Maternal experience of musculoskeletal pain during pregnancy and birth outcomes: significance of lower back and pelvic pain.

Aim: to examine the association between back and pelvic pain during pregnancy and birth outcomes.

Background: back and pelvic pain during pregnancy is a common occurrence. It is known to affect maternal functioning and well-being during pregnancy and can persist postnatally and beyond. However, there has been little examination of the impact upon birth outcomes such as birth mode, duration of labour and pain experience.

Method: five hundred and eighty mothers with an infant aged zero to six months completed a retrospective questionnaire documenting their pain during pregnancy and birth outcomes (e.g. mode, duration, interventions, perception of pain). Participants also rated overall pain and pain in specific body regions for each of the three trimesters. Estimations of fetal position before birth were given.

Findings: higher pain ratings during the third trimester of pregnancy were associated with increased incidence of caesarean section, assisted delivery and a longer duration of labour. Specifically, lower back and pelvic pain were associated with an increase in complications, potentially due to occurrence of malpositioning of the fetus during pregnancy.

Conclusion: mothers who experience high levels of pain during pregnancy may be at increased risk of complications during labour. Explanations for this may be physiological, mechanical or psychological but greater awareness should be given to the potential impact of maternal pain ratings during pregnancy upon birth outcomes.