Factors Associated With Postoperative Pain Severity and Patient Satisfaction Among Post-Caesarean Women in Rajshahi District, Bangladesh.

Background: Caesarean delivery (CD) is a common surgical procedure, and effective postoperative pain (POP) management is essential for maternal recovery and psychological well-being. Despite the increasing use of CD in Bangladesh, evidence regarding POP severity, pain-related outcomes, and patient satisfaction remains limited, particularly in regional healthcare settings. This study assessed POP severity, pain management outcomes, patient satisfaction, and factors associated with satisfaction among women undergoing CD in Rajshahi District, Bangladesh. Methods: A hospital-based cross-sectional study was conducted between November and December 2024 among 297 women who had undergone CD within the previous 24 h in selected public and private healthcare facilities in Rajshahi District. Data were collected through face-to-face interviews using the Bangla version of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R). Descriptive statistics, chi-square tests, and binary logistic regression analyses were performed to identify factors associated with satisfaction with pain management. Results: Substantial POP was reported during the first 24 h after CD. Overall, 84.2% of participants experienced moderate-to-severe pain, while 72.1% rated their worst pain as severe. Pain substantially interfered with physical activities, with moderate-to-severe interference reported for activities in bed (84.9%) and out of bed (76.1%). Emotional distress was also considerable, particularly fear (78.1%), anxiety (68.4%), helplessness (54.9%), and depression (52.9%). Despite this pain burden, 65.0% of women were satisfied with their pain management. However, 35.0% reported no pain relief, while only 5.7% reported complete relief. Adverse drug effects were reported by 34.0% of participants. In multivariable analysis, women aged 25-29 years had lower odds of satisfaction than those aged ≥ 30 years (AOR = 0.43, 95% CI: 0.19-0.96), whereas overweight women had higher odds of satisfaction than obese women (AOR = 3.27, 95% CI: 1.26-8.49). Those who received no pain medication also had higher odds of satisfaction (AOR = 5.49, 95% CI: 1.37-22.06). Conclusion: Women undergoing CD in Rajshahi District experienced a substantial burden of POP, physical interference, and emotional distress despite relatively high overall satisfaction with pain management. Limited pain relief and inadequate pharmacological management appear to be important concerns. Strengthening standardized, multimodal, and patient-centered POP management may improve pain control and maternal recovery following CD.