Pain After Childbirth

Breast pain

You may have swollen breasts and sore nipples for a time after childbirth. You can help ease swelling by breastfeeding often and putting cool packs on your breasts. You may have nipple pain from breastfeeding. Dabbing a small amount of breastmilk on the nipple or using a breast shield can help with this problem. Cream or ointment on the nipples doesn’t always help. But if you use any kind of cream or ointment on your nipples, make sure to wipe it off before breastfeeding. Your healthcare provider may also advise a medicine, such as ibuprofen. If you’re having ongoing nipple pain, talk with your healthcare team. They can help you tell if your baby is latching on normally, and if your breast pump fits your breasts well.

Uterus pain

Cramping pain in your uterus after childbirth is also known as afterpains. It’s more common in people who have given birth before. It often happens during breastfeeding in the first few days after birth. A heating pad on your belly may help ease pain. Taking ibuprofen or naproxen can also help reduce pain.

Perineal pain

The perineum is the area between the vagina and the anus. It can be bruised and sore after childbirth. You may have a tear or cut in the area. You may have pain for days or weeks. Putting an ice pack or cold pack on the area in the first 1 to 3 days may help reduce swelling. Do this for 10 to 20 minutes several times a day. Or sit in a shallow bath of cold or iced water several times a day. Pain medicine, such as ibuprofen or acetaminophen, can help manage this pain. If you have stitches in the area, gently rinse them with warm water each time you use the toilet. Don't wipe the stitches with toilet paper. If you have constipation, it can make perineal pain worse. Talk with your healthcare team if you need laxatives to help keep your stool soft.

Hemorrhoids

These are enlarged veins in the rectum and anus. They can itch and hurt. They can happen from the pushing during the second stage of labor. You can treat these with hemorrhoid medicines, such as cream, ointment, or astringent wipes that have witch hazel.

Types of medicines

Pain medicine you may be given after childbirth include:

• A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen, naproxen, or ketorolac

• Aspirin

• Acetaminophen

• Dexamethasone (a steroid)

If your pain is not helped by these medicines, your healthcare provider may advise stronger ones called opioids. Opioid medicine may be given through an IV, injection, or by mouth. Tell your healthcare team if you have had any problems with opioid medicines in the past, such as opioid use disorder. Opioid medicines can also make you sleepy. This can make it harder to care for yourself and your baby. The medicines can also cause constipation. This can make perineal pain worse. And it can affect your baby if you are breastfeeding. Talk with your team about the risks and benefits if you need opioids.

Taking medicines while breastfeeding

Some medicines are not advised to take if you are breastfeeding. The effects of opioid medicines on your baby vary by dose. Talk with your healthcare team about the risks and benefits of any medicine you may take. After you leave the hospital or birthing center, you may have pain medicines to take at home. Your healthcare team will talk with you about the safest doses and timing of medicine if you’re breastfeeding. They will also tell you how to watch your baby for signs of opioid effects.

When to call your healthcare provider

Call your healthcare provider if any of these occur:

• Fever of 100.4°F (38°C) or higher, or as advised by your provider

• Redness, swelling, or fluid leaking from your incision that gets worse

• Pain that gets worse

• Symptoms that don’t get better, or get worse

• Severe headache

• Other new symptoms