At least 40 million women are likely to experience a long-term health problem caused by childbirth every year, according to a new study.
Published in The Lancet Global Health, the research found a “high burden” of postnatal conditions that persist for many women in the months – and even years – after giving birth.
The authors of the paper said there needs to be greater recognition within healthcare systems of these problems, many of which occur beyond the point where women typically have access to postnatal services.
In the UK for instance, women might be seen by a midwife a couple of times after the birth, and a GP six- to eight-weeks postpartum, before the routine check-ups end.
It’s led to some campaigners calling for more maternal checks.
The most common issues women face after childbirth
The study found the most commonly experienced issues post-birth were:
- Pain during sexual intercourse (dyspareunia), affecting more than a third (35%) of postpartum women
- Low back pain (32%)
- Anal incontinence (19%)
- Urinary incontinence (8-31%)
- Anxiety (9-24%)
- Depression (11-17%)
- Perineal pain (11%)
- Fear of childbirth (6-15%)
- Secondary infertility (11%)
Other conditions that can occur, but the study flagged as being less common, include:
- Pelvic organ prolapse
- Post-traumatic stress disorder
- Thyroid dysfunction
- Mastitis
- HIV seroconversion
- Nerve injury
- Psychosis
- Venous thromboembolism
- Peripartum cardiomyopathy.
These conditions can have lifelong social, economic and health consequences.
The authors flagged that most of the data comes from high-income countries with well resourced health systems and there are scarce population-level data from low-income and middle-income countries.
Dr Pascale Allotey, director of sexual and reproductive health and research at the World Health Organisation (WHO), said: “Many postpartum conditions cause considerable suffering in women’s daily life long after birth, both emotionally and physically, and yet they are largely underappreciated, underrecognised, and underreported.
“Throughout their lives, and beyond motherhood, women need access to a range of services from health-care providers who listen to their concerns and meet their needs – so they not only survive childbirth but can enjoy good health and quality of life.”
Unsurprisingly, these conditions aren’t well-researched
As with many things relating to women’s health, the study flagged these conditions have been largely neglected in clinical research, practice and policy.
The study forms part of a wider series, titled Maternal health in the perinatal period and beyond, which calls for greater attention to the long-term health of women and girls, before and after pregnancy.
“Maternal health is not just something that we should start worrying about when the pregnancy bump appears,” said Joao Paulo Souza, centre director of the Latin American and Caribbean Center on Health Sciences Information (BIREME) and one of the authors of the paper.
“There are many factors that influence the likelihood a woman will have a healthy pregnancy, from the environment around her to the political and economic systems she lives in, or access to nutritious food and the level of agency she has over her life – all of these need to be addressed to improve her health, alongside access to high quality healthcare throughout life.”
The series argues for a “strong, multidisciplinary health system” which provides high quality, respectful maternity services but also prevents ill health and mitigates the impact of broader inequities.