Pain After Childbirth

After giving birth, your body needs time to recover. You may have different kinds of pain in your body that need extra care. Your breasts may hurt, and your uterus may cramp. The area between your vagina and anus (perineum) may hurt. If you had a C-section, your belly (abdomen) will be sore. Understanding how to manage pain after childbirth will help you care for your baby and yourself during this time.

You may have swollen breasts and sore nipples for a time after childbirth. You can help ease swelling by breastfeeding or pumping and putting cool packs on your breasts. You may have nipple pain from breastfeeding in the first few days. If the pain continues, dabbing a small amount of breast milk on the nipple or using a breast shield can help with this problem. Ask your care team about creams or ointments for sore nipples. If you use any kind of creams or ointments, make sure to apply them after you finish breastfeeding and then wipe it off before you start breastfeeding. Your doctor may also advise a medicine, such as ibuprofen. If you're having ongoing nipple pain, talk with your care team. They can help you tell if your baby is latching on normally, and if your breast pump fits your breasts well.

Cramping pain in your uterus after childbirth is also known as afterpains. It's more common in people who have given birth before. It often happens during breastfeeding in the first few days after birth. A heating pad on your belly may help ease pain. Taking ibuprofen or naproxen can also help reduce pain.

The perineum is the area between the vagina and the anus. It can be bruised and sore after childbirth. You may have a tear, cut, or stitches in the area. You may have pain for days or weeks. Putting an ice pack or cold pack on the area in the first 1 to 3 days may help reduce swelling. Do this for 10 to 20 minutes several times a day. Or sit in a shallow bath of cold or iced water several times a day. Pain medicine, such as ibuprofen or acetaminophen, can help manage this pain. If you have stitches in the area, gently rinse them with warm water each time you use the toilet. Don't wipe the stitches with toilet paper. If you have constipation, it can make perineal pain worse. Talk with your care team if you need stool softeners to help keep your stool soft.

Hemorrhoids are enlarged veins in the rectum and anus. They can itch, hurt, and bleed. They can happen from the pushing during the second stage of labor. You can treat them with hemorrhoid medicines, such as cream, ointment, or astringent wipes that have witch hazel.

Pain medicines that you may be given after childbirth include:

• A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, or ketorolac.
• Aspirin.
• Acetaminophen.
• Dexamethasone (a steroid).

If your pain is not helped by these medicines, your doctor may advise stronger ones called opioids. Opioid medicine may be given through an I.V., injection, or by mouth. Tell your care team if you have had any problems with opioid medicines in the past, such as opioid use disorder. Opioid medicines can also make you sleepy. This can make it harder to care for yourself and your baby. The medicines can also cause constipation. This can make perineal pain worse. And it can affect your baby if you are breastfeeding. Talk with your care team about the risks and benefits if you need opioids.

Some medicines are not recommended if you are breastfeeding. The effects of opioid medicines on your baby vary by dose. Talk with your care team about the risks and benefits of any medicine you may take. After you leave the hospital or birthing center, you may have pain medicines to take at home. Your care team will talk with you about the safest doses and timing of medicine if you're breastfeeding. They will also tell you how to watch your baby for signs of opioid effects.

Contact your doctor now or seek immediate medical care if:

• You have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.
• You have redness, swelling, or fluid leaking from your incision that gets worse.
• You have red streaks or new painful lumps in your breasts.
• You have pain that gets worse.
• You have symptoms that don't get better, or get worse.
• You have a severe headache.
• You have other new symptoms.