The truth is revealed! It is not her fault for the back pain after childbirth!

Painless childbirth (labor analgesia) is a method of reducing labor pain through epidural anesthesia technology, which has gradually been accepted by more pregnant mothers in recent years. However, the saying that "painless childbirth will cause back pain after childbirth" has been widely spread on social media and word of mouth, and has even become a reason for some mothers to refuse to use painless childbirth. In fact, scientific research shows that there is no direct causal relationship between painless childbirth and back pain after childbirth. The following is a detailed analysis of this issue from the aspects of technical principles, research data, causes of back pain and preventive measures.

1. Technical principles of painless childbirth

The core technology of painless childbirth is epidural anesthesia. The anesthesiologist injects local anesthetics into the epidural space through lumbar puncture to block the transmission of pain signals to the brain. The puncture needle only stays in the epidural space and will not damage the spinal cord or nerve roots. The entire operation is completed under the guidance of ultrasound or anatomical landmarks, which is relatively safe.

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2. The actual incidence of postpartum low back pain

Research data reveals the truth

Several international studies have compared the incidence of low back pain in women who received painless childbirth and those who did not, and found that there was no statistical difference in the incidence of low back pain 6 weeks after delivery [1]. At the same time, the study pointed out that there is no causal relationship between epidural anesthesia and chronic low back pain after delivery [2]. A multicenter study in China in 2021 also found that the incidence of low back pain one year after delivery is about 30% to 40%, which has nothing to do with whether epidural anesthesia is received [3].

Time pattern of low back pain

Postpartum low back pain is mostly concentrated in 1-3 months after delivery, which does not overlap with the recovery period of epidural anesthesia (usually 24-48 hours), suggesting that low back pain is more likely related to physiological changes during pregnancy rather than a direct consequence of painless delivery.

3. The real cause of postpartum back pain

Physiological changes during pregnancy

Hormonal influence: Increased secretion of relaxin leads to relaxation of the pelvic ligaments and decreased stability of the lumbar spine.

Mechanical load: enlargement of the fetus and uterus, aggravation of lumbar lordosis, and long-term compensatory muscle strain.

Postpartum behavioral factors

Improper breastfeeding posture: bending over for breastfeeding or lying on your side for a long time will increase the burden on your waist.

Weak core muscles: The rectus abdominis separation during pregnancy has not recovered, and the waist is unable to compensate.

Calcium deficiency and osteoporosis: The calcium demand increases during lactation, and if not supplemented in time, it may affect bone health.

Psychological factors

Lack of sleep, anxiety, etc. can lower the pain threshold and amplify the discomfort.

4. Scientific prevention and treatment of postpartum low back pain

Prenatal prevention

Strengthen core muscle exercises during pregnancy (such as Kegel exercises, yoga ball training, etc.).

Control weight gain during pregnancy (it is recommended that those with normal BMI gain 11-16kg during pregnancy).

Postpartum recovery

Correct breastfeeding posture: Use a nursing pillow for support and keep your spine in a neutral position.

Physical therapy: electrical stimulation, heat compress or professional postpartum rehabilitation training.

Nutritional support: Daily calcium intake should not be less than 1g (during lactation).

Psychological Adjustment

Allocate parenting tasks reasonably, avoid overwork, and seek psychological counseling support when necessary.

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5. Advice for expectant mothers

Painless childbirth is a safe and effective analgesia technology, and there is no need to refuse to use it because of the rumor that it "causes back pain".

If postpartum low back pain occurs, physiological factors of pregnancy should be excluded rather than attributing it to anesthesia.

Through scientific rehabilitation methods, more than 90% of postpartum low back pain can be relieved within 6 months.

Summarize

Painless childbirth does not directly cause postpartum back pain. The occurrence of postpartum back pain is more related to physiological changes during pregnancy, postpartum behavioral habits and psychological factors. Through scientific prevention and rehabilitation measures, the occurrence of postpartum back pain can be effectively reduced and recovery can be accelerated. Expectant mothers can rest assured to choose painless childbirth and enjoy a more comfortable childbirth experience.

References

1. Anim-Somuah S, et al. Epidural versus non-epidural analgesia for pain relief in labor. Cochrane Database Syst Rev. 2020.

2. Wang L, et al. Long-term backache after childbirth: a prospective cohort study. BMJ Open. 2018.

3. Chinese Medical Doctor Association Anesthesiology Branch. Expert consensus on labor analgesia (2021 edition). Chinese Journal of Anesthesiology. 2021.

Source: Chongqing Science Writers Association

Author: Wang Wei, attending physician of the Department of Anesthesiology, Bishan Hospital Affiliated to Chongqing Medical University, and Zou Jingbo, chief technician of Mr. Zou's Science Garden

Audit expert: Li Hanbin

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