Overview
After a baby arrives, the mother’s body must recover from pregnancy and childbirth. Abdominal muscles, including the uterus, need time to get back to a normal, non-pregnant size. These changes can cause intense abdominal pain for the first few days after birth.
Significance
After birth pains, sometimes called after-pains, can be quite debilitating. After the placenta is delivered, the site where it was attached is like an open wound requiring pressure to stop bleeding. The contractions that come after birth help close off the wound by squeezing the uterus. Pain is caused by contraction and relaxation of the uterus.
Factors
After pains are much more common in women who have given birth more than once. With increasing numbers of pregnancies, uterine muscle tone decreases and the uterus has a tendency to relax. In first-time moms who do not experience after-pains, uterine muscle tone is good and the womb stays contracted without intermittent relaxation.
Breastfeeding
Nursing the baby stimulates the production of the hormone oxytocin by the pituitary gland. Oxytocin triggers the let-down reflex that releases milk from the breasts and also causes the uterus to contract even more. This effect creates additional abdominal discomfort. According to Helen Varney, Certified Nurse Midwife and author of “Varney’s Midwifery,” it is important to realize that the let-down, essential to breastfeeding, can be inhibited by pain.
Management
After birth pains will be relieved if the womb remains firmly contracted. Treatment will not be effective unless the mother’s bladder is emptied often. The displacement of the uterus from its normal position by a full bladder prevents efficient contraction of the womb, leading to relaxation and a vicious cycle of cramping and pain.
Once the bladder is empty, the mother will be more comfortable lying on her stomach with a pillow under her lower abdomen. The pressure on the uterus will keep it contracted. Varney advises warning the woman that abdominal cramps may intensify for a few minutes after she assumes a prone position, followed by complete relief.
Analgesia
The American Congress of Obstetricians and Gynecologists (ACOG) assures patients that cramps will go away in just a few days. In the meantime, ACOG advises mothers to take an over-the-counter pain reliever that do not contain aspirin. Acetaminophen, with codeine if necessary, is safe while breastfeeding, according to Varney.
Herbal Remedies
Susun S. Weed, author of “Wise Woman for the Childbearing Year,” suggests ground ivy leaf to ease after-pains and promote uterine tone. Catnip tea is a remedy for menstrual cramps and can also be taken freely for contractions after birth. Motherwort tincture is quite bitter, but it can relieve postpartum cramping. According to Weed, the dose differs widely for each woman; between five to 20 drops in a glass of water should be effective.
About this Author
Mary Earhart is a registered nurse, a public health nurse and licensed midwife. Her articles have appeared in professional journals and online ezines. She holds a Bachelor of Science in nursing from California State University at Dominguez Hills. She works in a family practice clinic, has a home birth practice, and her specialty is perinatal substance abuse.
