More than one in three women have lasting health problems after giving birth, study finds

Every year, at least 40 million women are likely to experience a long-term health problem caused by childbirth, according to a new study published today in The Lancet Global Health.

Part of a special series on maternal health, the study shows a high burden of postnatal illness that persists in the months and even years after childbirth. These include pain during sexual intercourse (dyspareunia), affecting more than a third (35%) of postpartum women, lower back pain (32%), anal incontinence (19%), urinary incontinence (8% to 31%), anxiety (9% to 24%), depression (11% to 17%), perineal pain (11%), fear of childbirth (tokophobia ) (6% to 15%) and secondary infertility (11%).

The article’s authors call for greater recognition within the health system of these common problems, many of which occur beyond the point where women typically access postnatal services. Effective care throughout pregnancy and childbirth is also an essential preventive factor, they say, to detect risks and avoid complications that can lead to lasting health problems after birth.

“Many postpartum conditions cause considerable suffering in women’s daily lives long after birth, both emotionally and physically, and yet they are largely underestimated, underappreciated and underestimated,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO.

“Throughout their lives, and beyond motherhood, women need access to a range of services from healthcare providers who listen to their concerns and respond to their needs – so that they they can not only survive childbirth, but also enjoy good health and a good quality of life.

Despite their prevalence, these conditions have been largely neglected in clinical research, practice and policy, the paper notes. In a literature review spanning the past 12 years, the authors identified no recent high-quality guidelines to support effective treatment for 40% of the 32 priority conditions analyzed in their study, and found no no high quality guidelines coming from low or low level. middle-income countries. Data gaps are also significant: there have been no nationally or globally representative studies for any of the conditions identified in the research.

Taken as a whole, the special series of The Lancetentitled Maternal Health in the Perinatal Period and Beyond, calls for greater attention to the long-term health of women and girls – after and before pregnancy.

According to its opening paper, a holistic approach is needed to reduce maternal deaths, focusing not only on their immediate biomedical causes, but also on the complex interplay of broader social, economic and environmental conditions that affect the health of women. These include factors such as racial and gender inequalities as well as economic context, nutrition, sanitation, environmental risks or exposure to violence and conflict.

The lack of attention to these fundamental issues partly explains why 121 out of 185 countries have failed to make significant progress in reducing maternal deaths over the past two decades, the paper says.

“Maternal health is not just something we should start worrying about as soon as a pregnancy bump appears,” said Joao Paulo Souza, director of the Latin American and Caribbean Center for Science Information. of Health (BIREME) for PAHO/WHO and one of the authors. of the first article.

“Many factors influence a woman’s likelihood of having a healthy pregnancy, from the environment around her to the political and economic systems in which she lives, to access to nutritious foods and the level of action which she has throughout her life. it must be addressed to improve one’s health, while having access to high-quality health care throughout one’s life. »

Fundamentally, the series advocates for a strong, multidisciplinary health system, which not only provides respectful, high-quality maternity services, but also prevents ill health and mitigates the impact of wider inequalities, including specific interventions that support the most vulnerable women and girls.

Provided by the World Health Organization (WHO)