Post Caesarean Section Pain Management

Incision pain, uterine cramping and gas discomfort are the most common experiences after a caesarean section. Most of the mothers have moderate pain, however one in five mothers may suffer from severe acute pain. Good pain relief is important to promote general well-being of the mother.

Early pain relief prevents chronic pain
In Singapore, 9.2%1 of mothers develop chronic pain (pain lasts more than three months) after caesarean section. During first few days after operation, unrelieved pain, stress and fear of movement are the risk factors for developing chronic pain. Chronic pain also increases the risks of postnatal depression. Therefore, regular pain relief medications are important to break the cycle of pain.

Good pain relief promotes mobilisation
Early walking is crucial to prevent post-operative complications, such as:

• Development of life-threatening blood clots. The clot usually forms in deep veins of legs and travels along the blood stream to brain, lungs and/or heart. Walking facilitates blood circulation, prevents clot formation and promotes wound healing.
• Trapping of air inside the stomach causes pain as your bowels are resting after operation. Walking helps to facilitate bowel movement and release gas. You may want to use abdominal binder which can help to support the wound during ambulation and relieve some pain.
  
  

Early pain relief promotes successful breastfeeding
You are encouraged to breastfeed your baby as soon as possible after operation. However, picking up and holding a baby can be a challenge due to pain. It is important that you take your pain relief medications regularly and position yourself comfortably.

Why are you given more than one pain relief medications?
There are three groups of pain relief medications: Paracetamol, NSAIDs group (Mefenamic acid, Ibuprofen, Naproxen and Diclofenac) and opioid (Tramadol). They work in different ways.

Optimised pain relief can be achieved through the combination of medications from different groups with lower dosage. This ensures that the dosage does not exceed and you will have lesser side effects from each type of medication.

What are the common side effects of pain relief medications?
For the mother, paracetamol is generally safe. NSAIDs may irritate your stomach, so doctors may prescribe you with another medication together to protect the stomach. Tramadol may cause giddiness or nausea for some mothers.

For the baby, paracetamol and NSAIDs are safe for breastfeeding. Tramadol can cause excess drowsiness to the baby through breastfeeding. However, the risk is very low for well babies. Usually, mothers are allowed to take Tramadol during first few days if they have severe pain. Our staff will monitor your baby during your hospital stay.

Importance of taking pain relief medications regularly
It is important to take the pain relief medications regularly and on time. If you wait until one dose has completely worn off, it may take longer for the next dose to become effective.

Stay ahead of your pain!