Pelvic Girdle Pain after Child Birth: The Impact of Mode of Delivery

Abstract

Purpose: During pregnancy or postpartum period, several women experience some degree of pelvic girdle pain (PGP). In India, information is lacking about the prevalence and possible risk factors of PGP evaluated during postpartum period. This study aims to determine the prevalence of PGP in postpartum women who underwent vaginal or caesarean mode of delivery, and to estimate possible associated factors with or without PGP in both modes of deliveries. Methods: In this cross-sectional study, 284 postpartum women answered questionnaires and underwent clinical examinations. Clinical examination included pain provocation tests for the pelvis, as well as the active straight leg raise (ASLR) test. Probable associated factors were studied, using non-parametric tests and logistic regression analysis. Results: In this study of 234 women, 41% reported pain in the pelvic girdle during postpartum period. Overall, 33% of the women experienced PGP after caesarean delivery, as compared with 8.3% of women after vaginal delivery. Low back pain (LBP) before pregnancy, parity, active straight leg raise test score ≥ 4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with vaginal delivery group and caesarean delivery group during postpartum period. In both modes of delivery, the association of PGP with these common factors remained after adjustment for other study factors. Conclusion: The results show high prevalence of PGP in women who had caesarean delivery than those who had a vaginal delivery. The finding suggests that during postpartum period, LBP before pregnancy, parity, ASLR test score ≥4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with increased risk of PGP in both vaginal and caesarean modes of deliveries, but further studies are needed for definitive conclusions.