Study Reveals Vitamin D Deficiency Intensifies Early Postpartum Afterpains in Multigravida Women

Could a simple nutrient deficiency be intensifying the postpartum pain experience for your patients? Postpartum afterpains—those cramping uterine contractions in the days after delivery—are nearly universal, but why do some women suffer more than others? A new study in BMC Pregnancy and Childbirth investigates a potential dietary culprit: vitamin D.

Study Design: Cross-Sectional Analysis in Multigravida Women

Researchers conducted an analytical cross-sectional study involving 105 multigravida women (gravida 2 or 3) delivering at a single hospital in Iran. Participants’ serum 25-hydroxyvitamin D levels were measured within 24 hours postpartum using ELISA, and afterpain intensity was assessed at 6, 12, 18, and 24 hours after birth via a Visual Analogue Scale (VAS). The study excluded women with underlying health conditions, pregnancy complications, or recent use of medications affecting vitamin D.

Key Findings: Vitamin D and Afterpain Intensity

Lower vitamin D levels were significantly associated with higher afterpain scores at 6 hours postpartum.

The most marked pain occurred in the first 6–12 hours after delivery and generally subsided over 24 hours.

No significant association was seen between vitamin D levels and pain scores at 18 or 24 hours.

Additional Insights: Blood Type, Labor Dystocia, and Pain Perception

Women with blood type B reported higher pain at early time points, but this difference faded by 24 hours.

Labor dystocia (difficult labor) correlated with higher reported afterpain at 6 hours, though not later.

No significant relationship was found between afterpain and other factors such as maternal age, hematologic indices, or breastfeeding status.

Implications for Clinical Practice

These findings suggest that maternal vitamin D status—a modifiable factor—may influence the severity of postpartum afterpains, especially soon after delivery. Given the global prevalence of vitamin D deficiency in pregnant women, simple screening and supplementation strategies could potentially enhance postpartum comfort. However, causality cannot be established from this cross-sectional design, and further interventional studies are needed.

Why This Matters

Postpartum pain can hinder maternal rest, breastfeeding, and early bonding. Identifying risk factors—particularly modifiable ones—enables physicians to personalize postpartum care and potentially improve outcomes for mothers recovering from childbirth.

Conclusion

Low maternal vitamin D levels were linked to greater postpartum afterpain in multigravida women, particularly within the first 6 hours after delivery. While more research is needed to determine if supplementation reduces pain, these data highlight the clinical value of considering nutritional status during pregnancy and postpartum recovery.

Key Points

Lower serum vitamin D was associated with higher afterpain intensity early after birth.

Pain typically peaked at 6 hours and diminished by 24 hours for all participants.

Type B blood and labor dystocia were also linked to greater early postpartum pain.

No relationship was found between hematologic indices and afterpain severity.

Routine assessment of maternal vitamin D status may help identify women at risk for greater postpartum discomfort.

Citation:

Nikjou R., Isazadeh M., Kouhi S. et al. Serum vitamin D levels and postpartum afterpain in multigravida women. BMC Pregnancy and Childbirth. 2026;[in press]. https://doi.org/10.1186/s12884-026-09589-x