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Afterpains don't have to be a pain!

© Maurenne Griese

One of the earliest body changes you will experience after giving birth is the change in the size of your uterus. This process, called involution, is the process by which your reproductive organs return to their non-pregnant state. The top of the uterus (called the fundus)can be felt either right at your navel or just a fingerbreadth below your navel just after birth. Normally, it will decrease about a 1/2 inch lower in your abdomen each day. Most of these changes occur during the first 3-4 days following birth. Involution happens more quickly in women who breastfeed. Approximately 10 days after your baby is born, you will no longer be able to feel the top of your uterus in your abdomen.

Afterbirth pains, or afterpains, are uterine contractions that follow birth and are part of the involution process. Some women describe them as feeling like mild menstrual cramps and other women describe them as being worse than labor itself! It's been my experience, both as a mother of 3 children and a nurse, that the more babies you have, the worse the afterpains become after each birth. The good news is that the cramping gradually decreases and is usually quite mild by about 2 days following birth.

Why do women who have had more than one baby have worse afterpains? After each birth, there is a decrease in uterine muscle tone. These mothers are usually much more aware of afterpains than the mother giving birth for the first time.

Some breastfeeding mothers notice increased cramping when they nurse their babies during the first few days following birth. This happens because of the hormone oxytocin. Breastfeeding stimulates oxytocin production which leads to milk let-down. Oxytocin also causes uterine contractions.

A full bladder can make your afterpains much more noticable. Emptying your bladder every 2-3 hours may help minimize your pains. Be sure to use the bathroom, change your pads if needed and wash your hands before you nurse your baby.

Another helpful technique is lying on your abdomen with a pillow or folded blanket or towel putting pressure on your uterus to keep the uterus well contracted. The first few minutes in this position may be uncomfortable, but then complete relief is usually experienced. Some women find using an ice pack or a hot water bottle to the abdomen instead of a towel can also work well. For women who want to take a pain reliever, some find that taking a dose of acetaminophen, ibuprofen, or acetaminophen with codiene as prescribed by their primary care provider 30-40 minutes before breastfeeding can help to relieve the afterpains.