Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not “Do abdominal binders placed after cesarean delivery reduce postoperative pain?”

STUDY DESIGN: Systematic review of three peer-reviewed studies written in English, published between the years 2016 and 2018.

DATA SOURCES: All three studies are randomized controlled trials found using PubMed database, and they were the only existing RCTs evaluating this objective published at the onset of this review.

OUTCOME MEASURED: The primary outcome measured in each study is self-reported pain on postoperative day 1 following cesarean delivery. Pain is measured on a scale from 0 to10 using the Visual Analog Scale or as part of the Brief Pain Inventory- Short Form.

RESULTS: Two of the three randomized controlled trials found significantly lower reported pain levels in the binder group. The study by Gustafson, Dong, Duong, and Kuhlmann (Kans J Med. 2018;11(2):48-53. PMID: 29796155) found significantly lower average level of pain at 24 hours post-op (p= 0.024). The study by Ghana, Hakimi, Mirghafourvand, Abbasalizadeh, and Behnampour (Int J Gynecol Obstet. 2017;137(3):271-276. doi:10.1002/ijgo.12134) reports significantly lower pain scores (p<0.001) at all time points postoperatively, measured up to 5 days. The third study did not find a significant difference in pain level on post-op day 1 (p=0.33) but cited the most weaknesses in experimental design (Gillier CM, Sparks JR, Kriner R, Anasti JN. Int J Gynecol Obstet. 2016;133(2):188-191. doi:10.1016/j.ijgo.2015.08.026).

CONCLUSIONS: Because two robust RCTs reported significantly lower postoperative pain levels in the binder group, and substantial limitations in the third study lessened the validity of those findings, this review finds stronger evidence to support using abdominal binders in multimodal reduction of post-cesarean pain.