So, what can hurt so much compared to labor and delivery? According to ACOG (the American Congress of Obstetricians and Gynecologists), somewhere between 53-79% of women experience tearing during childbirth whereas their British counterparts estimate that number to be as high as 90%. Either way, chances are good that moms having vaginal births will have some type of laceration. Not only can the repair process be extra uncomfortable for moms without an epidural, but suture in such a sensitive area can definitely cause some discomfort for some time after delivery. We also know that some amount of labial swelling is also normal after delivery, and this is especially true for women who push for a long period of time. In some cases, we can even see extra separation of the pubic bone where it stretches to accommodate a baby's head (pubic symphysis diastasis). As for breastfeeding, pain can happen from the latch process, cracked nipples with thrush, mastitis and even the uterine contractions associated with breastfeeding. Breastfeeding causes release of oxytocin, the same hormone used to stimulate labor, and this can result in pretty significant uterine contractions for some moms. Lastly, moms who need cesarean delivery are expected to have pain after their surgery, too.
Is there anything to do about all this fun stuff? During suturing of a vaginal tear, moms who have an epidural are already a little ahead of the game, although we certainly do our best to help numb the area with lidocaine for those who don’t have an epidural. That being said, even with an amount of lidocaine injections that would be drool-inducing in the mouth, it’s quite a challenge for us to effectively numb the vagina. Ice packs can be a big help for some of the labial swelling after delivery. Occasional sitz baths may also be beneficial for women with tears as can stool softeners to help prevent constipation and straining in the area of a vaginal repair. Pubic symphysis diastasis may require physical therapy or even a walker for a brief time. With breastfeeding, moms are encouraged to take advantage of the knowledge of a lactation consultant to ensure proper latching and nipple care. Thrush and cracked nipples often respond well to topical treatment whereas mastitis generally requires antibiotics to resolve. Regrettably, there’s not much we can do to suppress contractions when breastfeeding. Tylenol and Ibuprofen are also helpful for pain following a vaginal delivery, although postoperative pain from a cesarean delivery is likely to require something stronger.
For many fortunate moms, pain from labor and delivery fades soon after their baby is born; however, for others, some amount of discomfort may persist a bit longer. Collaborating with your provider is generally the best way to ensure a satisfactory healing process, so if you are having issues, be sure to let them know. The sooner you feel better after delivery, the more time you can focus on loving that new baby 😊