Diagnosis
The diagnosis of normal pain in the puerperium is usually based on the symptoms. In the case of severe pain with suspected postpartum congestion, it is important to examine the abdomen in detail and to carry out a gynaecological examination. The status of the uterus (fundus status) is assessed.
This allows conclusions to be drawn as to whether the uterus is receding normally. The postpartum flow (lochia) is also assessed (normal amount, appearance, colour, etc.). During the gynaecological examination, the cervix is examined to see whether the closure of the uterine orifice is functioning properly. If necessary, an ultrasound scan can be performed to assess the uterus more precisely (length, any remaining placental remains in the uterine cavity).
Therapy
There is no proper treatment for postpartum pain. If the pain becomes too strong, a painkiller can be taken. However, it should be noted that the painkiller is approved for breastfeeding.
Paracetamol is approved for use during breastfeeding, for example. Otherwise, some women find that warmth or the use of a hot water bottle helps to relieve the cramps. If the pain is caused by congestion of the uterus and this has been clarified by a doctor, oxytocin (hormone) and an antibiotic can be prescribed to stimulate the contractions of the uterus and to treat or prevent bacterial infections.
Forecast
Normal pain in the puerperium can last for a few days and usually ceases when the uterus regresses. Constipation and the pain associated with it also usually go away over time.
Prophylaxis
Pain in the puerperium caused by a lochial congestion can possibly be prevented by starting regression exercises in time. In non-nursing women, the administration of oxytocin may help to promote uterine regression.
