Introduction: Persistent pain is a common yet underrecognized issue in the postpartum period, with particular relevance for military service members given strenuous occupational demands. This work aimed to address research gaps by estimating the prevalence of chronic pain during the first postpartum year among US military families and assessing differences by patient military status.

Methods: TRICARE patients with a live delivery from 2013–2022 were identified using Birth and Infant Health Research program data. Live births were ascertained via diagnostic/procedure codes in medical encounter records and confirmed by linkage to enrollment data. Patients were required to have at least 6 months of observation (i.e., enrollment) throughout the first year postpartum. Chronic pain was defined as either one chronic pain diagnosis ≥30 days post-delivery or two non-chronic pain diagnoses ≥30 days apart. Prevalence was calculated overall and by pain site and military status. Timing of diagnoses in the first year was assessed. Crude prevalence ratios (PRs) for demographics were estimated by Poisson regression with robust error variance; models for occupational characteristics were adjusted for maternal age and birth facility type (military or civilian).

Results: Among 889,321 patients, 9.2% had indication of chronic pain within the first year postpartum. Back (4.6%), abdominal (2.1%), and pelvic/perineal (2.0%) were the most common pain sites. Back pain diagnoses rose from 1.5% to 2.0% between months 2-5 postpartum while other sites remained steady. Maternal age <25 years, unmarried status, military birth facility, and multiple birth were associated with higher prevalence. Prevalence among military patients was nearly triple that of non-military patients (aPR 2.83, 95% CI 2.79-2.87), with Army and mid/senior enlisted patients having the highest aPRs.

Conclusions: Chronic pain was relatively common in the first postpartum year and disproportionately affected military patients.