Immediately after the expulsion of the placenta in the postpartum period, the uterus begins to contract, decreasing in size. In this process, it is cleansed of blood and the remains of a child's place. In different women, the return of the uterus to the previous state occurs unequally and can occupy different time intervals. In addition, there are a number of factors that contribute to or hinder a faster reduction in the uterus. In particular, everyone knows that during the suckling of a baby's breast in the woman's body, the hormone oxytocin is released, which leads the uterus into tone, strengthening its contractile activity.
To return the uterus to pre-pregnancy size, an average of 1, 5-2, 5 months is required. The uterus most actively decreases in the first days after birth, losing about half its weight in the first week. This process is accompanied by cramping pains in the lower abdomen, and more pronounced and intense after repeated delivery. But it happens that the uterus after birth does not contract or shrink very slowly. More precisely, most often there is a decreased ability of the uterus to contract (hypotonia of the uterus), and complete paralysis of the uterine muscles (atony) is less common.
Hypotension is potentially dangerous for a woman, as it causes postpartum hemorrhage and a number of other complications.
Why does the uterus not contract after delivery?
Gynecologists identify several factors that affect uterine contraction in the postpartum period:
- features of the course of pregnancy and childbirth;
- the number of fruits;
- the location of the placenta;
- the weight of the child;
- the state of health of the mother in childbirth and so on.
Thus, uterine contraction may occur more slowly if the pregnancy was prolific, proceeded with complications (gestosis, nephropathy, hypertension), there was a presentation or a low attachment of the placenta, the body and nervous system of a woman were depleted, the baby is quite large, labor activity was poor, the woman does not move after childbirth. Poor or not at all the uterus contracts after giving birth if there are the following factors:< ul>
The soft bottom of the uterus speaks of the low ability to contraction, which a gynecologist can establish upon examination of the mother in childbirth.
If the uterus does not contract after giving birth
The condition of the uterus and its contractile activity is checked in the hospital, and more than once. Immediately after birth, a cold water bottle is applied to the abdomen to stop the bleeding and accelerate the contraction of the uterus.
A woman is not discharged from the hospital until the uterus begins to contract normally. If she is not able to cope on her own, the doctor will prescribe to the woman the uterine contractions enhancing the contractile activity (usually oxytocin or prostaglandins), as well as, perhaps, a massage of the uterus bottom, which is made through the abdominal wall.
To strengthen the contractions and accelerate the recovery of the uterus in size after delivery, it is very important to immediately start breastfeeding (feed on demand) and, if possible, just move. It is recommended to lie more often on the stomach.
If the uterus does not shrink after childbirth, then the remains of the placenta and lochia may be retained in its cavity, and internal uterine sores can be clogged with blood clots, which leads to the development of an inflammatory process in the uterus and, even beyond its limits. Therefore, if the described actions are ineffective in case of weak contractile activity of the uterus, the woman is sent for purging. It's a bit of a shame to admit, but very often doctors act so solely because of reinsurance: probably for many it's no longer a secret that most of them do not care about the health of the mother and child, but try to normalize the condition only for the duration of stay in the hospital, to absolve oneself of responsibility.
However, it is possible that the uterus does not contract at all after childbirth and no measures improve the condition of the mother. In this case, surgery and even removal of the uterus may be required.
So it's always necessary to have your "own" gynecologist, which you trust in all matters and can consult with him in case of need.
But in most cases, the contractile activity of the uterus can be strengthened by these methods.