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Recommendations for managing postpartum pain have been developed and published in a Committee Opinion online May 17 in Obstetrics & Gynecology.

Recommendations Developed for Managing Postpartum Pain

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Impact of medications on mother-infant dyad should be considered, as many women breastfeed
Birth characteristics largely explain the higher child mortality in England versus Sweden

Birth Factors Mostly Explain England’s Child Mortality Rate

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Socioeconomic conditions also contribute to the excess child mortality in England versus Sweden
The rates of severe maternal and neonatal morbidity and mortality are elevated with attempted vaginal delivery after single prior cesarean delivery

Adverse Outcomes Up for Vaginal Birth After Previous C-Section

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Temporal worsening for link between vaginal birth after C-section, serious neonatal morbidity, mortality
Postpartum care should become an ongoing process rather than a single visit in order to optimize the health of women and infants

ACOG Committee Recommends Better, Ongoing Postpartum Care

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Provider contact within three weeks, comprehensive follow-up by 12 weeks rather than single visit
About half of pregnant women with HIV infection underwent cesarean delivery between 1998 and 2013

About Half of Pregnant Women With HIV Have C-Sections

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Increase in cesarean delivery among HIV-infected pregnant women from 1998 to 2013
Vaginal birth is associated with worse pelvic organ support five years after a woman's first delivery

Vaginal Birth Tied to Later Lack of Pelvic Organ Support

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Width of genital hiatus independently predicts worse support five years after vaginal delivery
Warm showers and perineal exercises may be effective for reducing the pain associated with childbirth

Warm Showers, Perineal Exercises Can Ease Birth Pain

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Findings showed a decrease in pain, anxiety, and epinephrine release in women giving birth
Ad lib oral intake during labor does not increase maternal or neonatal adverse outcomes compared with allowing women nothing by mouth during labor

Oral Intake During Labor Shows No Increase in Adverse Outcomes

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Group permitted nothing by mouth were significantly more likely to undergo unplanned c-section
Use of antihypertensive treatments during delivery hospitalizations in women with preeclampsia has increased since 2006

Rise in Use of Antihypertensives in Delivery With Preeclampsia

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Treatment trend associated with decreased risk of maternal stroke over same time period
Persistent and severe maternal postnatal depression is associated with increased likelihood of multiple adverse child outcomes

Postnatal Depression Tied to Child Behavioral Problems

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Persistent and severe PND linked to risk of behavior problems at 3.5 years, lower math grades at 16