Overcoming Postpartum Pain: What’s Normal, What’s Not and How to Find Relief

Having a baby is lifechanging, no doubt, but postpartum pain can also shapeshift you from the inside out. Many new moms expect to feel tired, but what catches them off guard is how much their body still hurts—often in ways they didn’t anticipate.

“In the weeks and months after delivery, women frequently put their own comfort on the back burner, focusing their energy on caring for their newborn,” said Kimberly Gregory, MD, MPH, director of Maternal-Fetal Medicine in the Department of Obstetrics and Gynecology and the Helping Hand of Los Angeles—The Miriam Jacobs Chair in Maternal-Fetal Medicine at Cedars-Sinai. “But postpartum pain isn’t something you should just tolerate.”

What Happens to Your Hormones After Giving Birth?

After delivery, estrogen levels drop dramatically, and that can lead to incontinence, painful intercourse, joint pain and even brain fog.

“Many women don’t realize the hormonal shifts after delivery are similar to the menopausal transition,” said Kristin Christensen, a Cedars-Sinai physical therapist who specializes in women’s health.

To complicate matters, the emotional intensity of pregnancy and new parenthood can wreak havoc on your mood and energy levels.

Here are some of the most common postpartum complaints—and what you can do to feel better.

“In the weeks and months after delivery, women frequently put their own comfort on the back burner, focusing their energy on caring for their newborn. But postpartum pain isn’t something you should just tolerate.”

Pelvic Floor Issues and Incontinence After Delivery

Up to two-thirds of women experience urinary incontinence after delivery. The pelvic floor muscles—which support the bladder, uterus and bowel—are stretched and stressed during pregnancy and childbirth, making leaks more likely.

But tightening your pelvic floor muscles with Kegel exercises isn’t always the solution.

“Some women have pelvic floor muscles that are tight but weak, and tightening more with Kegels can make things worse,” said Christensen. “In those cases, women need to learn how to relax those muscles before they can strengthen them appropriately.”

The fix: Learn how to engage—and relax—your pelvic floor muscles. Not sure how to identify and strengthen your pelvic floor? Ask your doctor for a referral to a physical therapist who specializes in pelvic floor therapy, and seek treatment if you have persistent leaking, pressure or pain.

Postsurgical Pain After a C-Section

Women who deliver by cesarean section may experience restrictions in movement that weaken core muscles and contribute to back pain and tightness or numbness around the incision.

“After a C-section, the abdominal muscles need time and the right kind of activation to recover,” said Christensen. “How you get out of bed, lift your baby or carry a car seat can either support healing or slow it down.”

The fix: Be mindful of how you move your body in the days and weeks after surgery. Roll on your side to get out of bed rather than sitting straight up. Instead of crunches, focus on gentle core activation exercises that retrain deep abdominal muscles.

Once your doctor confirms the incision has healed, scar massage can help improve mobility and decrease sensitivity. If you notice increasing redness, warmth, drainage or worsening pain around the incision, contact your provider right away.

Internal Pain and Constipation After Having a Baby

After delivery, women may feel like their internal organs are at risk of falling out. Constipation from hormonal changes and medications can intensify pelvic pain and pressure.

“Tearing during labor is common, and the pelvic floor is very receptive to pain,” said Christensen. “In response, muscles may tighten or ‘guard,’ which can make sitting, bowel movements and even walking uncomfortable.”

While clinicians typically clear women for sex at the six-week mark, some women don’t want to be touched for months after delivery, especially if they’re nursing.

The fix: Don’t assume pain with sitting, bowel movements or penetration is something you have to endure. Your provider may recommend stool softeners, hydration and fiber to ease constipation. “When you resume intimacy, go slowly, use plenty of lubricant and stop if pain persists. Pain is a signal, not something to push through,” said Gregory.

Neck, Shoulder and Back Pain From Holding Your Baby

Caring for a newborn—lifting a baby, leaning over cribs, and bottle feeding or nursing for long stretches—can strain your neck, shoulders and spine.

“Posture takes a real hit postpartum,” Christensen said. “Women are constantly rounding forward to care for their babies.”

The fix: Small adjustments make a big difference.

• When feeding, bring the baby to you instead of hunching over.
• Use pillows to support your arms and back.
• Position your baby at breast or bottle height.
• Relax your shoulders rather than shrugging them upward.

Wrist and Hand Pain From Caring for Your Newborn

Wrist and hand pain is common after delivery. Repetitive motions—buttoning clothes, changing diapers, prepping bottles and pumping—combined with postpartum swelling can irritate tendons and nerves in the wrist.

The fix: Whenever possible, use larger joints instead of smaller ones. Bend at your elbows rather than your wrists when lifting or positioning your baby. Wrist stretches, gentle rotations and wearing a wrist splint at night may also help reduce symptoms. If the pain persists or worsens, ask your provider for a referral to a hand therapist.

Breast Tenderness, Engorgement and Nursing Pain

In the days after delivery, breast engorgement and nipple pain are commonplace. As milk comes in, breasts may feel heavy, swollen, warm and tender. The skin can appear tight or shiny, and nipples may crack or bleed if your baby has trouble latching.

The fix: Work with a lactation consultant to ensure the correct latch. Air dry your breasts after bathing and showering, and apply Lanolin to decrease pain from cracked nipples. “Initially, nursing can be painful, but small changes in how you hold and position your baby can help ensure feeding success,” Gregory said.

To ease engorgement, nurse or pump frequently—about every two to three hours in the early days—to prevent milk from building up. Warm compresses or a warm shower before feeding can encourage milk flow, while cold compresses afterward can reduce swelling. Call your provider if you develop fever, flu-like symptoms or a painful red area on the breast, which may be signs of mastitis.

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When to Get Help for Postpartum Pain

Discomfort after childbirth is normal, but pain that lingers or worsens deserves attention. If your symptoms aren’t improving within six to eight weeks—or if pain is interfering with your ability to care for yourself or your baby—talk to your doctor.

Symptoms that require immediate attention:

• Sudden or severe leg pain or swelling
• Signs of infection (fever, increasing redness or drainage)
• Heavy bleeding or unending spotting
• Chest pain, shortness of breath or severe headache

Most important, be patient with yourself. While new moms generally feel better within six to eight weeks, complete recovery after pregnancy can take up to a full year, depending on your age, health status and prior activity level.

“Even if you’re only a few weeks out or less from delivery, if something doesn’t feel right, speak up,” Christensen said. “With the right support, education and treatment, most women can heal, regain strength and feel more like themselves again.”

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