After being expelled from paradise, man acquired the ability to independently reproduce his own kind, and the woman had to give birth to children in pain… Doctors classify pain during childbirth and pain after childbirth as inevitable. Even after a virtually painless birth, which is performed under epidural anesthesia, women experience pain during the postpartum period.

Most often, nagging pain after childbirth in the lumbar region and lower back is associated with displacement of the hip joints, as well as with the manifestation of those changes in the sacrococcygeal spine that occur throughout pregnancy and during the birth of the child.

Causes of pain after childbirth

We will look at typical pain after childbirth and their most common causes, although, of course, there are many clinical cases where the symptoms of pain after childbirth are individual in nature. For example, long-term severe headaches after childbirth torment women in labor who have undergone regional epidural (spinal) anesthesia, in which a labor painkiller is injected into the spinal region at the border of the lumbar and sacral regions. A severe headache lasting the first three days after birth (with blurred vision and nausea) can also be a sign of preeclampsia – if the expectant mother had a persistent increase in blood pressure in the second and third trimester of pregnancy.

Chest pain after childbirth, more precisely, pain in the chest with shortness of breath and cough, may indicate infectious diseases of the lungs, but these are also symptoms of pulmonary embolism (a blood clot in the pulmonary artery). Pain in the legs after childbirth – in the calves – can be a sign of life-threatening deep vein thrombosis, which causes redness of the skin, swelling and fever. And severe pain after childbirth in the abdominal area can be a sign of inflammation of the uterus at the placenta insertion site.

However, typical causes of pain after childbirth are associated with the fact that during the birth of a child, the birth canal is subjected to strong mechanical stress, which is often traumatic.

Abdominal pain after childbirth

Hormones that are produced during pregnancy cause ligaments and muscles to relax. This is necessary for the normal development of the fetus, and during the entire period of gestation the size of the uterus increases by 25 times. After childbirth, the uterus begins to return to its “pre-pregnancy” state. And pain in the lower abdomen after childbirth, which many mothers define as pain in the uterus after childbirth, is associated with a reduction in the size of the uterus.

These pains are most often cramping and intensify during breastfeeding. All this is absolutely normal. The fact is that the hormone oxytocin, which is produced in large quantities by the hypothalamus of a woman who has given birth, enters the blood and stimulates the contraction of the smooth muscles of the uterus. 7-10 days after the birth of the child, such pain in the uterus after childbirth goes away on its own.

The fundus of the uterus after childbirth is located approximately at the level of the navel. During the postpartum period, that is, 6-8 weeks, the uterus contracts to its previous size. But in women who had a large belly during pregnancy, the muscle tone of the peritoneum may be weakened, which often becomes the cause of an 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, pain in the stomach after childbirth, as well as pain in the intestines after childbirth, can occur due to constipation, which affects many women in labor. In addition, pain in this localization may bother those who have chronic gastrointestinal diseases: they may worsen in the postpartum period. So you can’t do without consulting a specialist.

Pain in the spine after childbirth

As doctors note, the reason that different women feel differently after childbirth largely depends on how their body copes with changes or drops in the level of hormones that were produced during the period of bearing a child.

After childbirth and the delivery of the placenta, the production of certain hormones suddenly stops. For example, the hormone relaxin, which during pregnancy helps to increase muscle elasticity and relax the ligaments of the pubic joint of the pelvic bones, almost completely ceases to be produced. But this hormone does not return to normal levels in the mother’s body immediately, but about five months after birth.

Therefore, the entire musculoskeletal system of a woman after childbirth gradually returns to normal functioning. And some parts of this process cause postpartum pain symptoms.

Pain in the spine after childbirth is due to the fact that relaxin, relaxing the abdominal muscles during pregnancy, also weakens the ligaments around the spine. It is the increased instability of the spine during pregnancy and even some displacement of the vertebrae that leads to nagging pain in the back after childbirth. Joint pain after childbirth has the same cause, including wrist pain after childbirth, leg pain after childbirth, and knee pain after childbirth.

Lower back pain after childbirth

Lower back pain after childbirth is partly a consequence of overuse of the quadratus lumborum muscle, which is located in the back of the abdomen and connects the ilium, ribs and transverse processes of the lumbar vertebrae. When it contracts excessively or during prolonged static loads, pain begins to be felt in the lower back and throughout the entire back.

In addition, during pregnancy, the abdominal muscles stretch and lengthen, and the muscles in the lumbar region, responsible for bending and straightening the torso and for stability of the lower spine, become shorter. And this also causes lower back pain after childbirth. Sprains of the ligaments of the pubic joint, spine and pelvic floor muscles are also causes of discomfort and pain in the lumbar region.

Pelvic pain after childbirth: pain in the sacrum and coccyx

Pain in the sacrum and coccyx after childbirth is usually not distinguished by women and pain in the coccyx is mistaken for 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 sacrum make up the lower, stationary portion of the spine.

From the anterior and posterior surfaces of the sacrum to the pelvic bones there are ligaments that firmly hold the bones of the pelvic ring. But during pregnancy – literally from the very beginning – a woman’s musculoskeletal system begins to prepare for childbirth. How?

Firstly, the lumbar vertebrae deviate backward from the axis of the spine. Secondly, the lower limbs begin to move away from the iliac bones, and the hip heads even emerge from the acetabulum. Thirdly, the bones of the pubic and sacroiliac joints diverge slightly. Finally, the arc of the coccyx changes, and the usually stationary bone of the sacrum moves slightly posteriorly. All these changes in the area of ​​the pelvic bones are provided by nature and allow the child to leave the mother’s womb.

If the baby is large or its presentation is incorrect, or if the birth took place too quickly, then pain in the sacrum after childbirth and pain in the coccyx after childbirth appears due to excessive pressure on the joints in the pelvic area. They provoke pain in the pelvis after childbirth and overstretching of these joints in the event of forced manual release of the passage for the baby’s head during childbirth.

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

Often, in complaints of pain in the sacral area, women in labor clarify that this is pain during bowel movements after childbirth. Indeed, pain in this localization may become stronger in the case of expansion of the sigmoid colon due to the accumulation of feces or in the acute phase of chronic colitis, which is a complication of postpartum constipation. We will tell you how to get rid of constipation in the postpartum period a little later.

Pubic pain after childbirth

Under the influence of hormones, which “signal” to all systems of the mother’s body about the end of the birth process, the mechanism of postpartum recovery is launched. And usually, immediately after childbirth, the pubic symphysis (symphysis) is restored, the bones of which diverge slightly during pregnancy.

If everything is normal, then the process of restoring the normal anatomical position of this joint occurs without noticeable consequences.

But if a woman who has given birth complains of pain in the pubis after childbirth, it means that the cartilage connecting the pubic bones is injured due to hyperextension of the pelvic floor (which occurs when the head of the child emerging from the womb is extended). In this case, there is likely to be a violation of the symmetry of the right and left pubic bones. Doctors diagnose this pathology as symphysitis – dysfunction of the pubic joint, in which the patient feels pain in the pubic area when walking and is forced to walk in a waddle.

If the pain is very strong and radiates to all the bones and joints of the pelvis, then this is not just a stretch of the cartilage, but a rupture of the symphysis pubis – symphysiolysis.

Pain in the perineum after childbirth

The perineal area (regio perinealis) forms the floor 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 obstetric practice, perineal injuries most often occur in women with well-developed muscles, in elderly primigravidas, with a narrow vagina with inflammatory tissue changes, with tissue swelling, as well as in the presence of scars after previous births.

With perineotomy, only the skin of the perineum is cut, and with episiotomy, the perineum and the posterior wall of the vagina are cut. Both of these procedures are done when there is a risk of arbitrary rupture of the perineum, as well as to avoid traumatic brain injuries to the newborn. If there is a rupture or cut in the perineum, they are sutured immediately after childbirth. External sutures are removed the day before discharge from the hospital, internal sutures dissolve over time.

At the same time, surgical dissection of the perineum is better than rupture, since the wound is smooth and clean and in 95% of cases heals, as doctors say, by prima intentio (primary intention) – that is, quickly and without consequences.

However, pain in the perineum after childbirth is inevitable. If hygiene is observed, the wound will heal in a couple of weeks, during which the woman should not sit so as not to disturb the stitches. With an episiotomy, sutures can cause pain in the vagina after childbirth, which will last longer – while the internal tissues are healing.

Pain in the groin after childbirth

Many women begin to experience pain in the groin area during pregnancy. Pain in the groin can be caused by 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 (radiating to the lower back) may be associated with the presence of a stone in the kidney or ureter. One cannot exclude such a cause as inflammation of the inner mucous membrane of the uterine body – endometritis. As gynecologists note, acute postpartum endometritis occurs when the uterus becomes infected during childbirth quite often, and after a cesarean section it occurs in almost 45% of cases.

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

In addition, groin pain after childbirth is caused by genital herpes, which was diagnosed in a pregnant woman.

Headaches after childbirth

Experts associate headaches after childbirth with several causes. First of all, this is a change in hormonal levels during the postpartum period: instability in the levels of estrogen and progesterone. Moreover, if a woman in labor does not breastfeed, then headaches occur much more often than in nursing women. Headaches after childbirth can also be caused by taking contraceptive medications that contain estrogen.

Stress, overwork, lack of sleep, etc. have a negative impact on a woman’s health in the postpartum period. Against the background of hormonal changes, these factors can lead to the new mother experiencing frequent and quite intense headaches after childbirth.

Muscle pain after childbirth

Muscle pain of various locations (in the lower back, pelvic muscles, legs, back, chest, etc.) is a natural phenomenon after such strong muscle tension, which they experience during the birth of a child. Such pain goes away naturally and does not require any therapy.

However, it should be borne in mind that all the changes that the body of a woman who has given birth again has to go through must be controlled and the exacerbation of existing diseases must be prevented. For example, diseases of the spine, genital area, and gastrointestinal tract, which can manifest themselves with renewed vigor after the stress suffered during childbirth.

Chest pain after childbirth

We have already talked about the hormone oxytocin, which stimulates uterine contractions after childbirth. In addition, oxytocin has another important function. During lactation, it causes contraction of the myoepithelial cells surrounding the alveoli and ducts of the mammary gland. Due to this, breast milk produced under the influence of the hormone prolactin passes into the subareolar ducts of the mammary gland and is released from the nipples.

Milk appears in the breasts after the baby is born, first in the form of colostrum. The timing of the “arrival” of milk itself varies from person to person, but obstetricians consider the norm for the onset of lactation to be 48-72 hours after birth. This process occurs literally before our eyes – through swelling of the mammary glands, which quite often accompanies chest pain after childbirth. In the future, the process of milk production will be regulated, and all unpleasant sensations will pass.

Pain during menstruation after childbirth

Very often, after giving birth, women’s periods become less regular than before pregnancy. And within 5-6 months after the baby is born, this should not be a cause for concern. In addition, during the first 4 months after childbirth, regulations can be of varying intensity and duration. Which is also not a pathology, since hormonal adjustment to the “pre-pregnancy” regime continues.

It has been noticed that most women who had algomenorrhea (painful menstruation) before pregnancy are freed from these pains after childbirth, or at least the pain becomes much weaker. But it also happens the other way around – pain during menstruation after childbirth begins in those who have not experienced it before.

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

Pain when urinating after childbirth

Pain when urinating after childbirth and an unpleasant burning sensation during this physiological process are a very common occurrence in the first days of the postpartum period.

Often, women in labor are faced with problems such as the inability to empty the bladder due to a complete lack of urge. All these symptoms have a cause. The fact is that the space for expansion of the bladder after childbirth has increased, or during childbirth the bladder could have been injured, then there may be no urge for some time.

Pain when urinating after childbirth is caused by swelling of the perineum, as well as pain in the sutures placed when stitching a tear or incision in the perineum. In any case, 8 hours after labor is completed, the woman should empty her bladder. This is extremely important both for the contraction of the uterus and for preventing possible urinary tract infections.

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

Pain during sex after childbirth

Postpartum recovery normally takes at least two months. Before this period, doctors do not recommend resuming sexual relations between spouses. However, even after these two months, at least a 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 what causes pain during sex after childbirth. And pain in the clitoris after childbirth is associated with its swelling and the presence of sutures in the perineal area, especially after episiotomy.

Diagnosis of pain after childbirth

In order to timely identify possible pathologies after the birth of a child, every woman needs to visit her doctor – one and a half months after birth. This visit will not be superfluous, even if the woman feels well and does not complain about anything.

An examination by a gynecologist, first of all, will show how things are with the woman’s reproductive organs. A woman’s health largely depends on their health.

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

If there is a need to examine a doctor of another specialization (for example, an orthopedic neurologist, gastroenterologist, nephrologist), then the patient is given an appropriate referral. And then the diagnosis of the existing pathology is carried out by a specialist using appropriate methods. For example, for pubic pain after childbirth, the diagnosis of symphysitis or symphysiolysis is made based on examination using an X-ray or computed tomograph.

Treatment of pain after childbirth

Pain in the lower abdomen after childbirth will disappear on its own within a maximum of 7-10 days, but this will happen faster if the woman establishes normal bladder emptying, which allows the uterus to contract.

Doctors say that Panthenol spray can be used for pain in the perineum after childbirth (it is usually used to treat burns). This bactericidal and local anesthetic drug is used to accelerate healing for various injuries 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 breastfeeding.

In order to injure the seams on the perineum as little as possible, doctors recommend using not ordinary pads, but special postpartum pads, in which the top layer is made of a material that does not stick to the seam.

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

  • lying on your back, bend your right leg at the knee, the left remains in a horizontal position,
  • place the toe of the bent right leg under the calf of the lying left leg,
  • With your left hand, grab your right thigh and tilt your right knee to the left.

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

If you have back pain, try to bend over less, do not lift anything heavy, and during feeding, choose a position that is as comfortable as possible for your back – with obligatory support under the lumbar region.

The primary task in the postpartum period is to get rid of constipation! Since problems with stool can increase pain in the coccyx and sacrum. No laxatives, except – in extreme cases – enemas or glycerin suppositories. The best and safest thing is to eat dried fruits, oatmeal, and dairy products; Take a tablespoon of sunflower oil in the morning, and on an empty stomach drink a glass of cold purified water without gas.

Remember that any laxative drug taken while breastfeeding will have a similar effect on your baby. But constipation in the mother will cause intestinal problems in the child.

But when treating pubic pain after childbirth, especially in the case of rupture of the symphysis pubis (symphysiolysis), bed rest, painkillers, physiotherapeutic procedures and a pelvic bandage to fix the bones are necessary. All this should be prescribed by a doctor – after diagnosis.

Folk remedies for treating pain after childbirth include decoctions and infusions of medicinal plants. Thus, shepherd’s purse is not only an excellent hemostatic agent, but also promotes uterine contraction. A decoction of shepherd’s purse is prepared at the rate of one teaspoon of herb per glass of boiling water (pour and infuse for about half an hour). It is recommended to drink it three times a day, a tablespoon.

Aloe will help heal perineal tears: the juice from the leaf is squeezed onto a sanitary pad. A compress with a decoction of ginger root will reduce pain during an incision or rupture of the perineum, and also soften breasts that have become hardened by the flow of milk: 50 g of ginger per liter of water.

And you can relieve headaches after childbirth with the help of essential oils (lavender, lemon, grapefruit, basil, rosemary and lemon balm), which are rubbed on the temples, behind the ears and the area of ​​​​the cervical vertebrae.

If pain after childbirth does not stop (or intensifies) three months after the birth of the child, then treatment cannot be avoided. But the use of any medications by a nursing woman, primarily painkillers, without a doctor’s recommendation is unacceptable!

Preventing pain after childbirth

Prevention of pain after childbirth should begin during pregnancy. For example, in order to reduce postpartum pain in the lumbar region, expectant mothers need to engage in special fitness or aerobics in water, master and correctly apply breathing techniques during childbirth. To avoid problems with pain in the spine, legs and muscles, it is necessary to strictly monitor your weight throughout pregnancy and prevent persistent swelling of the legs.

The postpartum period normally lasts from six to eight weeks. During this time, the mother’s body is rebuilt again, and her reproductive organs return to their prenatal state – they involute. Unfortunately, most women who have given birth experience pain after childbirth. But the pain quickly passes, and the joy of motherhood remains for life!

And so that pain after childbirth does not overshadow this joy, do not forget to consult your gynecologist. His recommendations will help you get back to normal faster and stay healthy.

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