A Literature Review on Factors Influencing Cesarean Section, Postoperative Pain, and Nursing Interventions

Junying Xu; Alita Conde; Francisco Obmerga

doi:10.63313/hmt.9015

Authors

Junying Xu Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines Author
Alita Conde Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines Author
Francisco Obmerga Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines Author

DOI:

https://doi.org/10.63313/hmt.9015

Keywords:

Cesarean section, Postoperative pain, Nursing interventions

Abstract

Currently, the cesarean section rate continues to rise globally, with its influencing factors and postoperative health outcomes becoming key focuses of public health and clinical attention. This review aims to systematically examine the status of postoperative incision pain following cesarean delivery, its impact on maternal quality of life, the effectiveness of nursing interventions, and to identify future research directions.

References

[1] Betrán, A. P., Ye, J., Moller, A.-B., Zhang, J., Gülmezoglu, A. M., & Torloni, M. R. (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health, 6(6), e005671. https://doi.org/10.1136/bmjgh-2021-005671

[2] Bimrew, D., Kebede, A., & Kassahun, G. (2022). Incidence and associated factors of acute postoperative pain after cesarean section. Journal of Pain & Palliative Care Pharma-cotherapy.

[3] Boerma, T., Ronsmans, C., Melesse, D. Y., Barros, A. JD., Barros, F. C., Juan, L. J., Moller, A. B., Say, L., Hosseinpoor, A. R., Yi, M., Neto, D. L., & Temmerman, M. (2018). Global epidemiol-ogy of use of and disparities in caesarean sections. The Lancet, 392, 1341–1348. Retried from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31928-7/abstract

[4] Chen, C., Yuan, Y. P., & Cui, X. H. (2016). Effect of anesthesia nursing intervention on post-operative analgesia and breastfeeding in women undergoing cesarean section.

Chinese General Practice Nursing, 14(13), 1326–1327. https://doi.org/10.3969/j.issn.1674-4748.2016.13.012

[5] Crandon, R., Storr, N., Parker, P., Nair, R., Pietrobuono, M., & Hughes, L. (2025). Enhanced recovery after caesarean section: an intrathecal morphine dosing study. Perioper Med 14, 108. https://doi.org/10.1186/s13741-025-00555-3

[6] Demilew, B. C., Zurbachew, N., Getachew, N., Mekete, G., & Lema, D. T. (2024). Prevalence and associated factors of postoperative acute pain for mothers who gave birth with cesar-ean section: A systematic review and meta-analysis. https://doi.org/10.1016/j.pmn.2024.05.010

[7] Colomar, M., Opiyo, N., Kingdon, C., Long, Q., Nion, S., Bohren, M. A., & Betran, A. P. (2021) Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences. PLoS ONE.16(5): e0251072. DOI: 10.1371/journal.pone.0251072

[8] Ding, J. M. (2021). Effect of comfort nursing on postoperative comfort and incisional pain in women undergoing cesarean section. Medical Diet & Health, 16(10), 176–177

[9] Hui, L. Y., & Chen, Y. (2022). Effect of acupoint massage on negative emotions, breast en-gorgement and feeding status among puerperal women. Modern Nurse (Zhongdui Hushi / Dangdai Hushi), 29(17). https://doi.org/10.19792/j.cnki.1006-6411.2022.17.013

[10] Jenabi, E., Khazaei, S., Bashirian, S., Aghababaei, S., & Matinnia, N. (2020). Reasons for elec-tive cesarean section on maternal request: a systematic review. J Matern Fetal Neonatal Med. 33(22):3867-3872. doi: 10.1080/14767058.2019.1587407.

[11] Jin, J., Peng, L., Chen, Q., Zhang, D., Ren, L., Qin, P. P., & Sun, M. (2016). Prevalence and risk factors for chronic pain following cesarean section: a prospective study. BMC Anesthe-siol 16, 99. https://doi.org/10.1186/s12871-016-0270-6

[12] Luo, Y. H., Xu, M. Y., Guo, L. D., & Wu, X. H. (2023). Clinical effect of individualized anesthe-sia nursing model for cesarean delivery and its influence on pain and complications. China & Foreign Medical Treatment, 28, 115–118. https://doi.org/10.16662/j.cnki.1674-0742.2023.28.115

[13] Nie, H. Z. (2020). Research on the effect of refined nursing on postoperative recovery of cesarean section women. Chinese Journal of Practical Medicine, 15(27), 120–122.

[14] O'Donovan, C., & O'Donovan, J. (2018). Why do women request an elective cesarean de-livery for non-medical reasons? A systematic review of the qualitative literature. Birth. 45(2):109-119. doi: 10.1111/birt.12319.

[15] Pan, G. M. (2025). The application value of pain management team of operating room nurses in delivery women undergoing cesarean section. Fertility & Health, 31(20), 13–15. https://doi.org/10.3969/j.issn.1006-9488.2025.20.005

[16] Rawal, N. (2023). Intrathecal opioids for the management of post-operative pain: review. Best Practice & Research Clinical Anaesthesiology. 37(2), 123-132. https://doi.org/10.1016/j.bpa.2023.01.001

[17] Roofthooft, E., Joshi, G.P., Rawal, N., Van de Velde, M. and the PROSPECT Working Group* of the European Society of Regional Anaesthesia and Pain Therapy and supported by the Obstetric Anaesthetists’ Association (2021), PROSPECT guideline for elective caesarean section: updated systematic review and procedure-specific postoperative pain manage-ment recommendations. Anaesthesia, 76: 665-680. https://doi.org/10.1111/anae.15339

[18] Sultan, P., & Carvalho, B., (2021). Evidence-based guidance for use of intrathecal morphine as an alternative to diamorphine for Caesarean delivery analgesia. British Journal of An-aesthesia, 127 (4): 501e505. doi: 10.1016/j.bja.2021.06.023

[19] Wang, L. Z., Huang. J. Y., Hu, H. J., & Xia, F. (2025). Incidence of chronic postsurgical pain after caesarean delivery: a systematic review and meta-analysis. Anaesthesia. 80(7):834-845. doi: 10.1111/anae.16596.

[20] Liu, J. Y. (2012). Investigation on pregnant women’s expected and actual experience of la-bor pain under different modes of delivery. China Journal of Pharmaceutical Economics. (2), 164–165.

[21] Wu, Q. Y. (2025). Evaluation of the effect of operating room care on incision healing in pa-tients undergoing cesarean section surgery. Fertility & Health, 31(20), 22–24. https://doi.org/10.3969/j.issn.1006-9488.2025.20.008

[22] Xu, H., Wang, Y. Q., & Liu, S. Y. (2025). Analysis of factors influencing the analgesic effect of butorphanol patient-controlled analgesia after cesarean section. Chinese Journal of Family Planning, 33(10). DOI: 10.3969/j.ssn.1004-8189.2025.10.03

[23] Xu, Y., & Hu, C. Y. (2025). Effect of ERAS- and 4P-concept–based pain management on postoperative pain among women undergoing cesarean section. Chinese Journal of Family Planning, 33(10).

[24] Yin, S., Chen, L., Zhou, Y., Yuan, P. b., Guo, X. Y., Lu, J., Ge, L., Shi, H. F, Wang, X. X, Li, L. Y., Qi-ao, J., Zhao, Y. Y., Qi, H. B., Ma, X. D., & Wei, Y. (2023). Evaluation of Cesarean Rates for Term, Singleton, Live Vertex Deliveries in China in 2020 Among Women With No Prior Ce-sarean Delivery. JAMA Network Open, 6(3): e234521. doi: 10.1001/jamanetworkopen.2023.4521.

[25] Yu, W. J., & Zhang, Y. L. (2023). Effect of anaesthesia nursing intervention on postoperative analgesia and breastfeeding in cesarean section women. Fuer Jiankang Daokan, 2(6), 173–175.

[26] Zeng, Y. F. (2025). Effect of acupoint massage combined with music therapy on intraoper-ative shivering, traction pain and nausea/vomiting in cesarean section patients. China Met-allurgical Industry Medical Journal, 42(5). https://doi.org/10.13586/j.cnki.yjyx1984.2025.05.069

[27] Zhang, A. R., & Su, H. T. (2011). Analysis of pain perception among cesarean section and neurosurgical patients and their family members during the perioperative period. Chinese Journal of Modern Drug Applications, 5(13). https://doi.org/10.14164/j.cnki.cn11-5581/r.2011.13.026.

[28] Zhang, Q. M. (2022). Effect of refined nursing on postpartum recovery and incisional pain/infection in women undergoing cesarean section. Grassroots Medical Forum, 26(21), 95–97.

[29] Zhang, X. Y. (2020). Effect of interventions guided by traditional Chinese medicine con-cepts on postoperative recovery and coagulation function of women after cesarean sec-tion. China Health Standard Management, 11(14), 104–106.

[30] Zhou, J., Zhang, B. Y., & Zhou, Y. Y. (2025). Observation on the effect of enhanced recovery nursing during uterine involution medication after cesarean section. Chinese Journal of Drug Dependence Prevention, 31(9), 1762–1763. https://doi.org/10.15900/j.cnki.zylf1995.2025.09.057