Pain after delivery: what, where and why it hurts

After the expulsion from paradise, a person found the ability to independently reproduce his own kind, and the woman had to bear children in agony ... Physicians attribute painful pains in the process of delivery and pain after delivery to the category of inevitable. Even after almost painless births that are performed under epidural anesthesia, women experience pain in the postpartum period.

The most common pain after delivery in the lumbar region and lower back is associated with the displacement of the femoral joints, as well as with the manifestation of those changes in the sacrococcygeal spine that occur throughout the pregnancy and at the time of the birth of the child.

[1], [2]

Causes of pain after childbirth

We will consider the typical pain after the birth and their most common causes, although there are certainly a lot of clinical cases when the symptoms of pain after delivery are individual. For example, prolonged severe headaches after childbirth torment women in labor who have undergone regional epidural (spinal) anesthesia, in which the anesthetic is given to the spine at the border of the lumbar and sacral areas. The severe headache (with a veil before the eyes and nausea) that lasts for the first three days after birth can be a sign of pre-eclampsia - if the future mother had a persistent increase in blood pressure in the second and third trimester of pregnancy.

Pain in the chest after childbirth, more precisely, chest pain with shortness of breath and cough, may indicate an infectious disease of the lungs, but these are the symptoms of pulmonary embolism (a thrombus entering the pulmonary artery). Pain in the legs after birth - in the calves of the legs - may be a sign of a life-threatening deep vein thrombosis, in which redness of the skin, swelling and fever are observed. And severe pain after delivery in the abdomen can be a sign of inflammation of the uterus at the site of attachment of the placenta.

However, the typical causes of pain after childbirth are related to the fact that during the appearance of the child the birth canal is subjected to a strong mechanical effect, which often turns out to be traumatic.

[3], [4], [5], [6]

Pain in the abdomen after childbirth

Hormones, which are produced during pregnancy, cause relaxation of ligaments and muscles. This is necessary for the normal development of the fetus, and for the entire period of gestation the size of the uterus increases by 25 times. After birth, the uterus begins to return to its "pre-pregnancy" state. And the pains in the lower abdomen after childbirth, which many women in labor give birth to as pain in the uterus after childbirth, are associated with a reduction in the size of the uterus.

These pains are often cramping and are intensified when breastfeeding. All this is absolutely normal. The fact is that the hormone oxytocin, which in large quantities produces the hypothalamus of a woman who has given birth, gets into the bloodstream and stimulates the contraction of the smooth muscles of the uterus. After 7-10 days after the birth of the child, such pains in the uterus after the birth pass by themselves.

The bottom of the uterus after delivery is located approximately at the level of the navel. During the postpartum period, that is for 6-8 weeks, the uterus shrinks to its former size. But in women who had a large abdomen during pregnancy, the muscle tone of the peritoneum can be weakened, which often causes the umbilical hernia. It is she who provokes pain in the navel after childbirth. To solve this problem, you should see a gynecologist, who observed the pregnancy.

By the way, the pain in the stomach after childbirth, as well as the pain in the intestines after childbirth, can arise from constipation, which affects many women in labor. In addition, the pain of this localization can bother those who have chronic gastrointestinal diseases: in the postpartum period, they can become aggravated. So without consulting a specialist is indispensable.

Pain in the spine after childbirth

As doctors say, the reason that different women feel different after the birth, largely depends on how their body copes with the change or decrease in the level of hormones that were produced during the period of bearing the child.

After delivery and release of the placenta, the production of certain hormones abruptly ceases. For example, the hormone relaxin almost completely ceases to be produced, which, during pregnancy, increases the elasticity of the muscles and relaxes the ligaments of the hip joint of the pelvic bones. But to a normal level of maintenance in an organism of a parturient woman this hormone comes back not at once, and approximately in five months after sorts.

Therefore, the whole musculoskeletal system of a woman after birth leads to normal functioning gradually. And some stages of this process cause symptoms of pain after childbirth.

Pain in the spine after childbirth is due to the fact that relaxin, relaxing the abdominal muscles during pregnancy, weakens and ligaments around the spine. It is the increased instability of the spine throughout pregnancy and even some displacement of the vertebrae that leads to pain in the back after delivery. The same reason has pain in the joints after childbirth, including pain in the wrist after childbirth, pain in the legs after childbirth and pain in the knees after childbirth.

Back pain after delivery

Back pain after parturition is partly a consequence of overexertion of the square muscle of the waist, which is located in the region of the back wall of the abdomen and connects the iliac bone, ribs and transverse processes of the lumbar vertebrae. With its excessive contractions or with prolonged static loads, pain in the lower back and in the entire back begins to be felt.

In addition, during pregnancy, abdominal muscles are stretched and lengthened, and the muscles of the lumbar region responsible for tilting and straightening the trunk and for the stability of the lower part of the spine become shorter. And this also causes pain in the lower back after childbirth. Stretching of the ligaments of the pubic articulation, spine and pelvic floor muscles are also causes of discomfort and painful sensations in the lumbar region.

[7], [8], [9], [10]

Pelvic pain after delivery: pain in the sacrum and coccyx

Pain in the sacrum and coccyx after giving birth to women usually do not distinguish and pain in the coccyx is taken as pain in the sacrum. Meanwhile, the coccygeal bone consists of several fused rudimentary vertebrae, and the sacrum is a large triangular bone that is located at the base of the spine, just above the coccyx. Together, the coccyx and the sacrum make up the lower, immobile part of the spine.

From the front and back surfaces of the sacrum to the pelvic bones there are ligaments that firmly hold the pelvic bone. But during pregnancy - literally from the very beginning - the locomotor system of a woman begins to prepare for childbirth. How?

First, the vertebrae of the lumbar spine deviate from the axis of the spine. Secondly, the lower limbs begin to move away from the iliac bones, and the hip heads even come out of the acetabulum. Thirdly, the bones of the lobate and sacroiliac joints slightly diverge. Finally, the arch of the tailbone is changed, and usually the immovable bone of the sacrum moves slightly posteriorly. All these changes in the pelvic bones are provided by nature and allow the child to leave the mother's womb.

If the child is large or his presentation is wrong, or if the birth is too fast, the pain in the sacrum after childbirth and the pain in the coccyx after delivery are due to excessive pressure on the joints in the pelvic region. Provoke pain in the pelvis after childbirth and hyperextension of these joints in the event of forced manual release of the passage for the head of the child during childbirth.

The more the sacrococcygeal joint was overloaded, the stronger and longer the pain in the pelvis after delivery and the longer the recovery process will be.

Often in complaints of pain in the sacral region, the parturient women specify that this is pain during defecation after childbirth. Indeed, the pain of this localization can become stronger in the case of enlargement of the sigmoid colon with accumulation of stool or in the acute phase of chronic colitis, which is a complication of postpartum constipation. How to get rid of constipation in the postpartum period, we will tell you later.

Puberty pain after childbirth

Under the influence of hormones that "signal" to all the systems of the maternity organism about the end of the child's birth process, the mechanism of postpartum recovery is triggered. And usually after the birth the restoration of the pubic joint (symphysis) occurs, the bones of which differ slightly during pregnancy.

If everything is normal, then the process of restoring the usual anatomical position of this junction goes without tangible consequences.

But if a woman who has given birth complains of pubic pain after childbirth, then the cartilage connecting the pubic bone is injured due to the overgrowth of the pelvic floor (which occurs when the head of the child leaving the lap extends). In this case, a violation of the symmetry of the right and left pubic bones is likely. Doctors diagnose this pathology as symphysitis - dysfunction of the pubic articulation, in which the patient feels pain in the pubic area while walking and is forced to go to the scrappage.

If the pain is very strong and is given in all the bones and joints of the pelvis, then it is not just a stretching of the cartilage, but the rupture of the pubic joint is symphysiolysis.

Pain in the perineum after childbirth

The perineal region (regio perinealis) forms the bottom of the pelvis and consists of muscles, fascia, adipose tissue and skin. Pain in the perineum after childbirth occurs when it is injured - rupture or dissection (perineotomy).

According to the data of obstetrical practice, most often crotch injuries occur in women with well-developed muscles, in elderly primiparas, with a narrow vagina with inflammatory changes in tissues, swelling of tissues, and also with scarring after previous births.

With perineotomy, only the skin of the perineum is dissected, and with an episiotomy, the perineum and the posterior wall of the vagina. Both these procedures are done with the threat of an arbitrary rupture of the perineum, as well as to avoid craniocerebral injuries to the newborn. If the perineum is ruptured or cut, immediately after delivery, they are sutured. External seams are removed the day before discharge from the hospital, the internal dissolving over time.

Moreover, surgical dissection of the perineum is better than a rupture, since the wound is smooth and clean and, in 95% of cases, heals, as doctors say, prima intentio (that is, quickly and without consequences).

However, pain in the perineum after birth is inevitable. With hygiene, the wound heals in a couple of weeks, during which the woman can not sit, so as not to break the seams. With an episiotomy, the sutures can cause pain in the vagina after childbirth, which will bother longer - while the healing process of internal tissues is going on.

Pain in the groin after birth

Many women begin to feel pain in the groin during the gestation period. Pain in the groin can lead to an increase in the volume of the uterus, as well as a gradual divergence of the pelvic bones. In addition, pain in the groin after childbirth (giving back) can be associated with the presence of a stone in the kidney or ureter. It is impossible to exclude and such reason, as an inflammation of an internal mucosa of a body of a uterus - an endometritis. As gynecologists note, acute postpartum endometritis occurs when the uterus is infected during the delivery process quite often, and after caesarean section it appears in almost 45% of cases.

Acute postpartum endometritis is characterized by symptoms such as pain in the lower abdomen and in the groin, fever, purulent discharge and uterine bleeding. If you have such symptoms, you should immediately seek medical help.

In addition, pain in the groin after childbirth gives genital herpes, which was diagnosed in a pregnant woman.

Headaches after childbirth

Headaches after childbirth specialists are associated with several reasons. First of all, this is a change in the hormonal background in the postpartum period: the instability of the level of estrogens and progesterone. Moreover, if the mother does not breast-feed, the headache occurs more often than in nursing women. Promotes headaches after childbirth and the intake of contraceptives, which contain estrogen.

The negative impact on the state of health of a woman in the postpartum period is exerted by stress, overwork, lack of sleep, etc. Against the backdrop of hormonal changes, these factors can lead to the fact that the newly mummy will pester frequent and rather intense headaches after childbirth.

Pain in the muscles after childbirth

Muscle pains of different locations (in the back, pelvic muscles, legs, back, chest, etc.) - a natural phenomenon after such a strong muscle strain, which they experience during the birth of the child. Such pains are natural and do not need any therapy.

Nevertheless, it should be borne in mind that all the changes through which the body of the woman giving birth again need to be monitored, and the existing diseases must not be exacerbated. For example, diseases of the spine, the genital area, the gastrointestinal tract, which can manifest themselves with new force after the stresses experienced during labor.

Chest pain after childbirth

We have already told you about the hormone oxytocin, which stimulates the contraction of the uterus after childbirth. In addition, oxytocin has one more important function. During lactation, it causes a reduction in myoepithelial cells surrounding the alveoli and ducts of the mammary gland. Thanks to this, the milk produced by the prolactin hormone passes into the subareolar ducts of the mammary gland and is released from the nipples.

Milk appears in the chest after the birth of the baby - first in the form of colostrum. Terms of "arrival" of the milk itself are individual, but midwives consider the beginning of lactation 48-72 hours after delivery. This process occurs literally in front of - by swelling of the mammary glands, which is often accompanied by pain in the chest after childbirth. In the future, the process of milk production is regulated, and all the unpleasant sensations will pass.

[11], [12], [13], [14]

Pain with menstruation after childbirth

Very often after the birth, menstrual periods become less regular in women than before pregnancy. And within 5-6 months after the birth of the baby this should not be cause for concern. In addition, the first 4 months after birth, reguli can be of varying intensity and duration. What is also not a pathology, as hormonal adjustment to the "pre-pregnant" regime continues.

It is noticed that the majority of women who before pregnancy had algomenorrhea (painful menstruation), after giving birth are relieved from these pains, or at least the pains become much weaker. But it happens the other way round - pains with monthly after birth begin with those who did not experience them before.

If there is the slightest concern about the recovery of the menstrual cycle after childbirth, including about pain, you need to consult a gynecologist.

Pain after urination after delivery

Pain during urination after childbirth and unpleasant burning during this physiological process is very common in the early days of the postpartum period.

Often, women in labor face such problems as the inability to empty the bladder due to the complete absence of urge. All these symptoms have a reason. The point is that the space for the expansion of the bladder after delivery has increased, or during the delivery the bladder could be injured, then for a while the urges may be absent.

To the pain of urination after delivery, swelling of the perineum is caused, as well as the soreness of the seams applied when sewing the rupture or cut of the perineum. In any case, 8 hours after completion of labor, a woman should empty the bladder. This is extremely important for both contraction of the uterus and for preventing possible infection of the urinary tract.

If the pain during urination after childbirth continues and after it heals the seam on the perineum, this is already a sign of trouble: it is probably an inflammation of the bladder, which is accompanied by an increase in temperature. In this case, you should immediately seek medical help.

Pain after sex after giving birth

Postnatal recovery normally takes at least two months. Earlier this term doctors do not recommend resuming sexual relations between spouses. Nevertheless, even after these two months, at least one third of women feel physical discomfort and even pain during sex after childbirth.

Pain in the vagina after childbirth can be caused by various local infections that lead to inflammation of the mucous membrane of the genital organs, and this is the reason for the painful sensations during sex after childbirth. A pain in the clitoris after childbirth is associated with its edema and the presence of stitches in the perineum, especially after an episiotomy.

Diagnosis of pain after childbirth

For the timely detection of possible pathologies after the birth of a child, every woman should visit her doctor - one and a half months after the birth. This visit will be superfluous, even if the woman feels well and does not complain about anything.

A gynecologist's examination, first of all, will show how things are with the women's genital organs. Their health largely depends on the health of women.

If there are any complaints, the diagnosis is made on the basis of the same examination and history, including the history of labor, which indicates all their stages, complications and manipulations.

If it becomes necessary to examine a doctor of another specialization (for example, orthopedist of neurologist, gastroenterologist, nephrologist), then the patient is given the appropriate direction. And then the diagnosis of the existing pathology is carried out by a narrow specialist - the appropriate methods. For example, with pubic pain after childbirth, the diagnosis of symphysitis or symphysiolysis is based on an X-ray examination or a computer tomograph.

[15], [16], [17], [18]

Treatment of pain after childbirth

The pain in the lower abdomen after birth will disappear in a maximum of 7-10 days, but this will happen more quickly if the woman normalizes the emptying of the bladder, which will allow the uterus to contract.

Doctors say that it can be used for pain in the perineum after delivery Panthenol spray (it is usually used to treat burns). This bactericidal and local anesthetic preparation is used to accelerate healing with various damages to the skin and mucous membranes and postoperative wounds. Panthenol is applied to damaged skin several times a day, it can be used during pregnancy and during lactation.

In order to minimize injuries to the crotch as much as possible, doctors recommend using not ordinary pads, but special postnatal ones, in which the top layer is made of a material that does not adhere to the seam.

With pain in the spine after childbirth and back pain after childbirth, physical exercises are recommended:

• lying on the back to bend the right leg in the knee, the left one remains in a horizontal position,
• to make a toe of the foot of the bent right leg under the cavity of the lying left leg,
• With your left hand, take hold of the right hip and tilt the left knee to the left.

This exercise is done 8-10 times, then the same is done with the left foot.

With back pain, try to bend less, do not lift anything heavy, during feeding, choose the position most comfortable for the back - with the obligatory support under the lumbar region.

The task of paramount importance in the postpartum period is to get rid of constipation! Since problems with the stool can exacerbate pain in the cob and sacrum. No laxatives, except - in extreme cases - enemas or glycerin suppositories. It is best and safer - there are dried fruits, oatmeal, sour-milk products; take in the morning on a tablespoon of sunflower oil, and on an empty stomach to drink a glass of cold purified water without gas.

Remember that any laxative drug when breastfeeding will lead to a similar effect for your baby. But the constipation of the mother will cause problems with the intestines of the child.

But in the treatment of pubic pain after childbirth, especially in the case of a rupture of the pubic joint (symphysiolysis), bed rest, pain relievers, physiotherapy and pelvic bandages are needed to fix the bones. All this should be prescribed by a doctor - after diagnosis.

Alternative means of treating pain after childbirth include decoctions and infusions of medicinal plants. So, the shepherd's bag is not only an excellent hemostatic agent, but it also helps to reduce the uterus. Decoction of the shepherd's bag is prepared from the calculation of one teaspoon of grass for a glass of boiling water (poured and infused for about half an hour). It is recommended to drink three times a day on a tablespoon.

Aloe can help cure tearing of the perineum: the juice from the leaf is squeezed out onto the sanitary napkin. Reduces pain in the incision or rupture of the perineum, and softens the chest, hardened from the rush of milk, compress with a decoction of ginger root: 50 grams of ginger per liter of water.

And to remove a headache after childbirth it is possible with the help of essential oils (lavender, lemon, greiprut, basil, rosemary and lemon balm), which are rubbed with whiskey, behind the ears and the region of cervical vertebrae.

If the pain after childbirth does not stop (or worsen) three months after the birth of the child, then treatment can not be avoided. But the use of any medication that nurses a woman, first of all, anesthetics, without the recommendation of a doctor is unacceptable!

Prevention of pain after delivery

Preventive maintenance of pain after childbirth should be started during pregnancy. For example, to reduce postpartum pain in the lumbar region, future mothers need to engage in special fitness or aerobics in the water, master and correctly apply breathing techniques during the birth. To avoid problems with pain in the spine, legs and muscles, it is necessary to carefully monitor your weight throughout the pregnancy and prevent the appearance of persistent swelling of the legs.

The postpartum period normally lasts six to eight weeks. During this time, the maternity body is again reconstructed, and its reproductive organs return to the prenatal state - are invoked. Unfortunately, most women who give birth experience pain after delivery. But the pain quickly passes, and the joy of motherhood remains for life!

And that pain after birth does not overshadow this joy, do not forget to consult your gynecologist. His recommendations will help you to quickly recover and stay healthy.