6 things you need to know about afterpains

What you need to know about after pains

Soaking up newborn cuddles not long after birth, it’s common to have the baby bubble burst by afterpains – intense cramps that some mums describe as period pain, and others say feel just like contractions.

Many new mums have never even heard of afterpains until they’re experiencing them. So we asked midwife Belinda Joyce to explain what afterpains actually are, why they’re important and how to help ease the ache.

All new mums expect some aches and pains in the early days after birth, but many are not aware of afterpains and how important they are for your recovery. These sometimes quite intense abdominal cramps vary greatly from woman to woman and from first birth to subsequent birth.

What are afterpains and why are they so important?

After pains are the result of your uterus contracting, causing a cramping feeling that many women report as similar to mild labour contractions or period-like pains. These contractions gradually shrink the uterus back to pre-pregnancy size, or close to, it will never be as small as it was before carrying a baby.

The medical term for afterpains is involution, and it begins immediately after birth. These pains occur regardless of the type of birth, vaginal or caesarean. Women describe these pains in a variety of ways, some report them as a dull ache, others a sharper pain that comes and goes, for some, it is mildly uncomfortable and for others more intense and painful.

What are afterpains doing?

The after pains are shrinking the uterus and expelling the contents. Many women report feeling a small gush of blood when breastfeeding as their uterus contracts and this is normal. This involution process can take up to six weeks however the majority of the work is happening in the first few days. This is also shrinking the wound inside the uterus where the placenta was attached, decreasing its surface area and reducing bleeding. It really is an amazing natural process that also reduces the risk of haemorrhage.

When do afterpains start?

The contractions continue immediately after birth as the uterus contracts down strongly to reduce its height to around belly button level within minutes. Your midwife will keep checking this by pressing on the top of your uterus the fundus to check the level and that it is well contracted.

When you are breastfeeding, oxytocin stimulates the uterus to contract thus creating afterpains which can be intense at this time.

How long do afterpains usually last?

Most women report that the after pains last for up to a week but have usually reduced dramatically in intensity after day three.

If the pains remain strong after a week or you have heavy bleeding requiring a change of pad more than every two hours talk to your midwife, doctor, or child health nurse to rule out any complications. If the bleeding is very heavy, visit the Emergency Department or call 000, especially if you are home alone with your baby, you should not drive in this situation.

Do afterpains get worse with each baby?

Yes, afterpains do generally get worse with each baby. Many women have only very mild pains or they don’t feel them at all with their first baby. But with each subsequent baby the pains get stronger and more intense.

If you think about it, the uterus needs to work harder each time due to reduced muscle tone
to shrink back down. Some women, particularly those having a third or fourth baby will report the pains to be almost as strong and intense as their labour pains were.

How to help ease afterpains

How to help ease postpartum afterpains

  • Rest up in those first few days, get to know your baby and focus on recuperating after the birth. Don’t feel like you need to rush to get back on your feet, take this time.
  • Heat packs on your tummy or lower back.
  • Breathing through the stronger pains similar to how you may have during labour can really help.
  • Gentle tummy massage can help.
  • Over the counter medications (simple pain relief) such as paracetamol or ibuprofen is all that most women require. These are safe medications to take while breastfeeding. If you require more than this, seek medical care.
  • Check your bladder isn’t full, in the first few days after birth some women find it hard to know when they have a full bladder, and this can interfere with the uterus contracting down well.

Just knowing that these pains are normal and that nothing is wrong is often all women need to be able to get through them. Try to be guided by how you feel and take the first week, at least more slowly. Take friends and families up on their offers of help, remember it also makes them feel better to help you.

Most of all, enjoy this special time with your new baby.

Have your say

We asked the huge community of mums on the Mum’s Grapevine Facebook Page just how painful afterpains actually are. Take a look at their answers and add your opinion below:

Are afterpains just as bad as contractions?

Posted by Mum’s Grapevine on Thursday, 8 October 2020

Belinda Joyce is a midwife, maternal and child health nurse, mother of four and author of ‘Survive and Enjoy Your Baby’. Belinda’s passion is in providing safe, evidence-based advice and options to parents so they can find their own path to parenthood. As an expert in her field, she regularly appears in the media and blogs on all things baby and parenting at Belinda Joyce.