Patient experiences of chronic postsurgical pain after caesarean delivery: an inductive thematic analysis

BackgroundChronic postsurgical pain after caesarean delivery affects 10-20% of women at 3-6 months postpartum, yet its broader impact on recovery is underexplored. This study examined lived experiences of chronic postsurgical pain and identified key domains of impact. MethodsTwenty-four women with self-reported pain at 3-6 months after intrapartum or planned caesarean delivery were recruited from two prospective studies. Semi-structured interviews, conducted in English or Spanish via secure video call, were transcribed and analysed using inductive reflexive thematic analysis. ResultsParticipants described a multidimensional, interconnected symptom burden. Pain persisted or worsened unpredictably, interfering with mobility, infant care, and daily life. Poor sleep and fatigue compounded distress. Cognitive and affective disruptions, including anxiety and fear, were common. Many avoided strong analgesics due to concerns about alertness or breastfeeding. Participants sometimes reported feeling dismissed or unsupported by healthcare professionals. Ten themes were identified: pain and sensory disruption; functional limitations and fatigue; interference with infant care and identity; psychological distress and cognitive load; sleep disruption; control and coping; intimacy and embodied recovery; healthcare gaps; peer and online normalisation; and reflections on future health. ConclusionsChronic pain after caesarean rarely occurs in isolation. Inter-related symptoms across sleep, pain, affect, cognition, and energy domains contribute to the lived experience of chronic caesarean delivery pain. These findings align with the multidomain SPACE-Postpartum framework, and support its further evaluation as a model for understanding and predicting postpartum pain outcomes. HighlightsO_LIChronic postsurgical pain (CPSP) after caesarean delivery is a multidimensional burden beyond pain intensity. C_LIO_LITen CPSP themes spanned physical, emotional, social, and care impacts. C_LIO_LISymptoms reinforced each other, compounding recovery challenges. C_LIO_LINarratives align with the SPACE (Sleep, Pain, Affect, Cognition, Energy) - Postpartum framework of domains. C_LI