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Postpartum Abdominal Pain: Normal Symptom or Cause for Concern?

Right after giving childbirth, you're most likely to feel exhausted, but you are not expected to experience postpartum abdominal pain. The postpartum period refers to the first 6 weeks after giving birth. It is the period where your body returns back to its state where it was before you became pregnant. Reading this article you will find out what hides behind your postpartum abdominal pain, and how you can heal it so you can get back to take care of your baby and yourself.
woman experiencing abdominal pain postpartum

Afterpains

If you are a new mom, most probably it is your first time to hear about them. Afterpains are known as postpartum cramping that is felt after giving childbirth and continue for several weeks later. In case of vaginal delivery Ice packs around the clock for the first 24 hours can be beneficial for both pain and edema in the perineum and labia. 

Having contractions several days after the delivery is a normal reaction. You will feel them as the cramps you are having during your period. These contractions are occurring because your uterus is shrinking back to the normal size. Your uterus is about 2.5 pounds after delivery and several weeks later it goes to just a couple of ounces.

These uterine contractions are getting more intense when you're feeding your baby because breastfeeding releases oxytocin in the body. But, these uterine contractions help to lessen the amount of postpartum bleeding and prevent hemorrhage. According to the statistics, the more babies you are giving birth to, the stronger and longer the afterpain contraction will be. Afterpains are most likely to disappear after the 6th week.

Taking a childbirth class is one of the many things that you can do in order to help yourself. Making and focusing on a deep breath, just like you did through the contractions in labor, will help you go through the contractions present after labor. Fill your diaphragm with a deep breath that will reach down to your abdomen.

Also, there are tons of products and herbs that can help you reduce your postpartum abdominal pain and provide you with the sense of calmness and relax. Stay hydrated and consumes food that is healthy.

Constipation & hemorrhoids

woman experiencing constipation after delivery

The major reasons for postpartum constipation are hemorrhoids, pregnancy hormones (high progesterone levels), iron deficiency, and surgical incision. You may experience constipation postpartum even though you didn’t have it during your pregnancy. Constipation may last for a few days if you do what is needed in order to treat the problem. Your doctor should first state the correct cause of your constipation and then provide you with the right treatment. 

Eating food rich in fiber is one of the best ways to fight against constipation. The rich food diet will improve your bowel movements. Foods like beans, bread, and rice are included here. Also, it is essential to keep your body hydrated.

Fluids help your feces to pass easier out of the body. Moving your body also helps you move your bowels. If you had a C-section, it will be difficult and painful for you to walk in the beginning. Begin with working when you will be comfortable on your own. Avoid foods that are processed and high in sugar and fats. 

If you are worried about if it hurts when you have hard stool, you should stop worrying. The nerves in and around the vagina stretch during the labor and the perineum is becoming numb for some time. As the nerves start recovering, you will start feeling the pain when you go to the toilet. Try to relax by reading a book or listening to music while you are in process.

Another issue of the bowel movement, which mainly comes together with constipation, is the postpartum gas. The main symptoms of postpartum gas are flatulence, postpartum sharp abdominal pain, and abdominal cramping. Postpartum gas usually goes away on its own or following changes in diet.

Your doctor can give you laxatives that will relieve constipation. Never take laxatives on your own, because your recommended dosage depends on whether you are breastfeeding or not. Postpartum constipation can be treated. It is not a serious condition if treated on time. But sometimes it can aggravate other problems like hemorrhoids.

External hemorrhoids is more likely to occur during pregnancy and disappear when the pelvic pressure is relieved after the delivery. External hemorrhoids is located below pectinate (dentate) line, external hemorrhoids receive somatic innervation from inferior rectal branch of pudendal nerve and therefore painful if thrombosed. It can also be the reason of the rectal bleeding, which means that you should look for an immediate medical help. 

C-Section healing

woman with a scar after c-section

In the last 20 years, the cesarean surgeries have become more popular. Sometimes, a C-section it's not just a woman’s choice, but it is the only way to deliver your baby safely. Going through cesarean surgery is quite rough and it can be painful as well. During the procedure, your abdominal muscles are incised, and this mostly causes pain after surgery. The scar from the surgery can go away even several years later. 

Right after the procedure, rest well and try to keep everything that you need close to you. Don’t lift heavy things in the first few weeks, except your newborn. Having lower abdominal pain after giving birth is normal because most of the incisions are done on the lower part of the abdomen. Your doctor may also provide you some medications to relieve pain. 

Two days after your surgery, your catheter will be removed. You will start walking to the bathroom and back. If you didn’t have any complications after giving birth, you should increase your physical activity as time passes because it helps with circulation and improves the bowel function. You should wash your skin where the incision is only with soapy water. You will still feel an abdominal pain 4 weeks postpartum, but you will be also moving more comfortably. You are most likely to be healed six weeks after the surgery. 

The scar will be raised and with a darker color at the beginning. But, it will start to shrink after the 6th week of surgery. 
More than 30% of deliveries in USA are now by cesarean section. C-section is usually done by straight incision 3 cm above the symphysis pubis (Joel Cohen incision). 

Be aware that since it is a surgical procedure, there are certain risks of getting a wound infection. Wound infections usual includes cellulitis or a wound abscess. 

Infections mainly can arise from lack of adequate local wound care, poor hygiene. Common signs of a post-cesarean wound infection are redness and swelling, lower abdominal pain and fever. In this case, you need to go and see your doctor immediately.

However, everybody is different and the healing process also varies from person to person. Tenderness and discomfort may last up to 8 weeks sometimes. 

How long does the pain last after giving a birth?

If you had a vaginal delivery, the pain will go away by itself after 8-10 days. You will experience cramps for the first few weeks, which will be more intense while breastfeeding. The pain should disappear by the time you have your first postpartum checkup which is usually around 6 weeks after the delivery. If you are still experiencing postpartum sharp abdominal pain, let your doctor know.

If you had a C-section, the severe pain is most likely to last a little bit longer – up to two weeks. After the fourth week, you shouldn’t feel any pain.

Like we said before, the healing capacity of each body is different and, in some women,, it may last up to 6 weeks. And if you are worried about your scar, just make sure that you are treating that skin area with the proper instructions given by your doctor. It may take up to several years before your scar will completely disappear.

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When to see the doctor

You should call 911 if you are experiencing some of the following symptoms:

  • Being short of breath
  • Having a chest pain
  • A cough with blood
  • Redness and swelling from the incision site
  • Feeling dizziness, weakness, confusion, having a fast heartbeat, rapid breathing and etc.

Otherwise, you are most likely to visit your doctor after the 6th week after your delivery. 

https://www.verywellfamily.com/is-stomach-pain-normal-after-giving-birth-290215
https://www.webmd.com/parenting/baby/news/20041103/pain-after-childbirth-common-often-untreated#1
Macarthur, A. American Journal of Obstetrics and Gynecology, November 2004; Vol 191: pp 1199-1204.
https://www.verywellfamily.com/oxytocin-and-breastfeeding-3574977
Turawa EB, Musekiwa A, Rohwer AC. Interventions for Preventing Postpartum Constipation. Cochrane Database Syst Rev. 2015 Sep 18;(9):CD011625.

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