Postpartum uterine cramps: what are they?

After the birth of your baby, your body begins an important recovery process. Your uterus, in particular, must return to its original size, causing contractions known as “postpartum uterine cramps.” What are they? What are the symptoms and how can they be relieved?

Postpartum uterine cramps: let’s take a closer look.

What are postpartum uterine cramps?

Postpartum uterine cramps are uterine contractions that occur in the days following birth, whether the delivery was vaginal or by cesarean section.

Postpartum uterine cramps: what is their role?

These contractions are normal during the postpartum period and are an integral part of the body’s recovery process after childbirth.

Postpartum uterine cramps are triggered by the need for the uterus to return to its pre-pregnancy size. Right after your baby is born, your uterus, which has reached the size of a large watermelon or cabbage, must gradually shrink back to about the size of a clementine. This process of uterine involution is made possible by repeated contractions, sometimes painful, that occur after delivery.

These contractions help to:

• Expel the placenta: immediately after delivery, your uterus contracts to detach and expel the placenta.
• Prevent hemorrhage: your uterus then contracts strongly to close the blood vessels that were connected to the placenta, thereby reducing the risk of postpartum hemorrhage.
• Shrink the uterus: contractions continue for several days, allowing your uterus to retract and return to its original size.

Good to know: The WHO recommends an oxytocin injection immediately after birth to help deliver the placenta.

Factors that can intensify postpartum uterine cramps

In some cases, postpartum uterine cramps may be more pronounced in certain patients:

• Multiple pregnancies: after a first delivery, cramps are often mild or even absent. But after several pregnancies, your uterus returns to its original shape more quickly and works harder to contract, making the contractions sometimes more intense and uncomfortable.
• Breastfeeding: these uterine contractions are often intensified during breastfeeding. Your baby’s sucking releases oxytocin, a hormone that strengthens contractions. It is therefore not uncommon to feel this pain during feedings.
• Multiple pregnancy or a large baby: the more the uterus has been stretched, the more it must “work” to return to its normal size, which can worsen the cramps.
• Cesarean or vaginal delivery: cramps occur in both cases, but the perception of pain may vary depending on the type of delivery and individual sensitivity.
• Fatigue or stress: a tired or stressed body may be more sensitive to contraction pain.
• Episiotomy or perineal tear: although these do not directly increase cramps, overall perineal pain can intensify the discomfort.

Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your journey as a new parent.

What are the symptoms and duration of postpartum uterine cramps?

After childbirth, it is completely normal to experience postpartum uterine cramps. Here is what you need to know about their symptoms and duration.

What are the symptoms of postpartum uterine cramps?

Postpartum uterine cramps mainly present as:

• Abdominal or pelvic pain, often felt as cramps or spasms, sometimes compared to severe menstrual pain.
• A pulling or pressure sensation in the uterus and vagina.
• Increased pain during breastfeeding.
• Sometimes, pain radiating to the perineum, especially after an episiotomy or a tear during childbirth.

Some patients only feel mild discomfort, while others describe intense pain. It is also common to notice postpartum bleeding at the same time, especially lochia, which is normal after childbirth.

What is the usual duration of postpartum uterine cramps?

The duration of postpartum uterine cramps is generally limited. After one week, the contractions should no longer be noticeable, although some discomfort may persist. The uterus takes about 6 weeks to return to its normal size.

Postpartum uterine cramps: when should you consult?

Some women will feel almost nothing, while others may need specific support.

It is important to stay alert to certain warning signs during postpartum uterine cramps. Seek medical advice promptly if you notice:

• Very intense uterine pain lasting beyond 7 days.
• A fever above 38°C (100.4°F).
• Very heavy bleeding (a postpartum pad saturated in less than one hour), or hemorrhage.
• Foul-smelling or unusual vaginal discharge.
• A general feeling of malaise, weakness, or dizziness.
• Difficulty urinating, burning during urination, or signs of incontinence.

These symptoms may indicate a complication requiring prompt care.

If in doubt, take advantage of home visits by a midwife during the postpartum period. These consultations help monitor proper healing, check bleeding, ensure the uterus is shrinking properly, and address all your questions about postpartum recovery or parenthood.

How can postpartum uterine cramps be relieved?

Postpartum uterine cramps can be surprising and sometimes very painful. Fortunately, there are simple actions and solutions to help ease these contractions. At home, consider:

• Rest: your body needs to recover after childbirth. Try to rest whenever possible, especially when your baby is sleeping, to help your uterus contract while limiting fatigue, which is often increased by hormonal changes and your new family routine.
• Gentle heat: apply a warm (not hot) heating pad to your lower abdomen to relax abdominal muscles and relieve contraction pain.
• Breathing and relaxation: take time to breathe deeply or practice simple relaxation exercises.
• Support from loved ones: don’t hesitate to ask those around you to help care for your baby.

In case of intense pain, do not hesitate to seek help from your medical team. Healthcare professionals can prescribe appropriate pain relief. Painkillers are usually offered as a first-line option and are compatible with breastfeeding.

Once the acute phase has passed, your midwife or gynecologist will support you with perineal rehabilitation and the prevention of urinary issues that may occur after childbirth.

A word from Elise Destannes, midwife:

“These well-known cramps are among the common discomforts of the first few days. To reduce the pain, beyond medication, a heating pad is extremely helpful! Remember to bring one with you for your maternity stay, as it’s not always available on site.”

In summary, postpartum uterine cramps are part of the normal physiological processes that accompany your body’s recovery after childbirth. Their intensity varies from person to person, but in most cases, they fade within a few days. Stay attentive to your body’s signals and do not hesitate to seek support from a healthcare professional.

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Photo credits: nanihta | micens | buregina | voronaman111

This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May US/UK app and consulting the healthcare professionals who are supporting you.