There are at least a handful of things that I wish someone had just mentioned to me before I ever had a baby. Things that reared their heads as angry surprises. After just barely having a baby, and feeling waist deep in exhaustion, stress, and overwhelm, it was not fun to be shocked by some really quite normal postpartum symptoms.
I had had so many contractions, but finally she was born. She was out of me, and I was done. I was free from all the pain. Right? Sadly, wrong.
I think I had an idea that the instant the birth occurred, those contractions would stop. Probably because I thought the contractions were only there to get the baby out, and once she was, well, what was the point? I wish I had known that more contractions were coming to be able to birth the placenta, and then even more which would help my uterus shrink back down again.
These contractions, sometimes referred to as "afterpains", can continue for several days or weeks after birth as the uterus continues to shrink. They're not exactly like the contractions in active labor, but for some moms, especially in those first few days, they can be agonizing.
[If you want to see a video that gives you the gist of this post, check out This reel I posted back in March 2023.]
Here are a few strategies to combat them when they come.
1. Expect them. Understand why they're happening. Know that they will not last forever, and it is all by design to help your body heal and your uterus shrink back down. Your uterus starts out about the size of a fist. Over nine or more months, it gradually grows to be able to hold your baby, placenta, umbilical cord, and plenty of fluid. After birth, it only takes about six weeks or so to shrink back down to its original size. This process is called uterine involution. Everyone goes through the process, and most will have the cramping, whether the birth is vaginal or C-section.
2. Have some pain relief ready. If you choose to use pain medication after birth, stay on top of it. You can now use heat on your abdomen, so take advantage of that. These cramps may come unexpectedly, but one time you probably can expect them is when you're breastfeeding. This is because breastfeeding creates the hormone oxytocin, which leads to contractions in the uterus.
When I would prepare to breastfeed the baby (which was happening quite often), I would warm up a ricebag, get myself some frozen chocolate-dipped pineapple I had prepared when pregnant, and be ready with those when I sat down to nurse. I'd get the baby latched on (at first this took many tries and often I'd be navigating pain with that alone), and then breathe deeply as I could expect the afterpains to come during the breastfeeding sessions. The ricebag and pineapple seemed to help.
3. Tell yourself some mantras. Thank your body for doing its job. Remind yourself over and over that this will not last forever, that they will get more manageable and one day you won't have them at all anymore. Remind yourself that the pain you are enduring is proof that you are an amazing mom who loves this baby so much.
4. Use breathing, visualizations, and any other pain management techniques that you might've used during labor. You thought you were training for birth, and you were, but those tools can still be very helpful when you find yourself with afterpains too. It could be helpful to imagine your beautiful uterus shrinking down to size like a glowing ball of light which slowly gets smaller and smaller. Perhaps you imagine that ball changing in frequency of brightness with each contraction- brighter, dimmer, brighter, dimmer.
5. Be sure to let new moms know about this symptom. We don't want to scare anybody about postpartum or discourage them. But with a heads up, they won't be terrified and even more overwhelmed when this happens to them too.
Also, anytime I'd mention afterpains to any experienced mom, they'd warn me that they seem to get worse/more intense with each subsequent birth. In my case this was totally true until for whatever reason, with baby #5 I was astounded by how mild they were and how soon they weren't happening anymore. I think they only bothered me for two days at the most.
Each mother is different and will experience this differently, but it's helpful to know before it even happens that you are not alone, that nothing is wrong with you, that it is all by design and an amazing way that your body is healing. Why it has to be so painful for some though? I'll never quite understand.
Was it helpful for you to learn about this common symptom of the fourth trimester? Come to the in-person class I'm teaching, "What to Expect AFTER You're Expecting" if you live in Utah Valley for more! Knowledge will empower you to feel more confident as you navigate this important transition after the baby is born! Go to dianeepperson.com/class for more info.