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Unique Pain Management Needs for Pregnant Women with Pre-existing PTSD and Other Mental Health Disorders

  • Obstetric Anesthesia (LR Leffert, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review describes how the presence of maternal mental health disorders influences peripartum pain. It provides practical guidance for tailored anesthetic plans that address the unique needs of pregnant women with such disorders.

Recent Findings

The role of maternal mental health conditions in the peripartum experience and postpartum course for the mother-baby dyad is an evolving area of interest in the current psychiatric and obstetric literature. It is only recently, however, that providers are beginning to understand how pre-existing maternal posttraumatic stress disorder (PTSD), anxiety, or depression influences how these patients perceive pain during labor or cesarean section. There is, unfortunately, a lack of understanding and consistency in the approach to pain management for these patients. Emphasis on recognition of these unique patient needs and tailoring of peripartum pain management strategies is crucial in helping to achieve a positive birth experience and minimize increased postpartum mental health symptom severity and/or chronic pain for these patients.

Summary

Peripartum pain during labor and/or surgical delivery can be influenced by a pre-existing history of mental health conditions. Specialized pain assessment and management strategies should accommodate the unique needs of these patients.

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Authors and Affiliations

  1. Department of Anaesthesiology, West Penn Hospital, 4800 Friendship Avenue, Pittsburgh, PA, 15224, USA

    Tracey M Vogel

  2. Allegheny Health Network, Pittsburgh, PA, USA

    Tracey M Vogel

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This article is part of the Topical Collection on Obstetric Anesthesia

Search Strategy

An extensive review of the literature was conducted using PubMed, Medline, CINAHL, and Google Scholar focusing on recent contributions (2012–2020). This review included, but was not limited to, systematic and major narrative reviews, large observational studies, and prospective and retrospective analyses. Papers published outside this range were included if they were found to be of significant benefit and support to the discussion. Headings/keywords used for the search included labor pain and mental health/mental health issues; inadequate anesthesia, cesarean section, consequences; anesthesia, cesarean section, emergency procedures; maternal PTSD and labor pain; maternal PTSD and surgical pain; PTSD and surgical pain and pain perception; and maternal mental health and altered pain thresholds, dexmedetomidine and pregnancy, anti-anxiety agents-pregnancy, chronic pain and pregnancy, opiate use disorder, and pregnancy.

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Vogel, T.M. Unique Pain Management Needs for Pregnant Women with Pre-existing PTSD and Other Mental Health Disorders. Curr Anesthesiol Rep 11, 1–11 (2021). https://doi.org/10.1007/s40140-020-00430-5

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