Managing Pain after Childbirth

Why is it important to manage pain after childbirth?

Pain management is more than just feeling better. Good pain control can help you: 

• Move around easier
• Lower your risk of blood clots 
• Breathe deeply and cough comfortably 
• Feed and care for your baby 
• Get more rest while your body heals 
• Reduce stress and anxiety, improve sleep, and help with depression 

If your pain is making it difficult to walk, sleep, feed your baby, or do everyday activities, talk to your obstetric provider. 

What pain is normal after childbirth?

The amount of pain you experience depends on the type of delivery and your individual recovery. 

After a vaginal birth, you may have: 

• Soreness around the vagina or perineum 
• Swelling or discomfort from tears or stitches 
• Swollen breasts 
• Cramping as your uterus returns to its normal size 

 Learn more about What to Expect after Vaginal Birth.

After a C-section, you may have: 

• Pain or soreness around your incision 
• Difficulty standing up straight or changing positions 
• Numbness or tingling near the incision as the nerves heal 
• Swollen breasts 
• Cramping as your uterus returns to its normal size 

Learn more about What to Expect after a C-Section.

How is pain managed after childbirth?

Pain can be managed through a variety of methods. This can include using medication(s), drug-free pain relief, or a combination of both. Opioids are used only when necessary, and for the shortest time possible. As your body heals after childbirth, the pain will gradually go away.  

Some people may have pre-existing medical conditions that make adequate pain relief more difficult. Pre-existing nerve and spinal damage, auto-immune conditions, arthritis, and addiction (substance use disorder) can all affect how well pain is managed after childbirth. For these patients, they should consult with their obstetric provider and pain specialist regarding their post-childbirth pain management plan. 

Common medications that are used to manage pain after childbirth include: 

• Ibuprofen (Advil®) 
• Acetaminophen (Tylenol®) 
• Prescription pain medication, if needed 

Medications can also be used to manage postpartum symptoms that have the potential to be painful, such as constipation, hemorrhoids, and nipple soreness. Medications that are effective in treating and managing these symptoms include:  

• Constipation: Stool softeners (docusate sodium), laxatives (such as polyethylene glycol [Miralax®]), and fiber supplements (such as psyllium husk fiber [Metamucil®]) that make having a bowel movement easier. 
  • Avoid stimulant laxatives, such as senna glycoside and bisacodyl [Dulcolax®], as prolonged use can lead to dependence and damage to the colon.   
• Hemorrhoids: Hydrocortisone creams and suppositories can provide short-term relief.   
• Nipple soreness: Soothing salves and creams can be used to help manage postpartum nipple soreness.   

Before using any over-the-counter medications, make sure you consult with your obstetric provider.   

Drug-free options to manage pain: 

• Heating pads for muscle discomfort, pain from cramping, or from the incision. If placing over a C-section incision, make sure it is on low heat, sessions are no more than 10-15 minutes, and place a towel in between your skin and the heating pad. 
• Ice packs for pain from the vagina or perineum. 
• Sit in a warm, shallow basin of water, called a sitz bath. 
• Use pillows to support your abdomen or perineum when sitting or changing positions. 
• Rest whenever you can. 
• Drink plenty of fluids, eat nutritious foods, and walk multiple times a day. 

If you had a C-section, you may be prescribed stronger pain medications. Make sure to take all medications as prescribed and let your obstetric provider know if your pain is not improving. 

What pain medications are safe for breastfeeding?

Ibuprofen (Advil®) is usually the best option, as very little of it passes into breastmilk. Acetaminophen (Tylenol®) is the second-best option and safe to take while breastfeeding. If you must take a medication that passes into breastmilk, such as an opioid, consult with your obstetric provider on the best course of action.  

Other drug-free ways to relieve pain may also be safe while breastfeeding. If you have questions or concerns, or your pain is worsening or uncontrollable, talk with your obstetric team and provider. 

How can I relieve pain from swollen breasts?

As your breastmilk comes in, your breasts may feel hard, very full, and tender. If you are breastfeeding: 

• Emptying out your breasts will help ease the pain and pressure. Your milk will regulate with time. 
• Use a cold pack if it provides relief. 
• Wear a well-fitted nursing bra. 
• If you are experiencing nipple pain, try using a nipple balm that does not contain lanolin, applying breast milk to your nipples and letting it air-dry, or using hydrogel nipple pads. 
  • Consider working with a lactation consultant to make sure your baby is positioned and latching correctly. 

If you are not breastfeeding: 

• Do not pump or remove milk from your breasts. 
• Wear a supportive bra, it may even help to wear one while you sleep. 
• Apply a cold pack to the breasts for 15 minutes at a time every hour. 
• Take ibuprofen (Advil®) to reduce pain and swelling. 

When should I call my obstetric provider?

Call your obstetric provider if you have: 

• Pain that suddenly becomes much worse or is not relieved by your prescribed treatment 
• Headaches that won’t go away, get worse over time, and/or get better when lying flat 
• Additional symptoms include light sensitivity, throbbing, nausea, vomiting, stiff neck pain, and visual changes 
• Severe chest, shoulder, or back pain 
• Severe abdominal pain that doesn’t go away 
• Severe nausea and vomiting  

Learn more about When to Contact Your Healthcare Team.

You may not be pain-free after childbirth, but your pain should be controlled so that you can move easily and care for yourself and your baby. Following your pain management plan and staying in contact with your obstetric team can help you recover safely.