Knowledge, Attitudes and Practices of Obstetricians for Postpartum Pain Control in the United States [33L]

INTRODUCTION: Postpartum pain is one of the most common morbidities in the postpartum period. Absence of clinical practice guidelines to treat postpartum pain combined with the ongoing opioid prescriptions epidemic has impacted the physicians' practices. The objective was to study the knowledge, attitudes and practices of obstetricians in regards to postpartum pain control across the United States. METHODS: This nation-wide cross-sectional study was conducted electronically from 3/2018 to 5/2018. Participants included obstetrics-gynecology or family medicine-trained obstetricians practicing in academic institutions. Survey included 34 questions and response rate was 35% (648/1878). Institutional review board approval was obtained for this study. RESULTS: Respondents' characteristics included mean age 46.2 (±11.0) years, females 422 (66%) and Caucasians 483 (75%). Regarding knowledge about guidelines, 153 (24%) were familiar with postpartum pain management and 351 (54%) were familiar with chronic pain management guidelines. Regarding the most common source of pain post-vaginal delivery, 87 (13%) correctly cited perineal pain, while post-cesarean delivery, 333 (51%) correctly cited incisional pain. Regarding pain level, 474 (72%) felt there is mild pain post-vaginal delivery, while 506 (78%) felt there is moderate pain post-cesarean delivery. Regarding opioids for treating postpartum pain, 367 (57%) felt that it should be considered only if the pain is unresolved, while 195 (30%) felt it is unnecessary most of the times. The national attention to opioids prescription epidemic has moderately to severely impacted practices of 230 (36%) respondents. CONCLUSION: This study provides unique obstetricians' perspectives around postpartum pain management that can help develop clinical practice guidelines for treating this common morbidity.