Postpartum Abdominal Pain: What Should I Expect?

Afterpains

If you are a new parent, afterpains may come as a surprise at first. Afterpains are postpartum cramping that occurs after childbirth and continues for several weeks. After a vaginal delivery, using ice packs for the first 24 hours can reduce pain and swelling in the perineum and labia. 

Many people experience contractions several days after delivery. They often feel like period cramps. These contractions happen because your uterus is shrinking to its normal size. The uterus is about 2.5 pounds after delivery but shrinks to just a few ounces after several weeks. 

These uterine contractions may feel more intense when you're feeding your baby because breastfeeding releases the hormone oxytocin. This cramping sensation actually lessens the amount of postpartum bleeding and prevents excessive blood loss. With every birth, afterpains will get stronger and last longer. In general, these contractions will disappear in six weeks.

Taking a childbirth class before giving birth can give you some guidance on what to expect. Focusing on taking deep, belly-filling breaths through each contraction will help you feel calmer both during and after labor. Drinking plenty of water and eating a balanced diet can also minimize the extent of afterpains. 

If your afterpain cramping doesn’t resolve within six weeks, consider talking to a health care provider. They may prescribe a medication to help reduce your postpartum abdominal pain.

Constipation & hemorrhoids

Postpartum constipation often results from hemorrhoids, pregnancy hormones (such as high progesterone levels), iron deficiency, and healing from any surgical incisions related to labor. You may experience constipation postpartum even if you didn’t have it during pregnancy. Constipation may last for a few days but often resolves quickly with a few diet tweaks. Eating food rich in fiber is the doctor-recommended method to treat constipation. Fiber can improve your bowel movements by speeding up the transit time of food in your gut. Focus on foods like beans, whole-grain bread and cereal, vegetables, and fruits. Hydration always helps too! Try to avoid foods that are processed or high in sugar and fats. 

Moving your body regularly will also help your bowels. If you delivered your baby via C-section, walking may be difficult and painful in the beginning. Resuming activity carefully at the direction of your health care provider or midwife will relieve built-up gas and support your recovery process.

Some people worry about using the bathroom after giving birth. The nerves in and around the vagina stretch during labor, and your perineum may feel numb for some time. As the nerves start to recover, you may notice pain when you use the toilet. You can help prepare your body to relax by reading or listening to music while you’re on the toilet.

If you’re experiencing constipation, you likely also have some postpartum gas. This type of gas involves flatulence, postpartum sharp abdominal pain, and abdominal cramping. Postpartum gas usually goes away with movement or after including more fiber in your diet.

After determining the cause of your constipation, a health care provider can give you laxatives to relieve any discomfort. Never take laxatives on your own, as the recommended dosage depends on whether you are breastfeeding. 

Postpartum constipation can aggravate other problems like hemorrhoids. Hemorrhoids are swollen veins in the anus and lower rectum. External hemorrhoids tend to occur during pregnancy and disappear when pelvic pressure relaxes after the delivery. External hemorrhoids are located right under the skin around the anus; they can feel painful or itchy and may bleed a little after bowel movements. If rectal bleeding worsens or doesn’t resolve in a week, get medical help. 

C-section healing

In the last 20 years, more and more births have involved cesarean (“C-section”) surgeries. Sometimes, a C-section is the only way to deliver a baby safely. This procedure can be hard on your body and extend your postpartum recovery time. You probably have plenty of C-section questions, but here's the top line: During the procedure, the surgeon cuts the abdominal muscles to remove the baby from the uterus; these incisions can cause significant pain after surgery. Right after the procedure, it’s important to rest and avoid compressing your stomach. Lifting your newborn is fine, but try not to pick up anything heavy. If you’ve had a C-section, lower abdominal pain after giving birth is normal while your incisions heal. A health care provider can explain which medications are safe to take for pain. 

Your health care provider or midwife will ask you to stay in bed for six to eight hours after a Cesarean section. They’ll also prescribe pain relievers. If you had epidural anesthesia during surgery, you might not feel pain for about 24 hours.

Two days after the surgery, your catheter will be removed. Your health care provider or midwife will let you know when it’s time to start walking to the bathroom and back. If you had no complications after giving birth, increase your physical activity as time passes; this will boost blood circulation and improve your bowel function. 

If you want to shower, make sure to wash the incision only with soapy water. You will still feel abdominal pain 4 weeks postpartum, but you will also be moving more comfortably. By six weeks after the surgery, your body probably will have healed significantly. 

The surgical scar will be raised and dark at first. Then, it will start to shrink after about six weeks. 

Since a C-section is a surgical procedure, there is some risk of getting an infection. Infections mainly result from inadequate wound care and poor hygiene. Common signs of a post-cesarean infection include redness and swelling, lower abdominal pain, and a fever. If you notice these signs, see a health care provider immediately.

The healing process also varies from person to person. Some people may experience tenderness and discomfort for up to eight weeks after a C-section.

How long does the pain last after giving birth?

If you had a vaginal delivery, abdominal or pelvic pain will likely fade after eight to ten days. You may experience cramps for the first few weeks, especially if you’re breastfeeding. The pain should disappear by your first postpartum checkup, which is usually around six weeks after the delivery. If you are still experiencing postpartum sharp abdominal pain, let a health care provider know. 

If you had a C-section, the pain may last a bit longer. Make sure to care for your scar according to the instructions from your health care provider or midwife.

Seeing a health care provider

Most likely, you’ll visit your health care provider six weeks after delivery. In some cases, you may need to seek medical attention for postpartum abdominal pain. Call 911 if you are experiencing any of the following symptoms:

• Shortness of breath
• Chest pain
• Coughing that produces blood
• Redness and swelling at the incision site
• Dizziness, weakness, or confusion
• Rapid heartbeat or breathing