After-pains are painful contractions which occur after labor and delivery are over. These pains can happen for several days after birth, and they are completely natural and not a cause for concern. Women should also not be worried if they do not experience after-pains, because sometimes the contractions are not noticeable. If after-pains are extremely painful or they persist for over a week, it may be a good idea to contact a doctor, nurse, or midwife to explore possible complications which might be causing contractions, such as unexpelled tissue which the uterus is trying to get rid of.
During pregnancy, a number of things happen to the body as it accommodates the growing fetus and prepares for labor. The uterus grows in size as much as 25 times. After labor and delivery, the uterus needs to shrink back down to its normal size. This takes around four to six weeks, a rather impressive feat, considering the nine months of stretching involved. In the first few days, women can experience painful contractions as the uterus starts to shrink down. Sometimes the uterus also contracts to expel clots of blood which were left behind after the delivery.
Women sometimes notice that after-pains are more intense while breastfeeding. This is because breastfeeding stimulates release of the hormone oxytocin, which triggers uterine contractions. After-pains also tend to be more intense with each successive labor and delivery. For a first-time mother, they may be very mild, while for a woman who has given birth five times, they may be more intense.
The reason that after-pains are more severe with successive pregnancies is that the uterus loses its tone over time. While the uterus is designed to be highly stretchy so that it can expand and contract with pregnancy and delivery, it has limits, and repeated stretching during pregnancy makes it harder for the uterus to shrink back down to size.
There are a few things women can do to help with after-pains. Some find that it helps to lie face down with a pillow under the stomach, or to crouch on all fours and rock to reposition the uterus. Peeing to keep the bladder empty so that it will not press against the uterus also helps, and some women also benefit from gentle abdominal massage. A massage therapist certified in post-partum massage can provide this service and teach women self-massage skills. If a doctor approves it, a medication like ibuprofen can be used to manage the pain.