Dirty secrets. No one likes them, especially new moms! You get enough surprises in the first few days after having your baby (a tiny baby can poop that much at once? How!?) So let's expose a dreadfully dirty, seldom talked about secret of postpartum.

Are you ready for this scandalous reveal?

Don't say I didn't warn you!

The dirty secret is...afterpains.

The technical definition for them is, “The process of involution, the process by which the uterus attempts to return to its pre-pregnancy size and condition.”

But guess what? For many women, this description is not nearly enough. It doesn't tell you just how intense these contractions can be, especially after you've had more than one baby. I don't want to scare or alarm you, but I also want you to be prepared and aware.  Afterpains can be very intense, painful contractions.

 Photo courtesy of J L Scott Photography

Photo courtesy of J L Scott Photography

Allow me to put them into perspective. Afterpains have quite a chore. Think about it. Before you got pregnant, your uterus was about the size of an orange. During pregnancy, it grew to the size of a watermelon - that is, it increased 20 times its original weight and 1,000 times its initial capacity. It increased its muscle, tissue, blood vessels and nerves. Its shape changed from elongated to oval, to round, then back to oval, to elongated at term. Now that your baby is earthside, it has to go back to its original orange size after undergoing all those crazy and amazing changes.

With all that said, here’s a few things to know about afterpains:

If this is your first baby, you may not even notice them. Why? This is the one instance where you actually want to be a first time mom. First timers usually have better uterine tone, so the uterus contracts and has the tone to stay that way. In subsequent postpartums, your uterus tends to contract and then relax...contract even harder...and then relax. It does this because with each pregnancy, the tone of the uterine muscle becomes more and more lax. This in turn causes greater periods of relaxation with a corresponding need for the uterus to contract more forcefully. Basically, the more your uterus has stretched, the more it has to shrink and the harder it is for it to do just that.

The discomfort caused by afterpains seems to intensify with each child you have.

Afterpains can be especially intense during and after breastfeeding. This is because breastfeeding releases oxytocin, which stimulates uterine contractions. Breastfeeding may aggravate your afterpains to the point that you dread breastfeeding but try to see it as a positive thing. If your uterus doesn't contract and go back to its original size, you can experience much more serious problems (postpartum hemorrhage, to name one).

They are generally most intense within the first 48 hours and usually last 2-4 days.

If you do experience afterpains, here are some things you can try to ease the discomfort.

Tylenol with Codine, Motrin, Aleve, Advil, Motrin, etc (check with your care provider for something that is safe while nursing.)

  • Nonsteroidal anti-inflammatory drugs are usually the most effective form of pain relief for afterpains.

Pee! Having a full bladder displaces the uterus. Consequently, it can't contract as well as it should.

Lie face down with a pillow under your lower belly. This creates pressure on your uterus, which helps it stay contracted. This may make the discomfort worse at first but after about 5 minutes the pain should decrease.

Mini head lifts to encourage uterine contraction. Lie down with your knees bent, take a deep breath and as you exhale, lift your chin so it rests on your chest. Head lifts performed 5 to 10 times an episode, several times per day.

Massage your uterus. Do this frequently throughout the first three days postpartum. This may hurt but it discourages uterine relaxation, and thus the necessity for it to contract so forcefully. So you decide: hurt yourself a little now or suffer naturally later?

Practice your relaxation exercises again. Count, breathe, focal point, vocalize, whatever fits your style!

Stay hydrated.

Try a hot pack, such as a heating blanket, rice pack or warm water bottle, on your stomach.

Rest. No one feels good when they are overtired, especially a new mama.

Herbal remedies (always check with your healthcare provider to make sure these remedies are safe for you to use)

Earth Mama Angel Baby Comfort Tea

Skullcap and cramp bark tincture

Arnica, supposedly helps with the pain of bruises and aches.

AfterEase, a mixture of Crampbark , Black Haw bark, Yarrow aerials, and Motherwort aerials    

Hot tea with milk

Deepest thanks to J L Scott Photography for the picture! She's a Lincoln, NE photographer, so if you're in the area, hop over to her Facebook page or website and check her out!