Pain Management After Birth

Pain Management After Birth

• Pain after birth can be caused by various factors, such as uterine contractions, perineal trauma, breast engorgement, nipple soreness, wound healing, or infection. Pain can affect the woman’s comfort, recovery, mobility, breastfeeding, and bonding with her baby.

• Pain management after birth involves a combination of pharmacological and non-pharmacological methods tailored to the woman’s needs and preferences. The choice of pain relief depends on the type, intensity, and duration of pain, as well as the woman’s medical history, allergies, contraindications, and side effects.

• Pharmacological methods of pain relief include:

  • Paracetamol: an over-the-counter analgesic and antipyretic that is safe to take while breastfeeding. It can be used for mild to moderate pain such as headache, backache, or perineal discomfort. The usual dose is 500 to 1000 mg every 4 to 6 hours as needed, not exceeding 4 g per day.

  • Ibuprofen: an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) that has analgesic, antipyretic, and anti-inflammatory effects. It can be used for moderate to severe pain such as uterine cramping, perineal swelling, or wound inflammation. It is also safe to take while breastfeeding. The usual dose is 200 to 400 mg every 4 to 6 hours as needed, not exceeding 1.2 g per day.

  • Codeine: a prescription opioid analgesic that can be used for severe pain that is not relieved by paracetamol or ibuprofen. It can be combined with paracetamol or ibuprofen for enhanced pain relief. It can pass through breastmilk and cause sedation or respiratory depression in the baby, so it should be used with caution and only for a short period of time. The usual dose is 30 to 60 mg every 4 to 6 hours as needed, not exceeding 240 mg per day.

• Non-pharmacological methods of pain relief include:

  • Relaxation and breathing techniques: the same methods used during labor can help alleviate pain after birth as well. They include deep breathing, progressive muscle relaxation, guided imagery, meditation, music therapy, aromatherapy, or hypnosis.

  • Cold or warm compresses: applying cold packs on the perineum for the first 24 hours after birth can reduce swelling and inflammation. Applying warm compresses on the perineum after the first day or on the breasts before feeding can increase blood flow and ease pain.

  • Sitz bath: soaking the perineum in warm water for 10 to 15 minutes several times a day can help clean the area, promote healing, and relieve discomfort. It can be done after an episiotomy or a perineal tear.

  • Ice packs: applying ice packs on the breasts after feeding can reduce engorgement and inflammation. A bag of frozen peas makes a nice ice pack.

  • Massage: gently massaging the affected area during feeding can help drain the milk ducts and prevent clogging. Massaging the abdomen can also help stimulate uterine contractions and reduce bleeding.

  • Pillow support: using pillows to support the abdomen after a cesarean section or the breasts when engorged can reduce pressure and pain.

  • Mobility: starting to walk soon after birth can help improve circulation, prevent thrombosis, reduce gas pain, and enhance recovery. However, avoid strenuous activity or lifting heavy objects until fully healed.