afterpains
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GC: n

S: COCHRANE – https://bit.ly/2RYe3pg (last access: 14 November 2018); StVinPriHos – https://bit.ly/2FuBpBv (last access: 15 November 2018).

N: 1. From after (Old English æfter “behind; later in time” (adv.); “behind in place; later than in time; in pursuit, following with intent to overtake” (prep.), from of “off” + -ter, a comparative suffix; thus the original meaning was “more away, farther off.”) and pains (pain, late 13c., “punishment,” especially for a crime; also “condition one feels when hurt, opposite of pleasure,” from Old French peine “difficulty, woe, suffering, punishment, Hell’s torments” (11c.), from Latin poena “punishment, penalty, retribution, indemnification” -in Late Latin also “torment, hardship, suffering”-, from Greek poine “retribution, penalty, quit-money for spilled blood,” from PIE *kwei- “to pay, atone, compensate”).
2. Afterpains are contractions of the uterus that are experienced after the birth of your baby. They help:

  • reduce uterine bleeding, as they pinch off the blood vessels where the placenta was attached to the uterus;
  • shrink the uterus back to the size it was before you were pregnant, called ‘involution’.

3. Uterine cramping caused by contraction of the uterus and commonly seen in multiparas during the first few days after childbirth. The pains are more severe during breastfeeding but rarely last longer than 48 hr postpartum.
4. Afterpains may be worse and more intense if:

  • you delivered a large baby;
  • you’ve delivered more than one baby;
  • this isn’t your first baby.

This is because the more the uterus has to stretch the more it has to shrink.
5. Patient care:

  • Types of analgesia used to relieve the pain include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) included aspirin and naproxen, opioids including codeine and non-pharmacological methods such as transcutaneous electrical nerve stimulation (TENS).
  • *Only naproxen is still used in women who are breastfeeding.
  • *Aspirin is not recommended for use by breastfeeding women as there is concern that it will be passed to the baby in the breast milk. Aspirin should not be given if there is a tendency to bleed.
  • *Codeine was not always more effective than a placebo or NSAIDs in the included studies and can sedate breastfed babies. Women offered codeine for pain relief should be informed about the potential for adverse effects for their babies. Codeine should only be prescribed for breastfeeding women with after birth pain if there is no alternative and their breastfed infants should be closely monitored for sedation and signs of codeine toxicity.
  • Emptying the bladder can relieve pain.
  • The sooner an analgesic is given, the less is needed.

6. Physical Changes:

  • The vagina stretches to a larger than normal size during birth but will almost return to its prepregnant size during the first 6 weeks after birth. Doing Kegel exercises can help speed up the return of strength and tone to the vagina.
  • Stretch marks might have formed on your abdomen during your pregnancy. You may notice them more now since they are not stretched out flat. Stretch marks will stay red to purple for a while. Over the next 6 months they will get lighter on white skin and darker on black skin, but they will never go away completely.

S: 1. OED – https://bit.ly/2Bh6VPm; https://bit.ly/2A7uqIP (last access: 19 November 2018). 2. StVinPriHos – https://bit.ly/2FuBpBv (last access: 15 November 2018); CTORTHO – https://bit.ly/2FuBMfn (last access: 15 November 2018); HP – https://bit.ly/2A8nI5d (last access: 16 November 2018). 3 & 4. MEDICALDICT – https://bit.ly/2Abl2Ea (last access: 14 November 2018). 5. COCHRANE – https://bit.ly/2RYe3pg (last access: 14 November 2018). 6. HP – https://bit.ly/2A8nI5d (last access: 16 November 2018).

SYN:
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CR: Cesarean section, childbed, childbirth, midwife, oxytocin, pain, pregnancy.