You may have had your share of cramps and pains during pregnancy, but why are you experiencing them even after birth? After delivery, your body takes some time to return to its pre-pregnancy state, where you will experience postpartum cramping. Postpartum cramps are uncomfortable pains that signal the body is returning to its non-pregnant state. They remain for a few days after childbirth and vary in frequency (1). The most common cause of these cramps is the uterus returning to its original size; however, there may be other causes of afterbirth pains, such as hormonal changes, stress during labor, and poor digestion. Read on to understand postpartum cramping, its causes, and ways to overcome it.
Common Postpartum Pain and Cramps
Owing to the several changes the body goes through postpartum, you could experience pains in various parts of the body:
1. Back pain
You could have back pain due to your body’s physical changes during pregnancy. The physical stress during labor strains the back muscles causing pain, which remains until the muscles regain their strength in a few months. If you had back pain before pregnancy, there are high chances of having it after delivery. Being overweight or inactive also increases the risk (2).
2. Lower and upper abdominal pain
Lower abdominal postpartum pain could be due to prolonged contractions of the uterus and breastfeeding. Sometimes, the pain could also result from genital infections, appendicitis, ovarian cyst torsion, or cyst rupture (3). Upper abdominal pains are rare and may occur due to infections or gut inflammation. You should, however, let your doctor know about it.
3. Pelvic pain
During pregnancy, hormones stimulate the pelvic bones to expand and contract to aid delivery. The ligaments loosen, and any activity (even walking) causes pelvic pain after pregnancy. Postpartum pelvic pain is also due to the tear in the pelvic tissues and muscles during delivery. Pelvic pain may also be associated with difficulty with urination, pain during bowel movements, and during intercourse (4).
4. Leg pain
Postpartum leg cramps are common as the extra body weight during pregnancy exerts pressure on leg muscles. Postpartum hormonal changes relax joints and ligaments, adding to leg cramps. The intravenous fluids given during labor, sitting for a long time when nursing, lack of sleep, and deficiency of magnesium are other reasons for leg pain (5).
5. Hip pain
Hip pain is normal, especially after vaginal delivery, as the hips and pelvic bones undergo trauma during delivery. If there is difficulty in delivering the baby, the use of forceps or vacuum could bruise, dislocate, or even fracture the hip area, causing further pain. But, if the pain is severe and lasts more than two weeks, you should consult a doctor (5).
6. Chest pain
Chest pain after pregnancy could be due to physically strained muscles during labor or a chest infection. It could also result from pulmonary embolism (a blood clot in the lungs blocking the lung artery). Any severe pain, shortness of breath, or coughing up blood requires immediate medical assistance (6).
7. Headaches during breastfeeding
You may experience headaches during breastfeeding due to the oxytocin hormone. This is referred to as a lactation headache. It lasts from a few weeks or could continue until the baby weans off the breastfeeding. These headaches could also be from fatigue, lack of sleep, or a sign of preeclampsia. However, consult your doctor if you have constant headaches (7).
8. Stomach pain post-eating
Stomach ache after consuming food is common due to gastric inflammation or poor digestion or occasionally due to anal incontinence. One could also experience uncontrollable gas that lasts up to six months after delivery. If you have lactose intolerance or have a diet filled with whole grains, beans, fruits, and vegetables, it can increase the risk of stomach pain, cramps and discomfort (8).
9. Uterus pain
The uterus takes around six to eight weeks to return to its pre-pregnancy size after childbirth. The contractions during resizing cause postpartum uterus pain and subside in time. These pains could be felt during breastfeeding and usually get stronger with subsequent pregnancies (9).
10. Breast pain
In the first week after childbirth, breasts feel bigger and tender due to the first breast milk (colostrum). Irrespective of whether you breastfeed, there will be breast engorgement causing postpartum breast pain. The pain will go away in a few days, but if it stays longer, you should check with a doctor (10).
11. Thigh pain
The pelvic region ligaments stretch during labor and cause sharp pains or dull aches that extend into the thighs. The pain is also attributed to pushing efforts during labor and exhausting muscles. It subsides in a few weeks (11). Besides the above, the ribs ache, the abdomen begins to throb, the back turns sore, and the joints such as wrists, ankles, and others also hurt. These pains are due to the contractions and pressure the body has gone through during labor. The positions while nursing and holding your baby also add to postpartum aches in the body (12).
Causes Of Pain And Cramps After Delivery
Other factors besides pressure and strain on the body result in post-delivery pain.
Uterus contraction: During pregnancy, the uterus expands up to 25 times its normal size and is as large as a basketball. It then shrinks to the size of a tiny pear. This shrinkage can cause afterbirth pains and cramps or ‘involution’ (13). Breastfeeding: The baby’s sucking stimulates the production of oxytocin, leading to contractions and pain (14).
Cesarean delivery: If you have had a C-section, you will experience abdominal pain and a pulling sensation that lasts for a few months (15). The incision from the surgery also takes time to heal and causes pain around the lower abdomen.
Constipation: You may experience bowel movements after a few days of childbirth. Initially, the experience would be painful due to hemorrhoids and perineum tears (16).
Infections after delivery: Although the risk of postpartum infections is low, women may experience pain if they have any of these conditions. Postpartum endometritis is a bacterial infection that women may develop within ten days of childbirth. The symptoms may sometimes be seen even after six weeks of delivery (17). Bacterial vaginosis is a common infection caused by the overgrowth of bacteria in the vagina. Along with the pain, you may also experience foul-smelling discharge, itching, and burning sensations (18). Urinary tract infections occur in two to four percent of women after deliveries. They are generally mild but may cause pain, discomfort, and extended hospital stay (19).
What Do Afterbirth Pains Feel Like?
Afterbirth pains are as severe as menstrual cramps and labor contractions. They are mild in the first-time moms and worsen with subsequent deliveries as uterine muscle tone in first-time mothers is better compared to moms with multiple deliveries (20).
Treatment For Postpartum Cramps
You can manage postpartum pains with self-care, prescription, and over-the-counter medications. If you are breastfeeding, it is safe to take ibuprofen and acetaminophen for pain relief. Numbing sprays and laxatives may be used if you have a perineal tear or episiotomy. However, before following any treatment, you should discuss its safety and dosage with your doctor. For breast engorgement and pain, see a lactation consultant (16).
Home Remedies For Relieving Afterbirth Pains
If your doctor gives you the go-ahead, you can try these home remedies, which help relieve postpartum cramps.
1. Hot water compress
Hot water treatment is the best way to cure the unpleasant abdomen tenderness as it loosens the contracted uterus and improves blood circulation, relieving lower abdominal and uterus pain (21).
2. Rice water
Cook the rice in extra water and drink the strained water twice a day. This water soothes the stomach region, improves digestion, and prevents constipation.
3. Ginger tea
Ginger is anti-inflammatory and an excellent astringent and antiseptic, preventing pains and cramps after birth. Make ginger tea by adding some grated ginger to a cup of boiling water. You can also add ten parsley leaves and boil them together for some time. Add honey to taste and have it twice a day (22).
4. Fennel tea
Fennel seeds also have anti-inflammatory and analgesic properties that relieve post-pregnancy pains (23). Prepare fennel tea by adding two tablespoons of fennel seeds to two cups of water. Boil for ten minutes, cool it down and add honey for taste. You could have it twice a day.
5. Warm water bath
Bathing in warm water will help alleviate hip and uterus pains. You could soak in a bathtub for about 30 minutes, but ensure the temperature is not so hot. Try it twice a day to ease pains and soothe skin (16).
6. Lemon tea
Most postpartum problems are due to weakened immune systems. You should take more vitamin C, which is abundant in lemon or Indian gooseberry. Boil one cup of water, let it cool, and then add lemon juice squeezed from two lemons. Drink it twice a day to boost your immune system, and it also helps in relieving stomach cramps (24).
7. Fresh mint
Mint has soothing properties, which help relieve postpartum abdominal pains and headaches. Add mint leaves to a cup of boiling water, and allow it to simmer for around ten minutes. Strain, cool it down, and add lemon juice before drinking. Drinking it twice a day will reduce abdominal pains and cramps.
8. Chamomile tea
Chamomile helps relieve pains due to uterine involution. It is considered safe by the US FDA (Food and Drug Administration). Add dry chamomile blossoms to a cup of boiling water. Allow it to steep for ten minutes, strain, and have it. You could add honey and lemon for additional flavor. Drink it twice daily to relieve uterine contractions after delivery (25).
9. Oil massage
You can ask your partner to massage your abdomen with an oil mix. For a gentle massage, place hands on the navel and move in a circular motion, as this will stimulate contractions and make your uterus firm. To make an oil mix, take five drops of lavender oil, ten drops of cypress oil, 15 drops of peppermint oil, and one-ounce carrier oil (jojoba, olive, sweet almond, or coconut oil) (26).
How To Ease Pregnancy Cramps: Some Other Ways
Other than the home remedies, you can try some additional tips that help alleviate the pain and intensity of postpartum cramps.
Pee often: Pee often, even if you do not have the urge. A full bladder makes you uncomfortable, displaces the uterus, and worsens cramps. Deep breathing: Practice deep breathing techniques and meditation as they can help in uterus contraction and relieve you from afterbirth cramps. Sleep face down: You may consider lying face down with a pillow under your belly. It will help you get rid of the pain.
When To See A Doctor
Postpartum cramping and pain are normal and get better with time. However, if you experience pain that prevents you from doing your everyday activities, you should see a doctor. These are some conditions that you should not avoid (16):
Chest pain Seizures Cough and breathlessness Swelling and tenderness in the legs Headache that causes vision changes Fever higher than 100.4°F Nausea and vomiting Pain and burning sensation while urination Painful lumps on the breasts Heavy bleeding that soaks two sanitary pads in an hour
