Postpartum Pain Management

Frequently Asked Questions Expand All

• What are normal postpartum symptoms?

  No matter how your labor and delivery go, your body will need time to heal after giving birth.

  Common postpartum symptoms include:

  • Vaginal bleeding

  • Cramping

  • Pain in your back, neck, or joints

  • Pain in your perineum (the area between your vagina and anus)

  • Pain around your incision (if you had a cesarean birth)

  • Swollen breasts

  • Bladder problems

  • Bowel problems

  • Hemorrhoids

• How long does postpartum pain last?

  The type, intensity, and duration of postpartum symptoms will vary from person to person. Some symptoms may last a few days, while others may last several weeks.

• What can I do about postpartum pain?

  There are many ways to control pain, including self-help treatments, over-the-counter medications, and prescription medications. Talk with your obstetrician–gynecologist (ob-gyn) about your options for pain relief before you leave the hospital.

• When should I call my doctor or 911?

  While most postpartum discomforts are normal, they should not prevent you from being able to take care of yourself and your baby. Some symptoms may be a sign there is a serious problem.

  Call 911 or seek emergency help right away if you:

  • Have chest pain

  • Are coughing or gasping for air

  • Have seizures

  • Have thoughts of hurting yourself or your baby

  • Have severe pain in your lower abdomen

  • Have pain, swelling, and tenderness in your legs

  Call your ob-gyn right away if you have

  • A headache that does not get better after taking medicine, or a bad headache with changes in vision

  • A fever of more than 100.4°F

  • Persistent nausea and vomiting

  • Pain or burning during urination that is severe or that continues more than a few days after delivery

  • Heavy bleeding (bleeding that soaks through two sanitary pads an hour for more than an hour or two)

  • Red streaks on your breasts or painful new lumps in your breasts

  • Pain that doesn’t go away or that gets worse from an episiotomy, perineal tear, or abdominal incision

  • Redness or discharge from an episiotomy, perineal tear, or abdominal incision

  • Vaginal discharge that smells bad

  • Feelings of hopelessness that last more than 10 days after delivery

• What pain relievers are safe to take while breastfeeding?

  It is important to consider a pain reliever’s benefits for you and its effect on your baby. Ibuprofen is usually the preferred first step because little of it passes through breastmilk. Acetaminophen also is safe to take while breastfeeding. Both medications are available over the counter.

  Talk with your ob-gyn if you feel you need other options, or before combining two or more pain medications. They may prescribe low doses of a mild opioid (a pain reliever such as codeine) for you to take for a short period of time.

• What is the best relief for uterine cramping or “afterpains”?

  After delivery you will feel your uterus contract and relax as it shrinks back to its normal size. This cramping also is called “afterpains.” It may feel like menstrual cramps or even labor contractions. Afterpains are more common in women who have given birth before. They also are more common during the first few days of breastfeeding.

  Applying a heating pad to your abdomen will help relieve this discomfort. If you need to take an over-the-counter pain reliever, ibuprofen may work better than acetaminophen.

• What should I do if I have pain in my back, neck, or joints?

  Talk with your ob-gyn if you have back, neck, or joint pain. This pain may be caused by strain on your back muscles, abdominal muscle weakness, and hormone changes during and after pregnancy. Depending on your situation, your ob-gyn may suggest you see a physical therapist.

  You also can try these tips to improve or prevent pain:

  • Use a heating pad on your neck or back to ease discomfort.

  • Take ibuprofen or another over-the-counter pain medication.

  • Ask your ob-gyn to show you the best positions for breastfeeding. Relax your shoulders,
    use a pillow to support your arms, and keep your back supported.

  • Look up while breastfeeding when possible. Looking down too much can hurt your neck.

  • Bend your elbows rather than your wrists when possible.

• What should I do if I have pain from a perineal tear or an episiotomy?

  As you heal from a vaginal delivery, you’ll likely experience a few weeks of swelling and pain in your perineum (the area between your vagina and anus). If you had a perineal tear or episiotomy, the pain may be more severe and the area may take longer to heal. Try these tips to relieve your discomfort:

  • Apply an ice pack or cold gel pack to the perineal area for 10 to 20 minutes at a time.
    This is most effective in the first 24 to 72 hours after birth.

  • Apply witch-hazel pads to the perineal area.

  • Take ibuprofen.

  • If sitting is uncomfortable, sit on a pillow. There also are special cushions that may be helpful.

  • Try a sitz bath (sitting in warm, shallow water). Special basins are made for this purpose.

  • When you are on the toilet, clean your genitals with warm water from a squeeze bottle.
    This also can help trigger the flow of urine. Pat dry when you’re finished.

  • Try breastfeeding while lying on your side. This position may be more comfortable
    because it doesn’t put pressure on your perineum.

  You also can ask your ob-gyn about:

  • Using a numbing spray or cream to ease pain

  • Taking a stool softener, which may make it easier for you to have a bowel movement

• What should I do if I have incision pain?

  If you had a cesarean birth, your abdominal incision (cut) may be sore for the first few weeks. The following may help provide relief:

  • Taking pain medication as recommended or prescribed by your ob-gyn

  • Using a heating pad or an abdominal binder (compression belt)

  • Choosing a breastfeeding position that puts less pressure on your incision

  There are pain medications you can take even if you are breastfeeding. Talk with your ob-gyn about your options.

• What is the best relief for swollen breasts?

  Your breasts may feel very full, hard, and tender as your breastmilk comes in. This is called engorgement. Breastfeeding more often can help ease this pain and pressure. Cold packs also may provide relief. If you are not breastfeeding, wearing a tight-fitting bra may help stop milk production earlier.

  For women who are breastfeeding, nipple pain also is normal and can be improved with proper breastfeeding technique. Talk with your ob-gyn or a lactation consultant to learn how. The International Lactation Consultant Association has a directory of certified consultants.

• What should I do if I have painful urination?

  In the first days after a vaginal delivery, you may feel the urge to urinate but not be able to pass any urine. When you do urinate, you may feel pain and burning. Here are some ways to help make urination less painful:

  • Try a warm sitz bath to lessen swelling and pain.

  • When you are on the toilet, spray warm water over your genitals with a squeeze bottle.

  This may help trigger the flow of urine.

  • Run the tap while you are in the bathroom.

  • Drink plenty of fluids.

• What should I do if I have constipation or painful gas?

  It may be hard to have bowel movements for a few days after delivery. You may be afraid to move your bowels because of pain from hemorrhoids or a tear in your perineum. You also may pass gas when you do not mean to or do not expect it. It may help to:

  • Drink plenty of fluids

  • Take short walks as soon as you can

  • Eat foods high in fiber

  • Ask your ob-gyn about a stool softener or laxative if needed

• What should I do if I have hemorrhoids?

  If you developed varicose veins in your vulva or hemorrhoids in or around the anus during pregnancy, they may get worse after delivery. These sore, swollen veins also can appear for the first time now because of the intense straining you did during labor. Treatments to reduce the swelling and itching can include

  • medicated sprays or topical ointments

  • dry heat (such as from a hair dryer turned on low)

  • sitz baths

  • cold witch-hazel compresses

  Straining when you have a bowel movement can make hemorrhoids worse. Ask your ob-gyn about taking a stool softener.

• Glossary

  Anus: The opening of the digestive tract through which bowel movements leave the body.

  Bladder: A hollow, muscular organ in which urine is stored.

  Cesarean Birth: Birth of a fetus from the uterus through an incision made in the woman’s abdomen.

  Episiotomy: A surgical cut made in the area between the vagina and the anus to widen the vaginal opening for delivery.

  Hemorrhoids: Swollen blood vessels located in or around the anus.

  Laxative: A product that is used to help empty the bowels.

  Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.

  Perineum: The area between the vagina and the anus.

  Postpartum: The 12 weeks following the birth of a child.

  Sitz Bath: A method for easing pain and swelling in the pelvic area. It involves sitting in a basin of warm water that is just deep enough to cover your buttocks and hips.

  Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.

  Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

  Varicose Veins: Swollen, twisted veins often caused by poor blood flow.

  Vulva: The external female genital area.