Childbirth takes a lot out of you. You expected to feel some soreness after your baby was born but perhaps cramping caught you off guard.
Many new parents are surprised by postpartum cramping, also called “afterbirth pains.” These cramps can happen whether you had a vaginal birth or a C-section.
Postpartum cramping is usually normal and part of the healing process. It helps your body recover after pregnancy. Still, it’s important to know when cramping could be a sign of a problem.
Here is what you need to know about postpartum cramping.
What causes postpartum cramping?
After giving birth, your uterus doesn’t just stay stretched out. It has an important job: shrinking back to its pre-pregnancy size. This process is called uterine involution.
“Uterine involution means the uterus contracts to return to its original size and squeezes blood vessels to reduce blood loss and prevent postpartum hemorrhage (bleeding),” said Michelle Abbate, MD, an OBGYN at Banner - University Medicine. “It’s a common process that happens after both vaginal birth and C-section.”
These contractions are triggered by oxytocin, the same hormone that causes labor contractions. Breastfeeding also releases oxytocin, which can make cramping feel stronger when you nurse your baby.
What does normal postpartum cramping feel like?
Most people experience uterine cramping within the first day or two after delivery and it usually lasts about three days. The cramps are often strongest during the first few days and then become less frequent and less intense.
Dr. Abbate said, “Cramping often feels like strong menstrual cramps or early labor contractions.”
You might notice:
- A dull, aching pressure in your lower belly
- Sharp or wave-like cramps that come and go
- Pain that spreads down your lower back
- Cramping that worsens during breastfeeding or pumping
- Relief after taking over-the-counter (OTC) pain medicines like ibuprofen or acetaminophen
Recovery from a C-section also involves pain from the incision. This can make it hard to tell what’s causing your pain. If you have pelvic pain along with tender or swollen incision or signs of infection like redness or discharge, contact your care team.
Why do some people have stronger afterbirth pains than others?
Not everyone experiences postpartum cramping in the same way. One factor is how many times you’ve given birth.
"Women who have had children before tend to feel more pain," Dr. Abbate said. "Their uterus has less tone and alternates between contractions and relaxation, which causes more noticeable cramping.”
If this is your second, third or fourth baby, your afterbirth pains might feel stronger than after your first delivery.
Other factors that can affect cramping include:
- Breastfeeding or pumping
- Your personal pain tolerance
- The size of your uterus during pregnancy
- If you delivered multiples, like twins or triplets
How can you relieve postpartum cramping?
While postpartum cramping is normal, you don't have to suffer through it. Here are some ways to find relief:
- Take an OTC pain reliever: Ibuprofen (Advil, Motrin) is usually safe for breastfeeding parents and helps with afterpains. Always check with your doctor or midwife first.
- Use a heating pad: Placing a warm (not hot) compress on your lower belly can help ease cramps.
- Empty your bladder regularly: A full bladder presses against your uterus and can make cramps worse. Get up to use the bathroom often, even if you don’t feel like moving.
- Try gentle movement: Light walking can help your uterus contract better and may reduce cramps over time.
- Stay hydrated: Drinking enough water improves circulation and helps with recovery and milk supply if you're breastfeeding.
When should you call your doctor?
Most postpartum cramps are normal. However, sometimes cramping can be a sign of a problem that needs medical attention. According to the American College of Obstetricians and Gynecologists (ACOG), warning signs of postpartum infection include:
- Fever of 100.4°F (38°C)
- Chills
- Feeling very tired or sick
- Sharp pain on one side
- Foul-smelling vaginal discharge
Other serious symptoms can happen after delivery. Dr. Abbate said the most important signs to watch for are:
- Heavy bleeding
- Fever
- Foul-smelling discharge
“This could mean there is a complication, such as an infection, leftover tissue like the placenta or hemorrhage,” she said.
If you have these symptoms, call your health care provider. It’s always okay to ask questions and get care if something doesn’t feel right.
Seek emergency care if you have:
- Soaking through one or more pads an hour
- Severe dizziness or fainting
- Difficulty breathing
- Chest pain
- Severe abdominal pain
- Seizure
- Severe headache, vision changes or swelling in the fact or hands
- Passing large blood clots
The bottom line
Postpartum cramping helps your body heal and recover. It might be uncomfortable but for most women it’s normal and will or should go away soon.
Be kind to yourself. Use the tools available to manage pain. Rest when you can. If something doesn’t feel right, contact your care team. Find a Banner Health specialist near you.
Frequently asked questions about postpartum cramping
Is cramping normal after giving birth?
Yes, it is common to experience cramping as your uterus contracts to shrink back to its pre-pregnancy size and controls bleeding.
Is cramping normal after a C-section?
Yes. Even after delivering your baby through surgery, your uterus still needs to contract and return to its normal size.
How long do afterbirth pains last?
The strongest cramping usually lasts about three days after birth and then slowly gets better. Mild discomfort may last a little longer as your body heals. If cramps continue beyond two weeks or get worse, you should see your health care provider.
Why do I cramp when I breastfeed?
Breastfeeding makes your body release a hormone called oxytocin. This hormone helps with milk letdown and makes your uterus contract. This can cause stronger cramps during feeding or pumping.
Are postpartum cramps worse after having a second baby?
Sometimes they are. Cramping can feel stronger after later pregnancies because your uterus may need to work harder to contract back to normal.
When should I worry about postpartum cramps?
Contact your provider if your cramps are very bad, get worse, occur on one side or come with fever, heavy bleeding, foul-smelling discharge, dizziness, large clots or changes around your incision.
Can postpartum cramps be a sign of infection?
Yes. Cramps or stomach pain with fever, chills, foul-smelling discharge, pain while urinating or redness and drainage around your incision might be signs of an infection.
What helps postpartum cramps?
Provider-approved pain medicine, warmth, rest, hydration and emptying your bladder may help with normal postpartum cramping.
