Abdominal pain after childbirth

introduction

Abdominal pain is a common symptom after giving birth. In most cases, they are caused by the body's transition from pregnancy to the time after delivery, disappear on their own after a few days and should not be viewed as a cause for concern. During childbirth, it occurs through the afterbirth, i.e. the detachment of the placenta from the wall of the uterus (uterus) to a large wound area in the uterus that heals in about six weeks. This leads to the so-called weekly flow, which is to be assessed as wound secretion during this healing process.

Please also read our page Abdominal pain in the puerperium.

As with any other wound, this internal wound in the uterus can cause abdominal pain, but it should be gone by the end of the weekly flow. Is the birth by means of Caesarean section (Caesarean section), the caesarean section scar is also a possible cause of pain, as the structures separated by the cut, such as muscles, first have to grow together again. This healing process takes approximately four to six weeks. In addition, a urinary catheter is placed during a cesarean birth. The resulting mechanical Irritation of the lower urinary tract You may also experience abdominal pain similar to that of a bladder infection.

Also read our page Pain after a caesarean section or Abdominal pain after a caesarean section.

Pain within a few days after giving birth can also go through Aftermath caused. These have the function of bringing the uterus, which was roughly the size of a pear before pregnancy, back to its original size. The after-labor is triggered by the same hormone that caused the heavy labor in the expulsion phase of labor: that Oxytocin.
This hormone is also used in smaller amounts Breastfeeding released, which can cause the after-pains and the associated abdominal pain, especially during breastfeeding or afterwards.

Another cause of abdominal pain after childbirth can be the Relocation of internal organs on the position they held before pregnancy. In addition, the birth means an enormous one hormonal change for a woman's body, which is also on the intestines in the form of Constipation (Constipation) can express. This and the accompanying flatulence can also result in abdominal pain.

In contrast to the aforementioned pains with physiological causes, pathologies that cause abdominal pain and can also appear after childbirth in need of treatment are. It can happen, for example, that the outflow of the weekly flow is disturbed, so that it accumulates in the uterus. This is called Lochialstau. The reason for this is for example a Blood clotsthat clogs the cervix. The symptoms appear in most of the cases within the first week after delivery and are localized in the lower abdomen.
Another key symptom of Lochialstau is one decreased amount or even a Absence of the weekly flow. The retained weekly flow can be colonized by bacteria and has an unpleasant smell due to bacterial decomposition. It can also become a inflammation come in the body that relate to the uterus (Endometritis) or on Fallopian tubes and ovaries (Adnexitis) can expand. A possible accompanying symptom here is fever.
Even without a congestion of the weekly flow, during the so-called puerperium, the uterus can quickly become inflamed by bacteria rising from the vagina. This is going through frequent vaginal exams during childbirth or generally by a long birth duration favored.

causes

In most cases, the causes of abdominal pain are immediately after birth and the time after it harmless and normal circumstances owed the regression of all pregnancy changes.

So on the one hand the Uterine muscles with aftermath Piece by piece togetheruntil the uterus has returned to its original size. Also the Tapes the uterus, which was also properly stretched during pregnancy, form back again.

On the other hand, the Wound inside the uteruscaused by the loosening of the placenta, also lead to pain in the healing phase. If the birth was carried out by means of a caesarean section, it is also Healing cesarean scar quite a trigger for stomach ache.

Furthermore, there is another after the birth hormonal changewhich can sometimes affect the gastrointestinal tract (constipation, gas, etc.). In the same way it comes to one Change of position the previously repressed Abdominal organs, which now have more space after birth - a pinch in the stomach is not uncommon.

But abnormal circumstances can also trigger abdominal pain after the birth: Inflammation of the uterus, ovaries, fallopian tubes or bladder, a Obstruction of the puerperium flow or a No uterine regression can cause abdominal pain - this should be examined and treated immediately by a doctor.

Concomitant symptoms

Depending on, what cause who have abdominal pain after childbirth, these can also be accompanied by different symptoms.

Is it a stomachache? "Normal" symptom As part of the Uterine regression in the puerperium, there are usually no further symptoms.

Are the abdominal pain an expression of the fact that the gastrointestinal tract briefly passes through Organ position changes or hormonal changes is out of step, they can get through Constipation, gas or Diarrhea to be accompanied.

However, if the abdominal pain is caused by pathological circumstances, such as inflammation or a build-up of the puerperium flow, further symptoms can occur and corroborate the suspected diagnosis. These include, for example, a clear Tension pain over the uterus (in the case of uterine lining inflammation or a weekly flow congestion) or left / right next to it (with an ovarian or Fallopian tube inflammation), a pain when moving the cervix during the gynecological examination (for inflammation of the egg duct), fever and a Absence of the weekly flow.

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Postpartum abdominal pain with flatulence

As part of the hormonal change after the birth, it may well happen that the Intestines the mother something sluggish becomes.

The consequence can Constipation and gas which - depending on the severity - can lead to serious abdominal pain.

In addition, immediately after the birth there is suddenly much more space for the gastrointestinal tract, so that it spreads again and tries to take its original place.

This phase also means that the intestines can be "messed up" for some time, which can lead to digestive problems with flatulence.

Postpartum abdominal pain with cramps

Crampy abdominal pain after birth are often so-called Aftermath which are completely harmless and normal.

The reason for this aftermath is gradual Regression of the uterus: this was subject to a massive expansion during pregnancy, which must be reversed after the child has been expelled. The hormone helps here Oxytocinthat during childbirth also die Labor to expel the child triggered. This hormone is now increasingly released - especially during breastfeeding - and causes the muscles of the uterus to contract like labor, so that the uterus takes on its original size piece by piece.

Different locations of abdominal pain after childbirth

Left side abdominal pain

Unilateral pain after childbirth is more likely atypical and should be examined by a doctor to be on the safe side. Often the cause of left-sided abdominal pain is not birth but it is caused by other gynecological or internal diseases. A more precise definition of the cause of abdominal pain on the left can be made by differentiating the localization of the pain in the upper and lower abdomen.
If the pain occurs in the Upper abdomen on, so is often the stomach the cause. Another note for Stomach pain is the temporal correlation between the development of pain and food consumption. Another cause of abdominal pain left after giving birth is one Inflammation of the pancreas.
Due to the hormonal situation, it occurs more frequently during pregnancy and breastfeeding Gallstoneswhich can obstruct the common duct of the pancreas and bile duct and lead to inflammation of the pancreas (Pancreatitis).
If the abdominal pain is localized in the left lower abdomen, one will come Inflammation of the adnexa (Ovary and fallopian tubes) or one Inflammation of the colon considered as a cause of pain. Left-sided abdominal pain should definitely be examined by a doctor if it persists for more than a few days.
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Right-sided abdominal pain

As with abdominal pain localized to the left, those that only occur on the right are more likely after childbirth unusual and should be examined by a doctor. One possible cause is this Appendicitis, in which the pain can initially be localized imprecisely in the area of ​​the navel and only later migrates to the right lower abdomen. The intensity of pain increases steadily in appendicitis and the symptoms can go through vibration or Pressure on the painful area be reinforced.
Let the stomachache on the right upper abdomen localize comes the Gallbladder considered as the triggering organ. This can be caused, for example, by the mechanical irritation of a Gallstone inflamed and if the gallstone obstructs the duct of the gallbladder, stabbing, colicky pain of extreme intensity can occur.

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Side abdominal pain

Postpartum abdominal pain that occurs laterally can be caused by the Degeneration of the ligaments of the uterus that had to stretch a lot during pregnancy.

Another reason for side abdominal pain can also be one Inflammation of the renal pelvis or a Kidney stone be. A recent urinary tract infection and pain that can be triggered by knocking on the kidney pads in the area of ​​the back provide an indication of this. Here, too, a prompt visit to the doctor for a diagnostic clarification of the cause of the pain is indicated.

diagnosis

In order to find out the cause of abdominal pain after the birth, the treating gynecologist usually first does one gynecological check carried out. On the one hand, the Vaginal canal and the Cervix observed and looked for infections.

In addition, the Uterine stand examined to assess the progression of uterine regression. The weekly flow is also examined, for changes or even a weekly flow congestion. In addition, a Ultrasound examination can be done to examine the abdomen, ovaries, fallopian tubes, uterus, and bladder for changes and inflammation.

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Abdominal pain in the postpartum phase should usually no longer than the postpartum period lasts.

Under the Puerperium This means the time from birth to the complete regression of all pregnancy changes, i.e. also the time in which the uterus regresses completely and the puerperium takes place - both of which can sometimes lead to abdominal pain.

The puerperium should normally not last longer than 6 weeks. If abdominal pain does not appear until afterwards or if it is unusually severe during the puerperium, a doctor should always be consulted as a precaution in order to rule out possible complications and illnesses.

therapy

Although abdominal pain mostly occurs after childbirth harmless causes and normal regression processes of the body after pregnancy, they should still be taken seriously. In particular, if there are indications of pathological processes in the body, a gynecologist should be consulted immediately.

With normal postpartum abdominal pain after childbirth, must no special therapy be initiated, as slight complaints are normal and will come back on their own after a while.

If the pain is stronger and subjectively not easily bearable, you can Painkiller should be taken, however, strict attention should be paid to which painkillers are approved for breastfeeding (especially here Paracetamol!). In addition, can warmth and a bit slight movement be quite helpful and calming.

If the stomach ache occurs in the context of abnormal changes If, for example, there is inflammation or a weekly flow congestion, a doctor should be consulted as soon as possible, who will then initiate suitable therapy.

Such warning signs that should result in a doctor's visit are fever, Severe intensity abdominal pain, a Absence of the weekly flow or its unusual strength. Also a foul smell of the weekly river should be clarified gynecologically.

If the pain is caused by a congestion of the weekly flow, the cause of the congestion is eliminated and the inflammation is removed antibiotic counteracted.

If none of these warning signs are present and the pain can be explained in the context of the puerperium, you can alleviate the abdominal pain yourself. Effectively, the application is more suitable Painkiller, whereby you have to pay attention to which painkillers you can use, especially during breastfeeding. Is well suited Paracetamol.

Please also read our page Medication during breastfeeding.

Spasmodic pain caused by Aftermath (Contraction of the uterus) can use a Hot water bottle be alleviated. The regression of the uterus can be helped by standing in the uterus for about thirty minutes a day Prone position and also pushes a pillow under her stomach. Because of the release of the hormone Oxytocin when breastfeeding, this is particularly recommended for the regression of the uterus. It takes approximately time for the uterus to return to its original size six weeks.

Are constipation and flatulence cause of abdominal pain after childbirth one can help high fiber diet, one sufficiently large drinking amount and especially lots of movement. Rapid mobilization is also important after a caesarean section 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 is particularly painful when put under strain or pressure.

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Abdominal pain weeks to months after giving birth

If abdominal pain does not recur until weeks or even months after the birth, it can usually no longer be associated with the previous birth event. Possible causes can therefore be found in the internist or gynecological Area lie.
It should be noted that the abdominal pain lasts longer after the birth Signs of first menstrual periods after childbirth and breastfeeding could be. To be on the safe side, abdominal pain of unknown cause should be presented to a doctor.

Please also read our page stomach pain.

Up to what point should abdominal pain after birth be classified as normal?

Slight stomach pain after the birth normal, especially as part of the Uterine regression - these are usually easy convulsive felt throughout the lower abdomen.

Step in addition to the stomach ache other symptoms on, they are special strong or strictly one-sided localized, one should not shy away from a visit to the doctor in order to recognize possible pathological changes in the puerperium in good time.

Abdominal pain is just the same long after the birth, so after the puerperium (after approx. 6 weeks) always in need of clarification, since it can no longer actually be a question of pain in the context of regression, but rather other internal and gynecological causes come into question.

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