Pain Management

Evidence  

https://pmc.ncbi.nlm.nih.gov/articles/PMC8408636/ 

Caroline A Smith, Emma Hill, Anna Denejkina, Charlene Thornton, Hannah G Dahlen  

Pain relating to pregnancy and childbirth can have a significant impact on women during the postpartum period. Women may experience perineal pain, breast pain, low back pain, pain from the uterus returning to its pre-pregnancy size (involution) and incisional pain post caesarean. Experience of postpartum pain varies depending upon individual circumstance, mode of birth, previous conditions, level of psychosocial support and available options for pain management. Postpartum pain can be significant with potential detrimental impacts on maternal movement, mobility, sleep and mental health which may interrupt a woman's transition to motherhood.   

Education 

Pain after childbirth varies based on delivery type and personal circumstances. For those who had a vaginal birth, discomfort may come from perineal tears, an episiotomy, or general soreness and bruising in the perineum (the area of skin and muscle between the vagina and anus). Mothers who have had a C-section may experience pain around the incision site, which can persist for several weeks as the tissue and muscles heal.  

Uterine contractions, or "after pains," are another common source of post pregnancy discomfort, particularly when breastfeeding or expressing as the hormone oxytocin is released and triggers contractions. Breast and nipple discomfort, as well as muscle soreness in areas like the back, neck and shoulders, can also be common due to milk production, engorgement or delivery positioning.  

Managing pain is essential to a smoother recovery and helps you focus on caring for yourself and visiting your baby in the Neonatal unit.  

Here are some approaches to pain relief commonly recommended: 

• Over-the-counter pain relievers, such as paracetamol or ibuprofen, are generally effective for mild to moderate pain and your provider may suggest a stronger prescription if needed, particularly after a C-section.  

• Local treatments, like ice packs, sitz baths, or cooling sprays can offer relief from perineal pain, while numbing creams may also be beneficial with a healthcare provider's guidance.  

• Heat therapy, such as a warm heating pad on your abdomen can help ease uterine cramps and muscle soreness; just remember to keep a protective barrier, like a towel, between your skin and the heat source.  

• For breast pain, warm compresses before nursing and cold packs afterward can reduce engorgement discomfort and a supportive bra can help ease tenderness.  

• Supportive clothing, like girdles or belly wraps, may also help with abdominal and back pain, while resting and elevating your legs can relieve pain from swelling and reduce muscle pressure.  

It’s essential to consult your healthcare provider before starting any pain management method, particularly if you have medical needs or conditions that affect your recovery. 

Empowerment 

Pain is a normal part of the post pregnancy experience but managing it can help you focus more fully on recovery and bonding with your baby.  

Being kind to yourself and allowing rest without guilt can support both your mental and physical recovery. 

If pain is interfering with bonding or well-being, don’t hesitate to ask for additional support from your healthcare team.  

Useful Links 

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists 

https://ranzcog.edu.au/wp-content/uploads/First-Few-Weeks-Following-Birth.pdf 

Mater Hospital, Queensland 

https://brochures.mater.org.au/brochures/mater-mothers-hospital/after-birth-care-of-the-new-mother 

Health Direct Australia 

https://www.healthdirect.gov.au/medicines-and-breastfeeding 

NPS Medicine Wise 

https://www.nps.org.au/consumers/taking-medicines-when-breastfeeding 

COPE – Centre of Perinatal Excellence  

https://www.cope.org.au 

PANDA - Perinatal Anxiety & Depression Australia 

https://panda.org.au/ 

For When – Perinatal Mental Health and Wellbeing 

https://forwhen.org.au  

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