How to speed up the reduction of the uterus after childbirth: exercise, injections of oxytocin

Reduction of the uterus after childbirth is often the cause of lower abdominal pain or discomfort for a long time after the birth of the child. But this is not always a normal phenomenon and it is important when it is worth contacting the doctor, what are the normal timing of the involution of the uterus and possible options for treating the pathology.

Features of contraction of the uterus after childbirth

The body of a woman passes through many physical changes after childbirth, until it returns to a state that was before pregnancy. Each woman during the entire period of pregnancy and childbirth is a wonderful process to becoming a mother, and then it takes about 2 months for the body to recover from childbirth. One of the most noticeable and significant changes is the return of the uterus to the norm, called the involution of the uterus.

Terms of contraction of the uterus after childbirth vary depending on how the process of delivery was taking place, and whether there were traumatic factors. Reduction of the uterus after the first birth is more rapid and effective. This is due to the fact that in primiparous women the tone of the uterine muscle is higher, which means that the uterus can contract and remain contracted rather than relax and contract with interruptions. Reduction of the uterus after repeated and third birth can take a longer time, since with each pregnancy decreases the tone of the uterus and its ability to further normal reduction.

In general, the process of complete involution of the uterus takes about two months. The most active uterus is reduced in the first week after childbirth, and then comes a return to its previous size. After pregnancy, the uterus (not including the baby, placenta, fluid, etc.) weighs about 1000 g. Six weeks after birth, the uterus reaches a weight of 50-100 g.

Within a few minutes after the birth of the baby, the uterus shrinks, its crossed fibers are tightened the same way as during the birth. These abbreviations also help to separate the placenta from the uterine wall. After the placenta is separated, the uterine contractions close the open blood vessels to which the placenta has been attached. This compression of the vessels by contraction of the myometrium ("physiological ligature") leads to hemostasis. This helps to avoid bleeding and other complications in the early postpartum period.

Immediately after birth, the uterus is reduced in such a way that its bottom is at the level of the navel. After that, most of the reduction in size and weight occurs in the first two weeks, and at this time the uterus decreases and settles completely in the pelvic region. Over the next few weeks, the uterus slowly returns to its state, which was before pregnancy, although the total size of the uterus remains larger than before. Such a contraction of the uterus a woman can often feel in the form of spasms and painful sensations in the lower abdomen. Painful contraction of the uterus after childbirth can be most intense in the first three days, then the pulling pain should decrease.

The endometrium after birth and placental detachment is also quickly restored, so that by the seventh day there are already all layers in the endometrium. By the 16th day of the endometrium is restored throughout the uterus, with the exception of the placental area. The site of the endometrium, where the placenta was attached, undergoes a number of changes in the postpartum period. The size of the placental layer is halved, and changes in the placental layer lead to the allocation of lochia. Therefore, the symptoms of contraction of the uterus after childbirth, except for spasmodic pains, are also secretions from the genital organs, which are called lochia.

Immediately after delivery from the uterus, a large amount of red blood flows in the contraction stage. After that, the volume of vaginal discharge quickly decreases. Allocations with contraction of the uterus after childbirth have several stages and different characteristics. There are 3 normal stages of lousy. The duration of each stage is not so important, as that the number of lochies should become less and less, and the color should vary from red to white. Red or bloody lochia come out within three to four days, and gradually their color changes to a brownish-red, with a more watery consistency. Within a few weeks the amount of secretions continues to decrease, and eventually they become serous (lochia alba). The time period during which there are discharges after childbirth varies, although it is approximately 5 weeks.

The cervix also starts to return quickly to the previous state, but never returns to the state that was before the birth. By the end of the first week, the external sore is closed so that 1 centimeter remains.

The vagina also regresses, but it does not fully return to its previous size. Reduction of increased vascularization and edema occurs in 3 weeks. At this time, the vaginal epithelium passes through the stage of atrophy. Completely vaginal epithelium is restored in 6-10 weeks.

During the delivery process, the perineum was stretched and traumatized. Most of the muscle tone is restored in the sixth week, with great improvement over the next few months. Muscle tone can return to normal, depending on the degree of damage to the muscular, nervous and connective tissue. But all these changes can also affect the bad uterine contraction after childbirth. In this case, there are still prolonged bloody discharge and slow involution of the uterus, when at the end of the second week after the birth the uterus is still palpable above the bosom.

The resumption of normal ovarian function varies greatly and depends heavily on the infant's breastfeeding. In women who breastfeed their child, a longer period of amenorrhea and anovulation.

Rapid contraction of the uterus after birth occurs in the primiparous, when by the end of the first week the uterus is in the cavity of the small pelvis. Within four to five weeks, the uterus returns to its former form, which is considered a rapid recovery after delivery.

The consequences of poor uterine contraction after childbirth can be very serious - because insufficient compression of blood vessels can cause postpartum hemorrhage. If the uterus has not decreased enough, hypotension can develop, which leads to significant bleeding. If the uterus for any reason did not decrease at all, then bleeding after the removal of the placenta continues and this can lead to death, since it is very difficult to stop such bleeding. Complications can occur during the early postpartum period and late. Often incorrect hygiene in the postpartum period can lead to infection of the postnatal surface of the myometrium, since it is very sensitive to all bacteria. This threatens the development of postpartum septic states.

[1], [2], [3], [4], [5], [6], [7], [8]

Treatment of the violations of uterine contractions after childbirth

Since the long process of involution of the uterus leads to a pronounced pain syndrome, many women are wondering how to speed up uterine contractions after childbirth? First of all, you need to tell about all the symptoms to the doctor, so that he carefully examined the uterus and ruled out all dangerous postpartum complications. If there are no contraindications, then you can use different methods for better contraction of the uterus.

How to relieve pain with contraction of the uterus after childbirth? If there are pronounced painful sensations that can not be tolerated, then you should take only those painkillers that will not harm the baby if the mother is breastfeeding. Paracetamol or ibuprofen can be used for this purpose. These are the means that are allowed in children's practice, so they can be used by the nursing mother.

All methods of contraction of the uterus after childbirth can be divided into physical and medicamentous. Physical methods can be very effective, not only to reduce the uterus, but also to strengthen all the muscles of the pelvic floor. To this end, use a set of exercises that can be performed at home.

Exercises for contraction of the uterus after childbirth are performed only if the woman has no contraindications. Here are some of them:

1. Exercises with bent knees help the uterus to return to a vertical position. Lie on your back with your knees bent and put your feet on the heels on the floor. Raise one knee and press it to the abdomen, holding it with both hands. Store this position for 15-20 seconds, then release. Repeat this process with the other leg. Change your left and right feet two or four times each.
2. Pelvic contraction and relaxation

This exercise strengthens the muscles along the pelvic floor. This causes the uterus to move in an upright position. To do this exercise, you need to lie on the floor and take your hands to the side. Take a deep breath and lift the buttocks off the floor a few centimeters. Hold this position for a few seconds. Repeat this process five times to increase the strength of the pelvic muscles.

1. Inclined twisting

This exercise strengthens the oblique muscles of the press and causes the muscles of the uterus to contract under the influence of intra-abdominal pressure. It also works well for strengthening the pelvic muscles, which is important for correcting the ligament apparatus. Lie on the floor with your hands behind your head. Keep your knees bent, and your feet with heels on the floor. Raise your left knee while lifting your head with your hands. Turn the body when lifting, so that the right elbow touches your left knee. Repeat this exercise on the other side, so that the left elbow corresponds to the right knee. Do at least 10 such twists to get the best results.

Gymnastics after delivery for contraction of the uterus can be limited by simple torso inclinations to the side, by the mill and by several squats. Over time, the number of exercises is gradually increased, if there is no reaction from the uterus and abdomen.

Massage for contraction of the uterus after childbirth helps to change the position of the uterus and improve blood circulation, and can even help to return the uterus to the shape after birth and increase the birth rate. A woman can perform this massage herself. To do this, gently massage the area between the navel and the pubic bone.

Before starting the massage, choose a convenient place to lie (for example, a bed or a yoga mat). If possible, choose a quiet room with very few distractions. Lie completely on your back.

Click and swipe across the belly. Hold your hand palm down to press on the stomach, starting just below the navel. When you press, move your hand in a gentle circular motion. Then, lightly press the abdomen just above the pubic bone, and pull up gently, as if you are moving the uterus upward. Repeat this movement 15 times. The first time the massage should last about 5 minutes, then, if there are no painful sensations, you can increase the duration of the massage.

To make sure that you are performing the uterine massage properly, ask your midwife, nurse or midwife to demonstrate this before you try to do it yourself. If you are worried that the massage is not working, or something may not be right, contact your doctor immediately. A woman can also make an appointment for a massage of the abdominal cavity, which includes uterine massage as part of his treatment.

Preparations for contraction of the uterus after childbirth can be used even in the delivery room in the form of injections, or used later in tableted forms. To do this, use the so-called uterotonics - drugs that stimulate the contraction of muscle fibers of the myometrium. These include oxytocin, prostaglandins, ergometrine preparations.

Oxytocin after delivery for uterine contraction is used by all women for active management of the third stage of labor. Oxytocin promotes rhythmic contractions of the uterus, can stimulate its active reduction and has vasopression and antidiuretic effect. Can be used to control postpartum hemorrhage or hemorrhage. At birth, a very small amount of oxytocin causes severe uterine contractions. Oxytocin, at therapeutic doses, induces contractions in the bottom and body of the uterus only without affecting the lower segment. The drug compresses the myoepithelium of the milk alveoli and facilitates breastfeeding with milk. It is administered intravenously on glucose, the total dose should not exceed 5 units for the induction of labor for medical reasons (hypotonic inertness of the uterus). Oxytocin can cause anaphylactic reactions, but they are rare, and large doses can cause embolism of the amniotic fluid. It usually should not be combined with prostaglandin to stimulate uterine contraction. Oxytocin is contraindicated in conditions when there is a uterine scar from a major operation on the uterus.

Prostaglandin F2-alpha contributes to the reduction of myometrium, which causes hemostasis in the placentation site, which reduces postpartum hemorrhage and spasmodic pains that disturb when the uterus contracts.

Ergometrin and metergergometrin cause rhythmic contractions of the uterus, but with large doses they become more or less continuous. They have little effect on other smooth muscles. Ergometrine and methylergometrine at a dose of 500 (oral) or 250 (intramuscularly) micrograms make it possible to force the uterus to contract and, thus, to prevent bleeding after childbirth.

Common side effects of ergometrine are gastrointestinal disturbances, pain in the chest, vasoconstriction and transient hypertension.

Ergometrine is contraindicated in severe cardiovascular diseases, pulmonary, hepatic and renal function, sepsis and eclampsia.

But-spine for contraction of the uterus after childbirth is used only as an anesthetic. Since uterine contraction is accompanied by spasmodic pains in the lower abdomen, which are sometimes difficult to tolerate, you can use these injections to reduce the uterus after childbirth and reduce pain.

Alternative therapies

Alternative means for contraction of the uterus after childbirth are used very widely. In addition to medicines, you can try a few tips that will help alleviate the pain and intensity of postpartum spasms.

1. Deep Breathing: Practice deep breathing techniques and meditation, as they can help in contracting the uterus and relieve you of seizures after childbirth.
2. Sleep face down: you can try lying face down with a pillow under your belly. This will help you get rid of the pain.
3. Hot water treatment is the best way to reduce spasms in the lower abdomen, as it weakens the contracted uterus and improves blood circulation, thereby reducing pain in the lower abdomen and uterus.
4. Herbs for contraction of the uterus after childbirth can be used as a tea that tones the muscles and relieves a sharp spasm. Nettle for contraction of the uterus after childbirth helps not only in contraction of the uterus, but also reduces bloody discharge after childbirth. To do this, you need to stain the dichotomous nettle and take half a cup three times a day.
5. Water pepper for contraction of the uterus after childbirth also prevents the development of uterine bleeding. To prepare the infusion, you need to take two bags of herb water pepper and steaming in a liter of water. You need to take a tablespoon every three hours, then you can only three times a day.
6. Tincture for contraction of the uterus after delivery is used with white rice. To do this, you need to cook rice in unsalted water and take infusion water from this broth twice a day. This water soothes the stomach area, improves digestion and prevents constipation.
7. Tea for contraction of the uterus after childbirth can be done with individual herbs or combine them, making sure that the baby does not have any allergies.

Ginger is an anti-inflammatory, and also an excellent astringent and antiseptic that prevents pain and cramps after birth, relieving pain in the abdomen and thighs. Make ginger tea by adding a little grated ginger to a cup of boiling water. You can also add ten leaves of parsley and cook them for some time. Add honey to taste and take this tea twice a day.

1. Fennel seeds also have anti-inflammatory and analgesic properties that contribute to the relief of pain after pregnancy. Prepare the fennel by adding two tablespoons of fennel seeds to two cups of water. Boil for ten minutes, cool and add honey. You need to drink tea twice a day.
2. Most postpartum problems are associated with a weakened immune system. You must take more vitamin C, which is rich in lemon or Indian gooseberry.

Boil one cup of water, let it cool, and then add the lemon juice squeezed out of two lemons. Drink it twice a day to boost the immune system, and also helps in alleviating spasmodic pain with active contraction of the uterus.

1. Mint has soothing properties that help relieve abdominal pain and headaches after childbirth. Add mint leaves to a cup of boiling water and let it boil for about ten minutes. Strain, cool tea and add lemon juice before use. You need to drink twice a day, which reduces abdominal pain and cramps.
2. Chamomile helps relieve pain due to the involution of the uterus. This is considered safe for the baby if the mother is breastfeeding. Add the dry chamomile flowers in a cup of boiling water. Let the tea steep for ten minutes. You can add honey and lemon for extra taste. You can drink up to five times a day.
3. You can ask your partner to gently massage the belly with an oil mixture. To make the oil mixture, take five drops of lavender oil, ten drops of cypress, 15 drops of peppermint oil and one drop of jojoba oil. For massage, put your hands on the navel and move in a circular motion over the entire surface several times.

Homeopathy for contraction of the uterus after childbirth is also widely used. The choice of a drug is based on the theory of individualization and the similarity of symptoms using a holistic approach. This is the only way to restore the state of full health, removing all the signs and symptoms that the woman faces after giving birth. The goal of homeopathy is not only the treatment of pain and contraction of the uterus, but also the elimination of the underlying causes and individual susceptibility. As for therapeutic treatment, there are several treatments. For individual choice of drugs and treatment, the patient must personally contact a qualified physician. The following tools are available:

1. Kaulofillum - the drug is used for strong and early contractions of the uterus, which are accompanied by spasmodic and severe pain. After pain, there may be sensations, like a needle inside.
2. Tsimitsifuga - used to treat women with great sensitivity and intolerance to pain. Especially effective in pelvic pain from the hip to the thigh, chest pain with predominant localization on the left side.
3. Agaricus mousse - this remedy covers the spectrum of most complaints after childbirth.
4. Arnica Montana - calms the muscles of the vagina and uterus, gives an excellent sense of relief and comfort after delivery. Will absorb excessive spotting, and cause the maximum recovery of damaged nervous tissue.
5. Staphisagria - the drug is an excellent remedy for the restoration of the uterus, and its contractile function, when the baby is born after cesarean section.
6. Helba after delivery for contraction of the uterus is considered a very good remedy, which also stimulates lactation. This remedy is a plant that is grown mainly in the countries of the East. But its seeds are available for sale. To reduce the uterus, it is enough to take three seeds of this plant every day. It does not give side effects and can be accepted by almost all women.

Physiotherapy after delivery for contraction of the uterus can be used in the form of hydrotherapy and reflexology. Hydrotherapy is becoming an increasingly popular method of alleviating pain and stimulating uterine contraction. For a therapeutic effect, it may be sufficient to use a warm shower with a directed stream of warm water to the abdominal and pelvic area, followed by a massage of this area.

Reflexotherapy is the process of applying pressure to certain leg areas to relieve pain or problems in other parts of the body. The theory assumes that the legs are a map of the body. Stimulation of nerve endings sends messages to affected areas and releases endorphins and monoamines that control pain. This works well for spasmodic pains during contraction of the uterus during the first three days after delivery.

Electrophoresis with calcium after delivery for contraction of the uterus allows calcium ions to enter muscle fibers and stimulate contraction, keeping it for a long time. This is necessary in order that after contraction the uterus does not begin to relax again. Can be used in the late postpartum period.

The contraction of the uterus after childbirth takes from three days, when the uterus shrinks most intensively, and up to two months, when the maximum recovery and size and function take place. At this time, a woman can feel the trailing pain that is considered normal at this time. There are many ways to return the condition of a woman who was before giving birth - from gymnastics to alternative means, and all of this can be used in the absence of contraindications.

[9], [10], [11], [12], [13], [14], [15]