One in 300 women will become persistent opioid users after cesarean delivery (1). Cesarean
delivery is the most common surgical procedure in the United States, representing 31.9% of
the 3,788,235 deliveries in 2018 (2). Patients have to cope with the pain and challenges of
post-operative care while adjusting to motherhood and completing activities of daily living.
Often when they return home, they are also tasked with other domestic roles which compounds
the challenge of this post-operative period. With a potential impact just in the US on 1.2
million mothers each year, optimizing post-operative pain management in order to reduce the
risk of persistent opioid use represents an urgent unmet public health goal. To this end,
there are national efforts to reduce the cesarean rate and optimize post-cesarean pain
management (3,4). The majority of efforts in the last few years have focused on home-going
medications and alterations in prescription practices. Recent recommendations from the
Enhanced Recovery After Surgery Society indicate that patients should receive multi-modal
analgesia on a regular basis, along with early post-delivery mobilization (3). However, the
efficacy of scheduled non-steroidal anti-inflammatory medications (NSAID) along with
acetaminophen in the immediate post-operative period and after going home have not been
systematically studied in the cesarean population. We hypothesize that patients who receive
scheduled medications in the post-operative period are less likely to require opioids for
pain relief both in the hospital and after they return home.