Factors Affecting Pain Intensity Post Caesarean Section in Governmental Hospitals in the West Bank-Palestine

There has been a gradual increase in cesarean births over the past 30 years. In November 2005, the Centers for Disease Control and Prevention (CDC) reported that the international cesarean birth rate was the highest ever at 29.1%, which is over a quarter of all deliveries; The CDC has made it a national goal to get the number down for "low-risk" mothers by 2010. In the West Bank, there is no clear information (specific statistics) about the percentage of caesarean section ( CS). In Rafedia Surgical Hospital in Nablus the C.S was about 11% in the seventies and jumped to 13-14% in the eighties and nineties of this century. According to hospital records, in the last 4 years this percentage has been about 14-15%. During the ALAQSA Uprising in 2000-2004 this percentage remained the same till the incursion of Nablus city in 2002; the percentage jumped to about 21% as women demanded at their own choice or request caesarean delivery to avoid delay at check points. This study aims to identify factors affecting pain intensity postoperative in women undergoing caesarean section. The study was conducted during the period from February-March, 2007. It was implemented in three governmental hospitals in the cities of Nablus, Jennie and Ramallah. The patient questionnaire was conducted through face to face interviews and patients files. Several hypotheses were formulated and tested through SPSS, multiple comparison analysis and Microsoft office excel. At power of 0.05 there were significant statistical differences between pain intensity and the following variables: source of information about pain, history of pain post caesarean section, length of operation, type of stitches, nurse approach with pain and fatigue, way of pain reflection, ambulation post caesarean section, and bad events related to patients directly. However, at the same power, there were no significant statistical differences between pain intensity and the following variables: family support, baby weight, baby gender, health team, place of living, profession, income, qualification, anti-natal care, number of pregnancies, smoking, drinking tea, drinking coffee, route of medication used.Pain management has been established as one of the benchmarks of quality health care. A high percentage of 75.7% represents pain severity (6-10) on Visual Analogue Scales (0-10) post CS in this study; this result requires more attention for pain management post operative and the quality of hospital care now must include the assessment of pain relief. Our data showed that source of information and past history of pain have a strong association to pain intensity. The result also showed that operation technique and its time affected on pain intensity and let the lady to be early ambulation. This enabled the mother to take care of her baby. In conclusion findings showed that pain severity was high in most of the cases of pain on scale ( 6-10). Attention should be given for these factors which affect pain intensity post caesarean section.