Different localizations of abdominal pain after birth

Unilaterally localized pain after childbirth is rather untypical and should be examined by a doctor to be on the safe side. Often the cause of left-sided abdominal pain is not the birth but is caused by other gynaecological or internal medical conditions. The cause of abdominal pain on the left side can be more precisely defined by distinguishing the location of the pain in the upper and lower abdomen.

If the pain occurs in the upper abdomen, the stomach is often the cause. A further indication of stomach pain is the temporal correlation of pain development and food intake. Another cause of abdominal pain on the left side after giving birth is an inflammation of the pancreas.

During pregnancy and breastfeeding, the hormonal situation causes a higher incidence of gallstones, which can obstruct the common duct of the pancreas and bile duct and thus lead to inflammation of the pancreas (pancreatitis). If the abdominal pain is located in the left lower abdomen, an inflammation of the adnexa (ovary and fallopian tubes) or an inflammation of the colon may be a possible cause of pain. Left-sided abdominal pain should always be examined by a doctor if it lasts longer than a few days.

As with left-sided abdominal pain, this type of pain, which only occurs on the right side, is rather unusual after childbirth and should be examined by a doctor. A possible cause is appendicitis, in which the pain can initially be localised inaccurately in the region of the navel and only migrates to the right lower abdomen as it progresses. The intensity of pain increases steadily in appendicitis and the symptoms can be aggravated by vibration or pressure on the painful area.

If the abdominal pain can be localized on the right upper abdomen, the gallbladder may be the triggering organ. For example, the bladder may be inflamed by the mechanical irritation of a gallstone and if the gallstone obstructs the excretory duct of the gallbladder, it may cause stabbing, colicky pain of extreme intensity. Abdominal pain after birth, which occurs laterally, can be caused by the regression of the ligaments of the uterus, which have had to stretch considerably during pregnancy.

Another reason for lateral abdominal pain can also be an inflammation of the renal pelvis or a kidney stone. A recent urinary tract infection and a pain that can be triggered by tapping on the kidney bearings in the area of the back is an indication of this. In this case, too, a visit to the doctor in good time is indicated for diagnostic clarification of the cause of the pain.

Diagnosis

In order to find out the cause of abdominal pain after birth, the treating gynaecologist usually first carries out a gynaecological examination. During this examination, the vaginal canal and the cervix are examined to see if there are any infections. In addition, the uterus is examined to assess the progress of uterine regression.

The postpartum flow is also examined for changes or even a congestion of the postpartum. In addition, an ultrasound scan can be performed to examine the abdomen, ovaries, fallopian tubes, uterus and bladder for changes and inflammation. Abdominal pain in the postpartum period should generally not last longer than the postpartum period.

The postpartum period is the time from birth until all changes in the pregnancy have completely regressed, including the time when the uterus has completely regressed and postpartum flow takes place – both of which can sometimes lead to abdominal pain. The postpartum period should not normally last longer than 6 weeks. If abdominal pain occurs afterwards or is unusually severe during the postpartum period, a doctor should always be consulted as a precaution to rule out possible complications and illnesses.

Although abdominal pain after birth is usually due to harmless causes and normal regression of the body after pregnancy, it should still be taken seriously. Especially if there are indications of pathological processes in the body, a gynaecologist should be consulted immediately. In the case of normal postpartum abdominal pain, no special therapy is necessary, as slight complaints are normal and will disappear after some time.

If the pain is more severe and subjectively not easily bearable, painkillers can be taken, but strict attention should be paid to which painkillers are permitted during the lactation period (in this case especially paracetamol!). In addition, warmth and a little light movement can be quite helpful and calming. If the abdominal pain occurs in the context of abnormal changes, such as inflammation or a congestion of the lochia, a doctor should be consulted immediately, who will then initiate suitable therapy.

Such warning signs, which should result in a visit to a doctor, are fever, abdominal pain of high intensity, a lack of postpartum or its unusual intensity. Also a bad smell of the lochia should be clarified gynaecologically. If the pain is caused by a congestion of the lochia, the cause of the congestion is removed and the inflammation is counteracted with an antibiotic.

If none of these warning signs are present and the pain can be explained by the postpartum, the abdominal pain can also be relieved by the patient himself. Effective is the use of suitable painkillers, whereby one must pay particular attention to which painkillers one may use, especially when breastfeeding. Paracetamol is well suited.

Cramping pain caused by afterpains (contraction of the uterus) can be relieved by using a hot-water bottle. The regression of the uterus can be supported by lying in the prone position for about thirty minutes every day and by additionally putting a pillow under the abdomen. Due to the release of the hormone oxytocin during breastfeeding, this is particularly recommended for the regression of the uterus.

It takes about six weeks for the uterus to return to its original size. If constipation and flatulence are the cause of abdominal pain after giving birth, a diet rich in fibre, a sufficient amount to drink and, above all, plenty of exercise will help. Rapid mobilisation is also important after a Caesarean section in order to stimulate intestinal motility. After a Caesarean section it is also very important to avoid heavy lifting or the activity of the abdominal press, as the Caesarean section scar causes pain, especially when under stress or pressure.