Understanding After Pains and Contractions After Birth

Your uterus needs time to shrink back to its regular size.

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If you are having contractions after giving birth, do not panic! Your body knows what it's doing and these contractions are nothing like the contractions you experienced during labor. Unlike labor contractions, these contractions help your uterus shrink down to its original size and prevent you from bleeding too much after giving birth. If you haven't expelled your placenta already, these contractions can help you do so.

After Pains and Your Shrinking Uterus

While many mothers have not heard of after pains, most childbirth classes discuss them. After pains are the name given to contractions that occur after labor and delivery. These contractions signal the process of involution, the process of your uterus shrinking back down to its pre-pregnancy size and shape. It took nine months for your uterus to grow, and it now needs to return to its original size. Of course, given how much your uterus grew over time, while it will shrink, it won't be as small as it originally was.

Every woman experiences these contractions after giving birth. Your uterus spent the last nine months growing nearly twenty-five times its original size. The contractions you feel after birth help it shrink back down. This process occurs relatively quickly, in about four to six weeks.

Because it can take weeks for your uterus to shrink in size, you may continue to look pregnant after giving birth, up until your uterus returns to its normal size.


Second Time Mothers and After Pains

While after pains are not a reason to worry, they can cause discomfort and even pain. After pains can vary significantly from person to person. If this is not your first baby, your pain may be worse than you experience during previous pregnancies.

Some say that the after pains increase after each subsequent baby, though not everyone reports this to be true.

For pain, you can use comfort measures like warm packs (with your practitioner's approval), massage of the fundus through your abdomen, and certain medications. Over the counter medication works well for most women.

You may notice these contractions are the most intense within the first few days after giving birth. You may also notice them more when you nurse or breastfeed. This happens because your uterus is sensitive to the oxytocin you release while nursing. To make yourself more comfortable, you can try using comfort measures or medications immediately before breastfeeding to ease your discomfort while nursing. Basically, anything that helped you while in labor, also works during the postpartum period, including over the counter pain medications. Before taking any new medications, make sure they are safe to take while breastfeeding. 

Real Life Descriptions of After Pains 

"I remember when I first felt them, explains Amanda. "It was after my first baby was born. I was all cleaned up and in my postpartum room. I felt like we were all finally alone together. I started to nurse and then I felt it. I screamed for my husband to wake up! How could I still be having contractions? I was half panicked that there was another baby in there.

Thankfully they only lasted a few days. I can't even tell you when I last felt them because they just sort of faded in my memory." 

Do not be concerned if you do not feel after pains. Not every mother feels them. This does not mean that your uterus is not healing or shrinking. If you are concerned your uterus is not healing, ask your postpartum nurse to teach you how to feel your uterus. This way you can check its progress on your own. If you have any particular concerns, be sure to talk to your doctor or midwife for advice.


Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Sixth Edition.

Pregnancy, Childbirth & The Newborn by Simkin, Whalley, Keppler, Durham & Bolding. Fourth Edition

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