Episode 49: SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report

This episode of RAPM Focus challenges physicians to think differently about pain after cesarean delivery by showcasing a new approach for patient care after cesarean delivery. RAPM Executive Editor Eric Schwenk, MD, explores the SPACE-postpartum model with Sarah Ciechanowicz, BMBCh, FRCA, following the October 2025 publication of her brief technical report, “SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report.” The SPACE-postpartum model is essentially a multidomain symptom system for understanding recovery after cesarean delivery. This biopsychosocial framework brings together five interconnected symptom areas—sleep, pain, affect, cognition, and energy—for early risk assessment after surgery, offering a comprehensive approach to the entire recovery process after cesarean delivery. Early recovery is not just about pain scores, but about a pattern of symptoms that tend to cluster and shape a patients’ long-term trajectory. By assessing that pattern early on, we could potentially identify a modifiable risk profile for chronic pain and impaired recovery.  Dr. Sarah Ciechanowicz (“Chye-kha-no-vich”) is a consultant anesthetist at University College London Hospitals, researcher at Imperial College London, and former visiting fellow in obstetric anesthesia research at Stanford University. Her work focuses on improving postpartum recovery and pain prediction after caesarean delivery. She developed the SPACE-Postpartum framework—a multidomain biopsychosocial model designed to identify women at risk of chronic pain and inform intervention in the early postpartum period. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.