Racial and ethnic disparities are prevalent in maternal care, and improving health equity has been identified as a priority focus for the Medi-Cal program.
ACOG recommends shared decision-making using a stepwise, multimodal approach that includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) as first-line analgesics, especially for individuals who are breastfeeding.
If first-line options do not provide adequate pain control, ACOG recommends a low-dose, low-potency, and short-acting oral opioid, with appropriate options including codeine, hydrocodone, oxycodone, tramadol, and morphine. Codeine and tramadol should be avoided when breastfeeding.
The most important factor in the management of acute postpartum pain is the mode of delivery. After years of consistent decline, the rate of cesarean deliveries within the Medi-Cal MCP population has increased each year since 2019, going from 17.3% of deliveries in 2019 to 31.9% in 2022. Planning for pain management must begin during pregnancy and aim to avoid marginally-indicated cesarean delivery
Posted on May 11th, 2023 and last modified on May 11th, 2023.