pain on the first three postpartum days among mothers after vaginal delivery were 2.84, 2.1 and 0.84 respectively and for mothers after caesarean section were 1.6, 1.66 and 0.74 respectively. The scores were greatest on the first postpartum day. No association was found between after pain and variables like mode of delivery and age of the mother. It was found that after pain had an association with with parity on the first and third postpartum days. Conclusions: Since after pain is an indicator of uterine involution, strict protocols should be established in maternity care units for a comprehensive assessment of after pain.

Postpartum ağrının emzirme öz-yeterliliğine etkisi

“…After a normal vaginal delivery, approximately 50% of primipara women and 86% of multiparous women experience afterpain 1 . In multiparous women (with every consecutive birth), the sensitivity of the central nervous system and consequently the severity of the pain increase due to the decrease in uterine muscle strength 1,3,7 . Therefore, afterpain is experienced more severely in multiparous women than in primipara women 39,40 .…”

“…Postpartum uterine contractions are perceived as cramp-type pain (afterpain) in the abdomen. The pain can be quite severe within the first 12-24 hours and is noticeably felt by the woman during the first four days [5][6][7][8] . Afterpain is closely associated with several factors.…”

“…During the breastfeeding period, the pain-induced neurohormonal stress reduces the mother's willingness to breastfeed, reduce her interest in the newborn, weaken the process of attachment and bonding, and adversely affect milk secretion. For a mother who cannot breastfeed her baby, the possibility of mood changes such as guilt, anxiety and sadness increase 1,4,7,10 .…”

Pendampingan Ibu Postpartum Multipara dalam Penurunan Keluhan Afterpain di Kabupaten Kediri

“…Penyebab afterpain diantaranya iskemia uterus ketika ada kontraksi,[2] menyusui yang diakibatkan adanya pelepasan hormon oksitosin sehingga menyebabkan involusi uterus [3,4]. Afterpain dapat terjadi pada hari ke 3-10 masa postpartum, lebih sering dialami oleh postpartum multipara yang diakibatkan oleh meningkatnya sensitivitas sistem saraf pusat, [5,6] uterus yang cenderung kendur dan lebih teregang sehingga memerlukan kontraksi lebih kuat ketika involusi uterus [6,7]. Sebagaimana disebutkan dalam penelitian, bahwa kejadian persalinan normal secara spontan di dunia sebesar 79% hal ini dapat meningkatkan terjadinya afterpain pada masa postpartum [8].…”

Effect of Fundal Massage Technique and alternative leg lifting exercise on after pain Severity and uterine involution among Multipara Women

“…Cramping will be the most intense for the first day or two after delivery, but it should start to fade around the third day. The process of uterine involution begins immediately after the placenta expels, when the contraction of the uterine smooth muscles begins, which results in afterpain ( Namboothiri & Visswanath, (2016) Because the baby sucking triggers the release of the hormone oxytocin, which is a hormone that aids in uterine contraction and speeds up the involution process. Breastfeeding may be the bas ring on or make the after pain more intense.…”