taVNS Reduces Postpartum Uterine Contraction Pain After Cesarean Delivery: JAMA
China: Researchers have found in a new study that transcutaneous auricular vagus nerve stimulation (taVNS) appears to be a safe and effective therapy for reducing uterine contraction pain in women following cesarean delivery.
The trial, published in JAMA Network Open by Xingyu Xiong and colleagues from the Department of Anesthesiology at the Affiliated Hospital of Xuzhou Medical University in China, evaluated whether this non-invasive nerve stimulation technique could alleviate discomfort commonly experienced in the days after cesarean delivery.
The randomized clinical trial enrolled 156 women aged 18 years or older who were scheduled for elective cesarean delivery under combined spinal-epidural anesthesia. Participants were assigned to either active taVNS or sham stimulation in a 1:1 ratio. Both groups received 30-minute sessions once daily on the day of surgery and on the first two postoperative days. The primary outcome measured was the rate of moderate to severe uterine contraction pain by the third day after surgery. Researchers also assessed incision pain, mood symptoms such as anxiety and depression, overall recovery quality, and sleep outcomes.
The findings of the study were as follows:
- Only 5.1% of women in the taVNS group reported moderate to severe contraction pain on day three, compared with 28.2% in the sham group.
- This represented an 82% relative risk reduction (relative risk, 0.18).
- Participants in the taVNS group experienced less incision-related pain.
- Women receiving taVNS reported lower levels of anxiety and depression.
- Sleep quality was significantly better in the taVNS group compared to the sham group.
- Overall recovery improvements were greater among taVNS participants.
- The median depression score was 3 in the taVNS group compared with 5 in the sham group.
Postpartum uterine contraction pain is a common and often severe source of discomfort following cesarean delivery. Traditional pain management strategies frequently rely on medications, which may come with side effects or concerns about breastfeeding safety. The findings of this study suggest that taVNS, a non-pharmacological approach, could provide meaningful relief while also enhancing emotional well-being and recovery. “taVNS represents a novel, safe, and effective strategy for managing postpartum uterine contraction pain, with additional benefits for mood and recovery,” the authors concluded.
While the results are promising, the study had several limitations. Conducted at a single center and limited to women undergoing elective cesarean delivery, the findings may not be broadly generalizable. The trial also did not include objective biological measures, such as inflammatory markers, nor did it evaluate whether participants could correctly guess their treatment assignment, raising questions about potential bias. Furthermore, the optimal frequency and duration of taVNS sessions remain unclear and may vary between individuals.
"The randomized clinical trial provides encouraging evidence that taVNS can substantially reduce postpartum contraction pain and improve recovery in women after cesarean delivery. If validated in larger, multi-center studies, taVNS may become an important adjunctive option for postoperative pain management in obstetric care," the authors wrote.
Reference:
Xiong X, Tao M, Zhao W, et al. Transcutaneous Auricular Vagus Nerve Stimulation for Postpartum Contraction Pain During Elective Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(8):e2529127. doi:10.1001/jamanetworkopen.2025.29127
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