Persistent postpartum pain after vaginal birth in a prospective observational cohort study

Abstract Labour pain is among the most intense acute pain experiences and is usually considered temporary and physiological. Persistent postpartum pain (PPP) after vaginal delivery lacks a standardized definition, and its prevalence, correlates and long-term impact remain poorly characterized. In this exploratory, single-centre, prospective observational cohort study at University Hospital Bonn (January 2021–January 2023), women enrolled in the QUIPS-Birth registry after vaginal delivery completed follow-up questionnaires at 6 weeks and 6 months postpartum, assessing self-reported PPP prevalence and intensity, pain-related functional impairment, mood alterations and analgesic use. Of 270 women screened, 169 consented; 146 and 151 completed the 6-week and 6-month assessments, respectively. Self-reported PPP was reported by 46.6% of women at 6 weeks and 35.8% at 6 months ( p = 0.06; median numerical rating scale [NRS] score 4 at both intervals) and was frequently accompanied by functional impairment and mood alterations. In unadjusted analyses, primiparity (OR 3.0, 95% CI 1.4–6.5), use of multiple analgesic methods (OR 2.4, 1.1–5.1), wish for more analgesia (OR 2.3, 1.1–5.1) and PPP at 6 weeks (OR 5.82, 2.57–13.13) were associated with PPP at 6 months. These exploratory findings support systematic postpartum pain screening beyond the routine 6-week visit.