What are afterbirth pains/contractions?

Hands up to all the mamas out there that felt contractions even after their bubbas were born?? Afterbirth Pains! What are they? Why do they happen? How can I help? Well mama keep reading because afterbirth pains are a REAL thing and be quite uncomfortable following the birth of your baby. 

Firstly let’s talk about what happens during labour. When you are in active labour, the top of your uterus tenses up (like your bicep would) in a very tight ‘contracted’ state- this is why they are called ‘contractions’. The contractions begin at the top of your tummy and travel around the sides until your whole belly tenses up. Most importantly, these contractions need to be strong and powerful to push your baby down towards the birth canal. This process works in a ‘loop’ with all the labour hormones of oxytocin flowing to keep everything going.  The more that the baby’s head presses against your cervix (because of those strong contractions) the more it dilates and therefore more hormones are released. It goes around in a loop where the contractions continue until the baby is born. 

But wait mama, there's more… After your gorgeous babe is earthside, your placenta is born with the next contraction (mamas say that this part is easy as it is so soft and squishy) and then your midwife will usually give your tummy a firm massage. I am sorry in advance- this part is not the most comfortable. The reasoning behind this ‘fundal massage’ is to make sure your uterus is well-contracted and firm after your babe has ‘left the building. It often feels like a hard tennis ball- I’ve had mamas say to me… “What is that hard mass in my stomach- is this normal”... well mama, yes! This is completely normal and is 100% what we look for. A soft or ‘boggy’ uterus can cause big bleeds, so as midwives, we do everything in our power to stop that. 

Mama do you remember this massage? You might have also gotten it on the postnatal ward- they do it for the same reason there. When your midwife assesses this, they also check how far the uterus is down your belly- is it at your belly button? is it just under your belly button? All these things can indicate how well your uterus is contracting back to its pre-pregnant state. 

When you were carrying your baby, your uterus was the size of a watermelon and its pre-pregnant state is the size of an apple. That's nearly 25x times its size, wow! This is why mamas may still carry that baby bump after birth. Each day it will contract more and more, back to size its original size, and this process can take about 6 weeks. Voila! This is why you may experience those contractions after birth.

What are afterbirth pains...

Afterbirth pains, are the contraction type pain that mothers experience following birth. They are caused by the uterus contracting back to its pre-pregnancy state. This shrinking process is called ‘involution’. The pains feel short and ‘come and go’ just like your labour contractions would. Some mamas say that the pain level is just as bad, if not worse, than the labour ones... but other mamas say they feel like period cramps. It depends on person to person- sometimes they get worse the more babies you have. Some mamas have them constantly, others only have them for short periods. Afterbirth pains can happen to mamas who have had a C-section as well as they work on the mechanism of the uterus contracting not which way bubba was born.

When will I feel afterbirth pains…

Afterbirth pains are caused by the hormones like oxytocin that make your uterus shrink, they usually occur when hormones are flowing through your body. The most common time mamas report to have afterbirth pains is when they are breastfeeding. Having that connection and bond with your baby whilst they are suckling and stimulating your nipple brings on those hormonal changes. Breastmilk is produced the more your feed so having afterbirth pains when your milk is developing can also be common. Even when you hear your baby cry or when you are thinking about them can trigger the afterbirth pains. Hormones are a crazy thing right! Your maternal instinct, and transition to motherhood is truly special- your body is amazing and it can do incredible things. There are many times as a midwife where I am astounded by the anatomical makeup of a woman who can birth a child. It goes so far beyond birth mama, to the journey of your uterus shrinking in size ready for the next experience. Spectacular!

Afterbirth pains are the most strong in the few days following birth because that is when your uterus shrinks the most and happens the most quickly- your bleeding might also be heavy at this stage. Usually around day 3 the pains lessen in intensity. Afterbirth pains can occur for up to 6 weeks following the birth of your baby. They should be getting less intense with time. If your afterbirth pains are becoming more strong or painful seek advice from your midwife or medical professional immediately. 

As I mentioned, afterbirth pains can get worse the more babies you have, this is because your uterus is not as toned as it used to be and it has to work a lot harder to return back to its contracted state. When you have had more than one baby, afterbirth pains can be quite intense. Look after yourself- being a mama to more than one child is a handful in itself, so afterbirth pains are no ‘added bonus’. Take it easy, ask for help from friends and family and allow yourself to rest and recuperate. 

How can I help?

Resting your body is the number 1 thing that can help your afterbirth pains mama. Create a nest for yourself and your baby, and use some of these remedies to manage the pain. Give yourself permission to ask for support to ensure you get the rest you need in the days after birth.

If you’ve rushed to get back on your feet, trying to deal with motherhood, as well as afterbirth pains, can set you back a bit. Have some rest mama, and let your uterus do the marvellous work of protecting you from postpartum bleeding.

• Take analgesia to combat the pain. In the first few days ‘beating’ the pain with regular pain-relief is usually better than waiting for the pain to hit hard. When you are on the postnatal ward the midwives will usually offer you paracetamol or anti inflammatory medicines like nurofen or voltaren on a regular basis. If you need it mama, take it! It will make your experience much more seamless. Make sure to always check with a medical professional before taking any medication when breastfeeding. 

A great tool that I recommend all my Aussie mamas is the mothersafe hotline. It is a phone service that you can ring 24/7 for advice on safe medications in pregnancy and the postpartum. Its number is: 1800 647848. 

• Heat Packs: The warm and comforting sensation can ease the pain. Placing a wheat pack or a specialised heat pack over your belly can relieve the discomfort mama. If you have had a C-Section do not place the heat pack directly on your wound or dressing. In the case that you are making your own heat pack mama, ensure to follow directions carefully to avoid nasty burns. I recommend moving the heat pack from time to time so this doesn’t occur. 

• Empty your bladder: Go to the toilet regularly. A full bladder can get in the way of your uterus shrinking in size. As midwives we can usually feel this when giving that ‘fundal massage’ as the uterus sits off to one size. Keeping your bladder empty will help your bleeding and involution. 

• Lay face down: Laying on your stomach in bed with a heat pack or pillow under you can help ease the pain as it takes the pressure and focus of sitting upright. Do this to your comfort mama- ensure that you feel comfortable and supported in this position. 

• Gentle Movements: Similar to labour, we like gentle movements like swaying or moving the hips in circular motions. Try using a birth ball as this can take the focus off the pain. 

• Deep Breaths: Along with the movements, focus on your breathing to calm down mama. Slow, deep breaths can assist in relaxing you and slowing everything down. It helps your mental state to be more at peace and manage those pesky pains. 

Afterbirth pains are a normal and physiological aspect of the postpartum period mama. I hope this blog was helpful in explaining ‘why’ these pains actually occur. Always remember to work closely with your midwife when managing these pains as they can help create a specialised care-plan that specifically suits your needs. Additionally, do not be concerned if you do not feel these afterbirth pains. Not every mama feels them. This does not mean that your uterus is not healing or shrinking. Sometimes when you are having your first baby the uterus does the magic itself!