Dear Doctor, 

I gave birth six moths ago, but I still feel pain around the stomach. Should I be worried that one of my inner organs got damaged?

Mercy Rulindo

Dear Rulindo,

Abdominal pain can normally occur after child birth and can continue for weeks and months. The most common cause of abdominal pain after delivery is the strain put on the muscles of the abdomen, back and thighs during labour. Even muscles can tear in the process due to the strain, causing much pain until they are healed. Holding and feeding the baby in uncomfortable postures adds on the strain and pain. The evolution of the uterus back to its normal position can take a few days or weeks depending on levels of the hormone oxytocin. Breastfeeding the baby stimulates release of this hormone, causing delayed evolution of the uterus.

After delivery, some women tend to develop constipation which can contribute to the pain.

If episiotomy is done during delivery to facilitate passage of baby it can cause pain afterwards until the cut is healed totally.

Infection of the uterus or pelvic parts or bladder acquired after delivery or repeated infection can be reason for stomach pain after delivery. Here the pain may be concentrated more in lower abdomen. There may be associated symptoms of itching, vaginal discharge and or pain during urination. Those with diabetes or even poor hygiene are more susceptible to get these kind of infections.

If delivery was through C-section, there is theoretical risk of infection of abdominal muscles during the surgery which can cause persistent pain. Pain can even continue until the surgical wound has healed. Adhesions can form in the abdomen later on after a C-section causing pain.

It is better for you to consult a gynecologist and get tests like clinical examination and ultrasound done to know the precise cause of pain.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital