Pain after giving birth: what is normal, what helps

Pain for a few days after giving birth is common: contractions of the uterus, known as afterpains, a swollen or stitched perineum, a caesarean scar, tender breasts. Cold, gentle warmth, rest and prescribed pain relief help. Pain that gets worse, especially with a fever, needs checking.

Nobody really describes this pain to you before the birth. It arrives while all the attention is on the baby, and you do not always know what is expected and what is not. Here are the key points to recognise it, soothe it, and know when to call.

Which pains are normal after giving birth?

Your body has just made an enormous effort, and immediately starts repairing itself. The uterus shrinks, the perineal tissues go down, a scar closes, the breasts get ready to feed. Each of these changes can hurt. What matters is the direction: normal pain eases a little every day.

What are afterpains and how long do they last?

Afterpains are contractions of the uterus after the birth. They help it return to its size and limit bleeding. They feel like period pains, sometimes strong ones. They are stronger during feeds, because the hormone released by breastfeeding makes the uterus contract, and often more intense after a second or third baby.

They usually last two to three days and ease within the week. To relieve them:

• gentle warmth on the lower tummy or lower back, always checking the temperature;
• empty your bladder often: a full bladder gets in the way of the uterus contracting;
• breathe slowly through the contraction, as during labour;
• take the prescribed pain relief shortly before a feed, if the team has advised it.

After a caesarean, ask the team before putting warmth near the scar.

Why does the perineum hurt, and how can I soothe it?

As the baby passes through, the perineum stretches. It swells, and may tear or be cut during an episiotomy. In the first days it is tender, painful when sitting, and urine can sting on the stitches.

• Cold. An ice pack in its cover, 10 to 20 minutes, several times a day: our guide to the perineal ice pack explains how to use it properly.
• Lukewarm water. Rinsing during and after passing urine with a peri bottle dilutes the urine and avoids rubbing.
• Position. Lying on your side relieves the pressure; sit on a firm surface rather than a soft one.
• Bowel movements. Drink, eat fibre, raise your feet on a small stool, do not strain.

The discomfort usually eases within one to two weeks. For everything that comes next, read the perineum after childbirth.

Haemorrhoids: why, and what can I do?

They are common after pushing, and sometimes already there during pregnancy. Cold, drinking enough, a fibre-rich diet and not straining on the toilet help a lot. If the discomfort persists, ask your midwife or pharmacist for a local treatment compatible with breastfeeding.

How long does pain last after a caesarean?

The scar is painful for the first days, then less and less. Pain relief is often given at set times at first: taking it regularly lets you get up sooner, which helps recovery. Wind and bloating can hurt too. To cough, laugh or get up, holding a cushion against your tummy helps. The area around the scar may stay tender or numb for several months.

Why do my breasts hurt?

Milk usually comes in between the second and fifth day. The breasts become tight, warm and heavy. Frequent feeds help; warmth before a feed helps the milk flow, cold afterwards calms the swelling. Sore or cracked nipples often mean the latch needs adjusting: talk to your midwife. To find out more, read the first weeks of breastfeeding.

Back pain, aches, headache: is it normal?

Aching muscles after pushing and back pain are common in the first days. Warmth, rest and a good breastfeeding position help. A severe headache after an epidural, which gets worse when standing and better when lying down, must be reported to the team: there is a treatment.

How long does the pain last, and what helps?

Pain	Usual duration	What helps	When to seek advice
Afterpains	2 to 3 days, sometimes a week	Gentle warmth, emptying the bladder often, pain relief	Strong, constant pain, fever, foul-smelling discharge
Perineum	Eases within 1 to 2 weeks	Cold for 10 to 20 minutes, rinsing with water, lying down	Pain that gets worse, red and hot area, discharge
Haemorrhoids	A few days to a few weeks	Cold, water, fibre, recommended local treatment	Heavy bleeding, intense pain
Caesarean scar	Several weeks, easing	Regular pain relief, cushion against the tummy	Redness, heat, oozing, fever
Breasts	Peak of 1 to 3 days when milk comes in	Frequent feeds, warmth before, cold after	Red, painful breast with fever
Back and aches	A few days	Warmth, rest, breastfeeding position	Pain that does not ease
Headache	Variable	Drinking enough, rest	Severe headache, especially when standing, blurred vision

Which medicines can I take?

At the maternity unit, the team prescribes suitable pain relief, most often paracetamol, sometimes an anti-inflammatory for a few days. Most are compatible with breastfeeding, but not all. Before taking a medicine from your cupboard, ask your midwife, doctor or pharmacist, and stick to the stated doses.

When should I seek advice straight away?

• a temperature of 38 °C or more;
• pain that gets worse instead of better;
• very heavy bleeding, a full pad in less than an hour, or large clots;
• discharge that smells bad;
• a painful, hot or swollen calf;
• breathlessness or chest pain;
• a severe headache or blurred vision;
• persistent stinging when passing urine, or being unable to pass urine.

If you are breathless, have chest pain or feel faint, call 15 or 112.

Cold and warmth, chosen by beboon

Deux soins de notre sélection répondent aux douleurs les plus fréquentes : la poche de glace périnéale Maholi, pour le périnée et les hémorroïdes, et la ceinture chauffante Warmies, pour les tranchées et le bas du dos. Nos réponses sur

• afterpains
• perineal pain
• haemorrhoids after giving birth

Frequently asked questions

How long does pain last after giving birth?

The sharpest pain usually lasts a few days. The perineum stays tender for one to two weeks, a caesarean scar for several weeks, easing over time. What should worry you is pain that gets worse.

Is it normal to have contractions after giving birth?

Yes. These are afterpains: the uterus contracts to return to its size and limit bleeding. They usually last two to three days. Strong, constant pain with a fever needs checking.

Why are afterpains stronger during breastfeeding?

Feeding releases a hormone, oxytocin, which makes the uterus contract. It is normal, and it helps the uterus shrink. This pain eases within a few days.

Can I take ibuprofen while breastfeeding?

Ibuprofen is one of the anti-inflammatories considered compatible with breastfeeding, for a short time and at the stated dose. Always ask your midwife, doctor or pharmacist, who know your situation.

Hot or cold: which should I choose?

Cold for the perineum and haemorrhoids, especially in the first days, when the area is swollen. Gentle warmth for the lower tummy and back. Never warmth on a swollen perineum, never cold directly on the skin.

How long does the perineum hurt when sitting?

The discomfort is strongest in the first days and usually eases within one to two weeks. If it gets worse, or the area becomes red and hot, talk to your midwife.

Listening to what changes

The postpartum period is not an ordeal to go through in silence. Pain that eases day after day is part of the repair. Pain that settles in or gets worse deserves to be talked about. Either way, you have the right to relief.