Caesarean sections are associated with sleepless nights and painful recoveries

“Sleep is often overlooked during postpartum recovery, but is essential to the mother’s physical and mental health,” said Moe Takenoshita, MD, MBBS, lead author of the study and a postdoctoral researcher in the Department of Anesthesiology at Stanford University Center for Academic Medicine, Palo Alto, California. “Cesarean section in particular appears to increase the risk of severe pain and sleep disturbances, which can lead to postpartum depression, problems with thinking and memory, and fatigue, as well as disrupting bonding with their babies and relationships with family and friends.”

The research team used quantitative and qualitative methods. In the qualitative part, they interviewed 41 mothers about their postpartum pain and sleep experiences. Among them, 24 were vaginal deliveries, 11 were planned cesarean deliveries, and six were unplanned cesarean deliveries. Severe pain that affected sleep and daily activities was reported by more than two-thirds of those who underwent cesarean sections (73% of planned and 67% of unplanned), compared to only 8% of mothers who had vaginal deliveries.

The quantitative analysis was drawn from a National Insurance database of more than 1.5 million mothers who gave birth between 2008 and 2021. The results showed that mothers who had C-sections were 16 percent more likely to receive a new diagnosis of a sleep disorder (such as insomnia, sleep deprivation, or obstructive sleep apnea) within a month to a year after giving birth, compared to those who delivered vaginally.

Dr. Takenoshita advised new mothers, especially those recovering from a cesarean section, to take steps to manage pain effectively, because untreated pain can further disrupt sleep. Additional strategies to support better rest include engaging in light physical activity when possible, sleeping when the child sleeps, avoiding caffeine and alcohol later in the day, and relaxing before bed through activities such as bathing or practicing deep breathing.

“About one-third of births in the United States are cesarean sections,” Dr. Takenoshita said. “Those who plan to have a C-section should understand that the procedure is associated with severe postpartum pain and an increased risk of sleep disturbances. Anyone who has trouble sleeping during pregnancy or after birth should discuss their concerns with their doctor, who can evaluate the problem, make recommendations and refer them to a specialist if necessary.”