Pains and Contractions After Birth

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If you are having contractions after giving birth, do not panic! Your body knows what it's doing and these contractions are nothing like the contractions you experienced during labor. Unlike labor contractions, these contractions help your uterus shrink down to its original size and prevent you from bleeding too much after giving birth.

After-Pains and the Shrinking Uterus

While many expectant parents have not heard of after-pains, most childbirth classes discuss them. After-pains are contractions that occur after labor and delivery. These contractions signal the process of involution, the process of your uterus shrinking back down to its pre-pregnancy size and shape.

Your uterus spent the last nine months growing to nearly 25 times its original size. Note that you may continue to look pregnant after giving birth, up until your uterus returns to its normal size. The contractions you feel after birth help it shrink back down, though it won't be as small as it originally was.

Even though it took about 40 weeks for your uterus to expand, the reverse process happens relatively quickly, in about four to six weeks.

Second-Time Mothers

While after-pains are not a reason to worry, they can cause discomfort and even pain. After-pains can vary significantly from person to person. If this is not your first baby, your pain may be worse than you experienced during previous pregnancies.

Some say that the after-pains increase after each subsequent baby, though not everyone reports this to be true. For pain, you can use comfort measures like warm packs, massage of the fundus through your abdomen, and certain medications (with your practitioner's approval). Over-the-counter medication works well for most women.

Whether or not this is your first child, you may notice these contractions are the most intense within the first few days after giving birth.

You may also notice them more when you breastfeed. This happens because your uterus is sensitive to the oxytocin you release while nursing.

Easing the Discomfort

To make yourself more comfortable, you can try using comfort measures or over-the-counter medications immediately before breastfeeding to ease your discomfort while nursing. Before taking any new medications, make sure they are safe to take while breastfeeding. 

Do not be concerned if you do not feel after-pains. Not every mother feels them. This does not mean that your uterus is not healing or shrinking. If you are concerned your uterus is not healing, ask your postpartum nurse to teach you how to feel your uterus. This way you can check its progress on your own.

If you are experiencing severe, persistent, or worsening pain, or you have any other concerning symptoms, contact your doctor or midwife. You will need to be promptly evaluated.

2 Sources
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  1. Komatsu R, Carvalho B, Flood PD. Recovery after nulliparous birth: A detailed analysis of pain analgesia and recovery of functionAnesthesiology. 2017;127(4):684-694. doi:10.1097/ALN.0000000000001789

  2. Komatsu R, Carvalho B, Flood P. Prediction of outliers in pain, analgesia requirement, and recovery of function after childbirth: A prospective observational cohort studyBr J Anaesth. 2018;121(2):417-426. doi:10.1016/j.bja.2018.04.033

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.