Severe pain impacting sleep and activities of daily living is more likely in women with prior cesarean delivery, according to data presented at the ANESTHESIOLOGY 2025 annual meeting in San Antonio, Texas, from October 10 to October 14, 2025.1
Compared to patients without prior c-section, those with a history of c-section had a 16% increase in the risk of developing sleep disorders within 1 to 12 months following birth. According to Moe Takenoshita, MBBCh, lead study author and postdoctoral scholar at Stanford University Center for Academic Medicine, this highlights a need for adequate pain management in new mothers.
Key takeaways:
Women with a prior cesarean delivery had a 16% higher risk of developing sleep disorders within a year after birth.
Severe pain disrupting sleep and daily life was reported in over 70% of c-section patients, compared to 8% with vaginal birth.
Common sleep issues included insomnia, sleep deprivation, and sleep apnea.
Experts recommend exercise, relaxation techniques, and reduced caffeine or alcohol intake to improve postpartum sleep.
Negative Pressure Wound Therapy at –80 mmHg reduced surgical site infections and saved over $700,000 per 1,000 patients.
“Cesarean delivery in particular appears to increase the risk for severe pain and sleep disorders, which can lead to postpartum depression, thinking and memory problems, and fatigue, as well as disrupt bonding with their babies and relationships with family and friends,” said Takenoshita.
Severe pain and sleep issues more common after cesarean delivery
Both qualitative and quantitative analyses were performed to identify this association, with 41 mothers interviewed about their pain and sleep experiences following childbirth for the qualitative analysis. Of these:
- 24 had vaginal birth
- 11 scheduled c-sections
- And 6 unplanned c-sections
Severe pain disrupting sleep and daily activities was reported in 73% of patients with scheduled c-section and 67% with unplanned c-section, vs only 8% with vaginal birth. In comparison, the quantitative study assessed data from over 1.5 million mothers delivering from 2008 to 2021 within a nationwide insurance database.
Among patients in the database, those with c-section were 16% more likely to be diagnosed with a new sleep disorder from 1 month to 1 year after birth vs those with vaginal birth. These included sleep deprivation, insomnia, and obstructed sleep apnea.
Recommendations for improving postpartum sleep
Takenoshita noted that approximately 1 in 3 births in the United States are performed through c-section. To improve sleep, Takenoshita recommended measures such as regular exercise as appropriate, avoiding caffeine or alcohol intake late in the day, sleeping when the baby sleeps, and relaxing before bed with a bath or deep breathing.
“Anyone having sleep problems during pregnancy or after childbirth should discuss their concerns with their physician, who can evaluate the issue, make recommendations, and refer them to a specialist if necessary,” said Takenoshita.
There are also methods of reducing complication risks in patients undergoing c-section, including surgical site infection.2 In an interview with Contemporary OB/GYN, Tia Welsh, MD, MPH, FACOG, Chair of Women’s Services at Valley Medical Group, discussed the efficacy of single-use Negative Pressure Wound Therapy devices toward reducing infection risk.
Negative pressure wound therapy shown to improve outcomes
The effectiveness of this method was highlighted in a real-world evidence-based study of over 10,000 women, comparing outcomes from negative 80 wound therapy to negative 125. Outcomes indicated significantly improved efficacy from the former method toward reducing risks of surgical site infections, as well as seromas and superficial wound infections.
Additionally, greater cost effectiveness was highlighted from the negative 80 wound therapy, with a decrease of over $700,000 per 1000 women. Welsh encouraged providers to support their patients with wound complications during birth.
“When helping patients with their c-section recovery, you have to understand that any kind of wound complication significantly hinders women, whether it increases their rate of depression, decreases the bonding they have with their baby, and even it has been shown that there's decrease in breastfeeding rates,” said Welsh.
References
- Cesarean delivery linked to higher risk of pain and sleep problems after childbirth. American Society of Anesthesiologists. October 12, 2025. Accessed October 15, 2025. https://www.eurekalert.org/news-releases/1101059.
- Welsh T. Negative pressure wound therapy reduces c-section infections and costs. Contemporary OB/GYN. May 20, 2025. Accessed October 15, 2025. https://www.contemporaryobgyn.net/view/negative-pressure-wound-therapy-reduces-c-section-infections-and-costs.
