American College of Obstetricians and Gynecologists (ACOG): New Guidance on Postpartum Pain Management

Understanding that pain can interfere with a woman’s ability to care for herself and her infant, the American College of Obstetricians and Gynecologists (ACOG) has released a new set of recommendations for postpartum pain management. Untreated pain is associated with postpartum depression, development of chronic pain, and a risk of greater opioid use. ACOG recommends using a stepwise approach and a multimodal combination of agents to individualize pain management for women in the postpartum period. Patients should be evaluated on a case by case basis through shared decision-making. For vaginal birth ACOG encourages using nonpharmacologic treatments and mild analgesics if needed. For cesarean birth a stepwise multimodal approach is recommended with the use of standard oral and parenteral analgesic adjuvants, then opioids and finally opioids in combination formulations with either acetaminophen or an NSAID. Parenteral or oral opioids are recommended for breakthrough pain when analgesia from the combo of neuraxial opioids and nonopioid adjuncts is inadequate. ACOG also addresses pain control with special populations including women with opioid use disorder, and women who have chronic pain that may need additional support in managing postpartum pain. These recommendations take in to consideration women’s diverse needs in addressing their pain in the postpartum.

Link tot he article can be accessed by clicking here