Introduction
Abdominal pain in the puerperium describes a symptom that can occur in the period after giving birth. The postpartum period includes the time between delivery and the complete completion of the regression of pregnancy changes. This period is usually given as 6 weeks.
Abdominal pain can be of varying severity and, depending on the cause, may occur more in the upper or lower abdomen. In most cases, abdominal pain in the puerperium is a normal occurrence within the regression of pregnancy changes and is not a cause for concern. However, if the pain is very severe, it is better to clarify it in order to exclude a more dangerous cause. or on the subject of abdominal pain after a caesarean section.
Causes
In most cases, abdominal pain in the postpartum is a physiological phenomenon. Physiological means that it is normal for certain pains to occur in the abdomen after a birth. A frequent cause is afterpain, which means that the uterus continues to contract even after the baby is born.
During the birth this happens in order to expel the child. After the birth this happens more irregularly in order to stop possible bleeding on the wound area where the placenta used to be, and so that the uterus returns to its original size. Such afterpains can last for several days.
Most often they increase during and after breastfeeding. During breastfeeding, the mother releases the hormone oxytocin. This is done by stimulation at the nipple through the baby’s sucking and has the function of strengthening the regression process.
Another cause of abdominal pain in the puerperium can be that the internal organs shifted by the pregnancy return to their original place. This can lead to short-term irritation, which is perceived as abdominal pain. The activity of the intestines also changes again after the delivery.
After the birth, the hormone balance of the woman changes again. This hormonal change can make the bowel a little slower for a short time, so that constipation can occur. If, in addition to the abdominal pain in the postpartum, there is also a pressure pain over the abdomen and fever, the cause can be a lochial congestion (postpartum congestion, lochiometra). This is caused by a reduction or absence of postpartum flow due to a narrowing of the cervix.
Symptoms
The abdominal pain can be of varying degrees of severity depending on the cause. In most cases the pain occurs more in the abdomen, which is due to the regression of the uterus or the constipation. If the causes are physiological for the regression period, there are usually no additional symptoms. If there is an additional fever and lack of postpartum flow, a postpartum congestion (lochial congestion) should be considered.
