8 Postpartum Pains and Aches to Expect (and How to Manage Them)

Updated 13 February 2022 |

Published 22 November 2018

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Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK

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It is normal to experience some pains and aches after giving birth and usually these aches and pains subside with time. But, there are women who continue to experience severe pain and aches months after delivery. If you are going through severe postpartum pain, this is a warning sign that something is wrong and you should seek immediate medical attention. Here are postpartum pains and aches you should expect after delivery and how you can manage them.

You feel pain all over your body

It is normal to experience pain all over your body after giving birth. This is because the body goes through intense strain during contractions. Sometimes the contractions can be so intense that some women continue to experience pain and aches weeks after delivery. 

Most women after giving birth, complain about low back pain, which is not a surprise given the amount of strain and pain the body goes through during labor contractions. Other than back pain, you may experience headaches, aches and stiffness between your shoulders, or sharp pain in the hips or lower back. You may also experience tingling in your hands and wrists. 

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How to manage

If you continue to experience pain all over your body after your 6th week postpartum, seek medical attention. Your doctor may prescribe pain medication and other forms of therapy to help you manage the pain. 

You should also consider acupuncture, which is known to successfully treat back pain, headaches, anxiety, and depression among other health issues. 

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Your breasts grow a few cup sizes and get hard

One of the most common and major changes you start to notice after giving birth is how large and tender your breasts get. Patients usually experience the onset of lactation, engorgement or “letdown,” approximately 24 to 72 hours postpartum.

In other words, engorgement occurs when there is excess milk stored in the breasts, they become uniformly warmer, firmer, and tender. Patients often complain of pain or warmth in the breasts and may experience fever. 

Once you start breastfeeding, your breasts become less swollen and hard. As you continue breastfeeding, your breasts become less engorged. But, if your breastfeed less often, then your breasts are likely to become engorged again. 

How to manage

Nurse often. Breastfeeding often can provide relief to engorged breasts making them less swollen and hard. Consider nursing every 3 hours or so to help reduce engorgement. Avoid taking breaks of 4 to 5 hours between feedings as this causes your breasts to become engorged. Nurse your baby about 12 times a day to avoid breast engorgement. 

Manage the swelling using cold or heat. For patients not breastfeeding, ice packs, a tight bra, analgesics, and anti-inflammatory medications are all useful. 

Consider using a breast pump to reduce engorgement. 

You feel contractions (again?!)

It is normal to experience contractions after giving birth because the uterus is contracting back to its pre-pregnancy state. This is called involution. Another reason why you could you experience intense contractions or afterbirth pains is when you are breastfeeding. 

Breastfeeding triggers postpartum contractions. However, these contractions last only a few days and then subside.  

How to manage

To manage afterbirth pains, there are several things you can do:

• Talk to your doctor to prescribe pain medication. Try breathing and relaxation techniques to help alleviate the contractions.
• Urinate frequently.
• Increase breastfeeding frequency to alleviate the contractions.

Perineal tears

Perineal tears occur during vaginal delivery and these are usually lacerations of the soft tissue that is between the anus and the vagina. Perineal lacerations vary in severity. Most of them are mild and don’t require any treatment. But some tears are so severe that they can cause a lot of bleeding and chronic long-term pain.  

Depending on how severe the tear is, you may need perineal stitching to help promote tissue healing. However, minor tears do not require stitching and are left to heal on their own. 

How to manage

Several ways you can manage perineal pain include:

• Placing an ice pack on the wound for relief.
• Relaxing more and staying away from strenuous activities.
• Wearing comfortable loose clothing.
• Drinking plenty of liquids.

Your caregiver may also recommend pain medication to help manage the pain. 

C-section scar itches

It’s normal for scars to itch especially when they are healing. So if you have had a C-section and your scar starts to itch, know that it’s normal and the itching will subside as the scar continues to heal.

Other reasons why your scar could be itching could be owing to dry skin or infection. 

How to manage

You are more likely to experience itching as your scar begins to heal and the itching may increase as your wound continues to heal. Although you may be tempted to scratch it, don’t as scratching may cause more pain and it may also cause an infection. 

To relieve the itching, place an ice pack on the wound for a couple of minutes. But, if you notice that the scar is swollen and oozing pus, contact your caregiver immediately. 

You keep bleeding

Vaginal bleeding after delivery is normal and usually, the bleeding subsides after 10 days. By your 6th week postpartum, the bleeding should have completely stopped. However, if you experience persistent heavy bleeding after delivery for more than 10 days then you need to seek medical attention. 

Postpartum hemorrhage as it is called is serious and should not be ignored. It is known to cause complications such as low blood pressure, weakness, heart palpitations, chills, weakness, nausea, and blurred vision. 

How to manage

Your doctor will decide the best course of action depending on the severity of your condition. Treatment and therapy options your doctor may suggest include: 

• Medication to help your uterus shrink or contract
• Removing any parts of the placenta left in the uterus
• Blood transfusion
• Uterine artery embolization to help reduce blood flow to the uterus.

Sore calves

It should not come as a surprise that many women experience pain in their calf after giving birth. If you feel an ache or pain in your leg and you also notice some swelling, this could be a sign of a blood clot or deep vein thrombosis. 

If it is a blood clot, you may not experience any other symptoms other than pain and swelling. But if it is deep vein thrombosis, you may also experience shortness of breath (due to PE-pulmonary embolism).

How to manage

Make an appointment with your doctor. She will perform ultrasonography of the lower extremity veins and arteries to know where the thrombus is, whether it is in deep veins and will decide on surgery (thrombectomy). The doctor can also recommend you to wear compression stockings and some anticoagulant medication if needed.

Sometimes your doctor may decide that you need a filter in your vena cava to be placed to prevent blood clots from getting into your lungs.

You're constipated

Constipation in postpartum mothers occurs owing to the pain medication they get during delivery. 

How to manage

To relieve constipation, your doctor may prescribe a stool softener. You should drink plenty of fluids especially water and eat high-fiber foods. 

Breastfeeding considerations

• Maintain a healthy diet.
• Take plenty of rest.
• Drink plenty of fluids.
• Avoid poor lifestyle habits like smoking and excessive alcohol intake.
• If you are HIV positive avoid breastfeeding to avoid passing the virus to your baby through breast milk.
• Do not breastfeed if you are receiving cancer treatment such as chemotherapy.
• Do not breastfeed if you use illegal drugs such as heroin, marijuana or cocaine.
• Do not breastfeed if your child suffers from galactosemia, a condition where a baby cannot tolerate galactose, a natural sugar found in breast milk.
• Avoid breastfeeding your baby if you are on prescription medication for Parkinson’s disease, arthritis or migraine headaches. 

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When to see your practitioner?

It is important to go for your follow-up postpartum check-up to ensure that everything is fine. Your doctor will evaluate your blood pressure, your weight, your vagina, uterus, and cervix. Once your caregiver gives the okay, then you can discuss birth control options and what exercises to do to help tone your body.  

However, if notice that you are experiencing persistent heavy bleeding, severe headaches, leg pain, abdominal pain or breast pain, don’t wait until the 6th week of your postpartum to go see your doctor. Call your caregiver immediately you notice these signs to avoid complications or avert serious health problems such as mastitis, endometritis, or any other. 

History of updates

Current version (13 February 2022)

Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK

Published (22 November 2018)