Measuring pain in postpartum women: A first look

Bringing a new baby into the world is often described as joyful, overwhelming, and exhausting all at once. But what’s less often talked about is how the postpartum body—and brain—handle pain, especially for mothers dealing with postpartum depression.

A team of researchers led by Sandraluz Lara-Cinisomo, an associate professor in the Department of Health and Kinesiology at Illinois, recently took a bold step to explore that question. Their study, published in Psychiatry Research: Neuroimaging, asked: Can we measure how new moms’ brains respond to pain using fMRI ? And would moms even be willing to do it?

It turns out the answer is yes.

The study focused on 13 women, 11 without depression and 2 with postpartum depression. The point was to see if the idea would work: Would new moms come into a lab, be willing to experience a controlled pain test while researchers measured their brain activity?

The “pain test” was simple but effective: participants were exposed to a cold-pain device while in the scanner, enough to be uncomfortable but not unsafe. The experiment was repeated five times, during which the women reported how intense and how unpleasant the pain felt.

“Although there is growing interest in the postpartum brain, including in the context of depression, the focus on postpartum pain has stalled,” Lara-Cinisomo said. “Birthing people experience changes that are not often observable. fMRI offers an opportunity to measure their minds process pain while creating a space for them to tell us how it feels to be in pain. This study is the first step toward unveiling how postpartum depression affects pain perception.”

The researchers then compared those reports to what was happening in their brains.

For the women without depression, the scans showed activation in the places you’d expect:

• The amygdala (linked to the assessment of pain intensity)
• The insula (a key hub for processing physical sensations of pain)
• The anterior cingulate cortex, or ACC (involved in emotional components of pain)

When the researchers compared women with depression to those without, they found higher brain responses in the depressed group. Still, those differences were not significant, likely due to the small sample size.

Where things got interesting was in how the women described their pain.

Even though the numbers didn’t hit statistical significance, there was a clear pattern: women with higher depression symptoms tended to find the pain more unpleasant and intense.  The depressed group also tended to report the onset of pain earlier in the experiment than the non-depressed group.

So, what is the takeaway from this study?

First, it proved the concept. Postpartum women were willing to take part and found the process acceptable. That matters because there’s often concern about asking new moms to volunteer for time-consuming or physically demanding studies.

Second, it showed that fMRI can capture real brain activity linked to pain in this group. That opens the door to larger-sample studies that could dig deeper into how PPD changes the pain experience—and maybe test which treatments (such as therapy, medication or support programs) improve mood and pain.

The study also adds to the growing recognition that postpartum health is complex. It’s not just about healing physically or adjusting emotionally—it’s about how those two processes interact in ways that can shape daily life for mothers.

Lara-Cinisomo and her co-authors are clear about what’s next: larger studies, with more women experiencing postpartum depression, and identifying interventions to help alleviate their physical and psychological discomfort. That way, they can track how the brain responds to pain might shift as symptoms improve.

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