Chronic Pain After C-Section May Affect Recovery for Years

Key Developments:

• Review finds lasting effects of chronic post-C-section pain
• Pain was linked to problems with sleep, mood and daily activity
• Researchers call for earlier identification and better support

(News Medical Life Sciences) — September 25, 2026: A new synthesis of global research has found that chronic postsurgical pain following cesarean delivery can be associated with substantial disruption to women's quality of life and everyday functioning months and even years after childbirth.

Published in Anaesthesia, the journal of the Association of Anaesthetists, the systematic review examined 30 studies involving 28,295 women across 22 countries. The research was led by Dr Sarah Ciechanowicz of University College London Hospitals NHS Foundation Trust, with first author Samira Alwahabi of Florida Atlantic University and co-authors from Stanford University.

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The researchers examined studies published up to November 2025 that assessed persistent pain lasting at least three months after cesarean delivery and its association with maternal quality of life and functioning.

Because the studies used different definitions and measurement tools, the researchers summarised the findings rather than producing a single combined estimate for all outcomes.

The review found that persistent pain was associated with interference in several areas of daily life, including general activity, walking, normal work, sleep and mood. Fatigue and, in some studies, sexual functioning were also affected.

During the first three months after delivery, more than half of women reporting chronic postsurgical pain in four studies said that pain interfered with general activity, while similar interference was reported for mood. Walking, normal work and sleep were also affected.

The effects were reported at later stages as well. At six months postpartum, pain-related interference with mood and sleep remained evident, while at 12 months some studies continued to report substantial effects on these areas.

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Fatigue was also reported frequently. One large cohort included in the review found that around two-thirds of women experienced extreme tiredness at both six and 12 months following childbirth.

The review also examined depressive symptoms. Across nine studies, reported rates of postpartum depression ranged from 7% to 46% during the first year. One large study found that women with chronic postsurgical pain had higher odds of significant depressive symptoms at three and six months. These findings show an association between the conditions and do not by themselves establish that persistent pain caused depression.

A surprising side effect of having a cesarean section (c-section) is that c-section scars may continue to hurt months or even years after the scar has healed. Chronic c-section scar pain, defined as pain continuing beyond 3 months postpartum, occurs in up to 25% of people who have a cesarean birth. CREDIT: LadyBird Physical Therapy.

Dr Ciechanowicz said the findings point to the need to consider the wider effects of chronic postsurgical pain rather than focusing only on pain intensity.

“Our findings support a broader understanding of chronic postsurgical pain after cesarean delivery that recognises its substantial impact on physical, psychological and everyday functioning, rather than focusing solely on the sensation and intensity of pain,” she said.

The researchers also found evidence that the areas affected by pain may change over the course of recovery.

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“In the early months after childbirth, the impact of chronic pain appears to be more strongly characterised by limitations in physical function, while emotional and psychological effects may become more prominent over time,” Dr Ciechanowicz said.

The findings add to earlier research showing that chronic postsurgical pain after cesarean delivery is not uncommon. A 2025 systematic review and meta-analysis involving 50 studies estimated an incidence of 16.7% between three and six months after cesarean delivery. That analysis also found substantial interference with quality-of-life domains among women experiencing persistent pain, although the authors noted considerable variation between studies and rated the quality of evidence for the outcomes as very low.

Research published earlier in 2026 has similarly examined chronic pain after cesarean delivery as a multidimensional problem involving sleep, pain, mood, cognition and energy. A prospective cohort study by Ciechanowicz and colleagues explored these factors as potential predictors of persistent pain and impaired recovery.

Another 2026 qualitative study involving women who experienced chronic pain after cesarean delivery found that participants described effects extending beyond pain itself, including disrupted sleep, fatigue, difficulties with mobility and infant care, psychological distress and challenges surrounding intimacy.

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The new review's authors argue that identifying women who may be at higher risk earlier could help improve longer-term recovery.

“It is therefore crucial that we develop multidisciplinary strategies to support women and improve longer-term recovery after giving birth,” Dr Ciechanowicz said.

She also highlighted the potential wider consequences of prolonged pain.

You might have a higher chance of having a fever after pregnancy if you had a C-section (cesarean delivery). A fever after a planned or unplanned C-section can happen if the incision site gets infected. CREDIT: healthline.

“The burden of chronic postsurgical pain extends beyond its impact on quality of life, with prolonged recovery, reduced capacity to work and repeated healthcare visits potentially placing a considerable socioeconomic burden on affected women,” she said.

The researchers therefore emphasise routine assessment of persistent pain and its effects on daily activities and mental wellbeing following cesarean delivery.

The findings do not mean that every woman experiencing pain after a cesarean delivery will develop long-term disability or psychological difficulties. Rather, they indicate that persistent postsurgical pain can be associated with broader challenges during postpartum recovery and may warrant appropriate clinical assessment and support when it continues.

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