Some reasons for postpartum pain can be tied into the hormones that a woman’s body releases during her pregnancy. As I discussed in last weeks blog the hormone “Relaxin” is responsible for the softening of the ligaments essential for the delivery of the newborn baby. This hormone can take about 5 months to leave your body if you are not breastfeeding and can last up until 12 months if you are. Because of this you are much more prone to sprains and hurting yourself than you would be normally. The most common conditions that we see in our office after delivery are listed below and can respond with the same success that you may have experienced during your pregnancy.

1. Sore Muscles

You might find that your whole body is sore, from laboring in different positions and pushing. This might be a shock. You assume certain parts of your body would be sore, like your bottom, but why are your arms and legs sore?
We weren’t joking when we said labor was a marathon, and even a short labor can cause muscle strain and stiffness.
Sometimes your hips can really be sore as well. This can be from having your legs placed in stirrups for hours upon hours, or having your support team pull your legs in odd positions.
Your back might be sore if you had an epidural or if you had people using counter pressure from back pain in labor.

2. Joint Pain

You may also experience pain in joints throughout your body, including your hands, wrists, feet, and ankles. These pains may be due to the position you were in during delivery and recovery.

Your joints may also still be affected by the chemical changes during pregnancy that caused them to loosen. Carpal tunnel syndrome, pain in your wrists due to compression of nerves as they travel through the wrist to the hand, can take longer to go away and contribute to postpartum pain.

3. Headaches

You may experience more frequent or more severe headaches after delivery. This can be due to changing hormones, stress, and sleeplessness. However dehydration often plays a leading role in headaches. Dehydration is especially likely if you are breastfeeding. Try to keep a full bottle of water close by to sip throughout the day.

4. Back, Neck, and Shoulder Pain

Back pain is common during pregnancy. You may find that you still have back pain after delivery, although for different reasons. These can include the strain of labor and delivery or using an awkward posture while holding or breastfeeding your baby.

With time and with the aid of a treatment plan, postpartum pain will subside and you will feel more like yourself.

It is important for the expecting mother and everyone involved to stay well-informed of circumstances women encounter during pregnancy, particularly normal circumstances. Being well-informed of these circumstances along with when and why they occur makes the treatment change from trimester to trimester of the expectant mother.

First Trimester

Morning sickness is common during the first trimester of pregnancy. The woman tends to be nauseated with or without the presence of vomiting. Multiple etiologies have been cited as reasons for morning sickness. Hormonal influence on the GI tract, the growing uterus and emotional situations are among the most common. Changes in taste and smell also can occur with pregnancy. This can leave the woman hypersensitive to certain tastes or smells: tastes and smells that were not disturbing before. Nausea and/or vomiting may result from these hypersensitivities. Nausea and vomiting may prevent adequate nourishment, resulting in weight loss of 5 pounds or less. Weight loss of greater than 5 pounds is a concern and should be investigated.

Second Trimester

As the uterus grows during gestation, the round ligaments supporting the uterus are placed under tension. This tension can lead to stretching, resulting in lower abdominal and/or groin pain. This pain can be unilateral or bilateral and often occurs when the expectant mother shifts positions. This condition is most common in the second trimester. During the second trimester fatigue is another common occurrence. Factors that induce fatigue: increased energy requirements, stress placed on postural muscles as a result of weight gain, shifts in the center of gravity and sleep disturbances. Fatigue associated with weight gain will get worse if the patient gains more weight than expected during the pregnancy.

Third Trimester

Edema in the extremities is common during pregnancy especially during the third trimester. This is a result of decreased lymphatic flow and increased venous pressure. Significant swelling of the lower legs occurs as a result of these changes. Gastrointestinal symptoms are common once again in the third trimester and throughout pregnancy. Esophageal reflux can occur when hormonal changes result in relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus, creating “heart burn.” As the baby grows the most during this final trimester the increased abdominal size causes a shift in the center of gravity and increased strain on postural muscles. This is further complicated due to the production of the hormone relaxin during the third trimester. Relaxin’s function is to loosen ligaments of the pelvis to allow expansion of the pelvis and birth canal during delivery. The result in increased postural strain on a now- unstable frame. Relaxin is not target specific and circulates systemically so it can affect joints other than those of the pelvis, causing further postural and skeletal complications. As a result of postural changes the body makes during the three trimesters and an increase in relaxin during the final trimester it makes treatment of these gestational changes usually quite responsive to chiropractic care. A special point must be made regarding the effects of relaxin. The effects of the hormone are not reversed until 3-4 months post – partum. This means chiropractic care during the first three to four months post – partum is as important as care during the pregnancy.

Next weeks blog I will cover treatment after delivery for the mother and starting care for the newborn.