Causes

In most cases, the causes of abdominal pain immediately after birth and the time after are harmless and normal circumstances are due to the regression of all pregnancy changes. On the one hand, the uterine musculature contracts bit by bit with aftershocks until the uterus has regained its original size. The ligaments of the uterus, which were also stretched properly during pregnancy, also regress.

On the other hand, the wound within the uterus, which was caused by the detachment of the placenta, can also still cause pain during the healing phase. If the birth was performed by means of a Caesarean section, the healing Caesarean section scar is also a trigger for abdominal pain. Furthermore, after the birth there is a hormonal change again, which can sometimes affect the gastrointestinal tract (constipation, flatulence etc.). In the same way, there is also a change in the position of the previously displaced abdominal organs, which now have more space again after birth – a pinching in the stomach is not uncommon in this case. But abnormal circumstances can also cause abdominal pain after birth: Inflammation of the uterus, ovaries, fallopian tubes or bladder, a congestion of the postpartum flow or a lack of uterine regression can trigger abdominal pain – this should be examined and treated immediately by a doctor.

Associated symptoms

Depending on the cause of the abdominal pain after birth, it can also be accompanied by different symptoms. If the abdominal pain is a “normal” symptom in the context of uterus regression in the postpartum period, there are usually no other symptoms. If the abdominal pain is an expression of the fact that the gastrointestinal tract has briefly become out of synch due to changes in organ position or hormonal changes, it can be accompanied by constipation, flatulence or even diarrhoea.

However, if the abdominal pain is caused by pathological circumstances, such as inflammation or a congestion of the postpartum flow, further symptoms may occur and confirm the suspected diagnosis. These include, for example, a distinct pressure pain above the uterus (in the case of inflammation of the endometrium or a puerperal flow accumulation) or to the left/right of it (in the case of inflammation of the ovaries or fallopian tubes), pain when the cervix is moved during gynaecological examination (in the case of inflammation of the ovarian ducts), fever and a lack of puerperal flow. During the hormonal changes after birth, the mother’s intestines may become somewhat sluggish.

This can result in constipation and flatulence, which – depending on its severity – can lead to severe abdominal pain. In addition, immediately after the birth there is suddenly much more space for the gastrointestinal tract, so that it spreads out again and tries to take its original place. This phase also means that the intestines can be “disordered” for some time, which can lead to digestive problems with flatulence.

Cramp-like abdominal pains after birth are often so-called afterpains, which are completely harmless and normal. The reason for these afterpains is the gradual regression of the uterus: it underwent a massive expansion during pregnancy, which must be reversed after the child has been expelled. The hormone oxytocin, which also triggered the contractions to expel the child during birth, is helpful here. This hormone is now released in greater quantities – especially during breastfeeding – and causes the muscles of the uterus to contract further like a contraction in labour so that the uterus gradually returns to its original size.