Pain & comfort

How can I decrease pain and be more comfortable?

Pain and comfort needs are an important part of your recovery.  Your nurses will help to eliminate or reduce pain so that you can take care of yourself and your baby.

There will be different options available to you in the hospital and when you go home.  These options can vary depending if you had a vaginal birth or cesarean section, your medical history, and the doctor's orders.

Pain can be relieved by both medications and comfort measures.  Often a combination of both is needed. Ibuprofen and acetaminophen are both safe to take.  Your DR may prescribe other pain relievers that will not harm your baby, even if you are breastfeeding.  

Keeping your pain at a comfortable level can help by physical activity. It will be important to be up and moving around early on, as this will help promote good circulation for wound healing and prevent blood clots.  This is needed whether the delivery was vaginal or cesarean.  

Swelling of the perineum, and episiotomy soreness

  • This is the area between the vagina and rectum.  It can be swollen and painful after stretching to allow the baby to be born.
  • When attempting to sit down, try to tighten the muscles in your bottom before sitting.  Then relax them once seated.
  • Your doctor may have made a surgical incision, an episiotomy, to enlarge the vaginal opening.
  • You may notice pain or discomfort in the area for 2-3 weeks.
  • Apply an ice pack to ease soreness and swelling in the first 24 hours.
  • When you are at home you can soak this area while sitting in your bathtub.  Be sure to clean the bathtub well, before doing this.
  • If your doctor placed stitches, they will dissolve over time. Be careful the water is not extremely hot as this could dissolve the stitches too early.
  • Your doctor may have ordered a spray or ointment that can relieve pain.  Follow the provided instructions carefully.  Most can be used 3-4x a day.  There are also small pads containing witch hazel that can be placed on the sanitary pad are also comforting.

Incisional pain

  • If you had a cesarean delivery, the incision site can be quite sore.  
  • Your DR will prescribe pain medicine.  You may take as needed, for as long as it is prescribed.

Uterine contractions

During the first few days after delivery, your uterus will contract as it returns to its normal size.  Contractions may get stronger during breastfeeding.  Usually they feel like menstrual cramps and disappear by the end of the first week.

Hemorrhoids

  • These may have developed during pregnancy and increased in size during labor. 
  • Pressure associated with hemorrhoids may be very painful and uncomfortable.  This may be noticed when sitting, walking, and with bowel movements.
  • Take pain medicine as needed. Soak with warm or cold water baths.  Be sure to clean the bathtub well, before doing this. After soaking, apply topical pain medicine. Follow the provided instructions carefully.
  • It will be important to prevent constipation.  See below.

Constipation

  • Your first bowel movement may be delayed until the 3rd or 4th day after delivery.
  • There are several reasons for constipation.  Some are:
  • Effects of pain medicine or iron supplements
  • Episiotomy, lacerations, or hemorrhoids
  • Dehydration
  • Immobility
  • Fear of pain
  • Passing it can be painful, especially if you have had an episiotomy or if are constipated and the stool is hard.
  • Your doctor may prescribe stool softening medicine for several days after delivery.
  • Take warm or cold baths. Be sure to clean the bathtub well, before doing this.
  • Avoid rectal suppositories or enemas if you had a 3rd or 4th degree laceration.  This could damage the suture repair and cause bleeding or lead to an infection.
  • Eating a high fiber diet, drinking plenty of fluids, and keeping your pain at a comfortable level can help with this.  Call your doctor if constipation becomes a problem.

Gas Pains

  • It is very common to have bloating and gas pains, especially if you had a cesarean delivery.
  • Early moving and walking can help relieve gas pains.
  • Positioning on your left side may help to relieve gas.
  • Some physicians will prescribe medicine such as Tums, that can help with gas relief. Talk with your nurse or doctor about this.

References

AWHONN.  (2006).  The Compendium of Postpartum Care, 2nd Edition. Philadelphia, PA:  Medical Broadcasting Company.

Riley, L.  (2006).  You & Your Baby:  Pregnancy.  Des Moines, IA:  Meredith Corporation.