A study recently published in the Norwegian Institute of Public Health suggests patients with pelvic girdle pain choose vaginal delivery, when possible, over C-section delivery to reduce pelvic girdle pain postpartum. C-section rates are on the rise worldwide and not all are medically necessary. Some women choose elective C-section due to pelvic girdle pain, but researchers report the surgery could be causing even more pain than necessary.

According to Dr. Elisabeth Bjelland, researchers in the Norwegian Institute of Public Health’s Division of Mental Health, claims women believe a scheduled C-section is the best option because they are afraid vaginal delivery will be too painful to bear. “Some women with severe pelvic girdle pain might fear that a vaginal delivery will be too difficult or painful, or will worsen the condition after delivery -- even though scientific evidence is lacking.”

The study included about 10,000 women participating in the Norwegian Mother and Child Cohort. Women were selected based on answers to a questionnaire filled out between 17 and 30 weeks gestation and six months after delivery. All women reported pelvic girdle pain in the 30th week. At the conclusion of the study, about 80% of women delivered vaginally. Another 7% of women delivered vaginally with help, including forceps or vacuum assistance. About 13% of women gave birth via C-section, either emergency or planned.

Women who birthed via C-section reported severe pelvic girdle pain six months post delivery up to three times more often than women who gave birth naturally. An increase in pain was also noted in women who delivered via assisted vaginal birth. Previous studies have associated prolonged post-surgical pain with prolonged periods of pain prior to surgery, which could be playing a part in pelvic girdle pain.

Researchers suggest doctors make patients with pelvic girdle pain aware of the possible long-term pain associated with C-section deliveries. Bjelland goes on to state, “Our findings, which support previous assumptions, do not indicate that cesarean section represents a benefit for the process of recovery from pelvic girdle pain. If there are no medical reasons for a cesarean section, the findings suggest that vaginal delivery is the safest option for women presenting with severe pelvic girdle pain.”

Source: Elisabeth K. Bjelland, Britt Stuge, Siri Vangen, Babill Stray-Pedersen, Malin Eberhard-Gran. Mode of delivery and persistence of pelvic girdle syndrome 6 months postpartum. American Journal of Obstetrics and Gynecology, 2012; DOI: 10.1016/j.ajog.2012.12.002