A leading nurse researcher has issued a stark warning about the widespread problem of untreated pain during pregnancy, which affects between half and three-quarters of expectant mothers across the United States.
Julie Vignato, an Assistant Professor of Nursing at the University of Iowa, draws from both personal experience and professional research to highlight this critical maternity health issue. Her findings reveal that many mothers endure preventable suffering due to fears about medication safety during pregnancy.
The reality behind 'normal' pregnancy discomfort
Mothers are frequently told that pain comes with the territory of pregnancy and will disappear after giving birth. However, Vignato emphasises that when pain becomes so severe it prevents sleeping, working, or caring for existing children, it requires proper medical attention.
For many women, pregnancy pain doesn't simply vanish after delivery. Conditions like back pain and headaches can persist for more than three months, developing into chronic health problems that affect overall wellbeing.
Physical changes during pregnancy naturally contribute to pain. Hormonal shifts can cause headaches and loosen pelvic joints, while the baby's weight leads to back pain and abnormal spinal curvature called lordosis. These issues typically intensify during the third trimester when the baby is at its heaviest.
Systemic failures in pain management
Despite these common experiences, over 50% of mothers who report pain receive little to no treatment from healthcare providers, according to a comprehensive meta-analysis of existing research.
Current treatment options remain severely limited. While Tylenol is considered safe, it only addresses mild pain and proves ineffective for moderate to severe muscle discomfort. Alternative treatments like heat therapy, massage, chiropractic care, and physical therapy can help but often require combination approaches and ongoing sessions that may not be covered by insurance.
The most effective strategy involves multiple treatments, including therapeutic exercise. Unfortunately, this comprehensive care often proves costly for mothers without adequate insurance coverage, and awareness of these options varies significantly among healthcare providers.
Serious consequences of untreated pain
Vignato's research team discovered that mothers reporting pain are typically advised to rest, take Tylenol, begin maternity leave early, or combine these approaches. These recommendations fail to address the realities faced by mothers who must continue working or caring for other children.
Early maternity leave isn't feasible for many women who need to preserve their limited leave for after the baby arrives. Mothers frequently prioritise childcare and work responsibilities at the expense of their health when they perceive no alternatives.
This impossible situation creates a cycle where unmet expectations lead to feelings of guilt about not being adequate mothers or employees, contributing to mental health challenges.
When pain remains unaddressed, mothers often feel minimised and overwhelmed, leading to helplessness and hopelessness - key symptoms of depression. Approximately 44% of women experiencing severe pain report moderate to severe depressive symptoms during their third trimester.
The consequences extend beyond mental health. Untreated depression can lead to suicide, which accounts for 5% to 20% of maternal deaths in the United States.
Meanwhile, the prescription of opioid pain relievers for severe pregnancy pain has created another crisis. One in five women with pain reports misusing these medications during pregnancy, increasing the risk of newborns suffering withdrawal symptoms after birth.
Neonatal opioid withdrawal syndrome is becoming increasingly common, costing the country over $462 million annually. With suicide and drug overdoses now representing the leading causes of death in the year following childbirth, effective pain management during pregnancy has become urgently necessary.
Advocating for proper pain management
Managing pregnancy pain begins with open communication between mothers and healthcare providers. Vignato's studies show that by adjusting expectations, sharing feelings openly, and inquiring about available treatments, mothers can play an active role in ensuring their pain is properly addressed.
She recommends that pregnant women listen to their bodies and accept that slowing down is natural. If pain prevents lifting a toddler, that's acceptable - children will remember couch snuggles more than any physical limitations.
When discussing pain with loved ones, choose calm moments without distractions. Use "I" statements to express feelings clearly and specify the help needed. Sharing reliable articles or inviting family members to medical appointments can help them better understand the experience.
Healthcare appointments require preparation. Before visits, note main concerns and questions. Be honest about pain severity, especially if it disrupts sleep or daily activities. Describe whether pain is constant or intermittent, and its characteristics - aching, throbbing, sharp or dull.
Share what treatments have been attempted and their effectiveness. If pain persists, discuss other options like prescription medications or physical therapy referrals. Sometimes multiple conversations are needed to find relief.
When pain continues despite treatment, ask about specialist consultations. If insurance companies request discontinuing effective treatments, request provider assistance with appeals. Ongoing treatment throughout pregnancy may be necessary to properly manage pain.
Relief becomes possible when healthcare providers take pregnancy pain seriously rather than dismissing it as an unavoidable aspect of pregnancy.
