Afterpains are uterus contractions that happen after labor.  They are absolutely necessary; these contractions bring the uterus back down to its pre-pregnancy size. They generally feel like mild cramps during a menstrual cycle or like mild labor pains.  However, they get more intense after every delivery, meaning that first-time moms won’t feel them too much (usually), but by the third baby they can be much more intense.  They are mostly felt during breastfeeding, as they are created by oxytocin working on the uterus, and large amounts of oxytocin are released during breastfeeding.  I know of one mom who has three children, and she said that feeding her third was agony – not because of breastfeeding, but because of the afterpains.  She had to take pain medication before every feed otherwise she just couldn’t bear it.

Homeopathically, there is a lot to consider here.  Unlike other complaints I have covered in my post-partum series so far, where there is one “classic” remedy to know, with labor pains there are many possible options.  Because the main complaint -  after pains – is essentially uterine cramps, most remedies are going to be somewhat indicated.  In other words, most medicines are going to have some kind of abdominal cramping as a symptom.  So here is a situation where I would recommend having someone take your whole case, because what will distinguish one remedy from another are things like how your labor went, how your milk is coming in (or not) and your mental state in this early postpartum period.  Nonetheless, here are a couple remedies to pay special attention to:

Arnica!

Our old favorite!  Arnica, as a remedy indicated to heal from the physical trauma of birth – whether by C section, vaginal unassisted, or vaginal assisted – is a great one to try first for your afterpains, because it helps with other stuff anyway!  There’s no real downside to trying it out first. Boenninghausen in his Characteristics notes that Arnica is helpful with after pains that are too intense and long continued.  In the Materia Medica, we also read plenty of indications for spasms, cramps, and abdominal pains (237-241, 394, 426, 447, 482, 492 in Hahnemann’s Materia Medica Pura). 

Chamomila:

Chamomila is a remedy known for pains that seem absolutely impossible to bear - “unendurable” pains that cause a sinking down feeling and weakness are the way Boenninghausen puts it in his Characteristics. Hahnemann notes that this remedy is absolutely not suited “for persons who bear pain calmly and patiently” (introduction to Chamomila in his Materia Medica Pura). Pains are often worse at night, accompanied by feelings of heat and sweating (this is a common remedy to use during labor as well). There may be oversensitivity of all the senses as well - sensitive to noises, light, foods, odors. This oversensitivity may be felt more acutely after coffee or a painkiller (Boenninghausen’s Characteristics). Here are some of the amazing tidbits from Hahnemann’s Materia Medica Pura that match the intensity of some women’s afterpains: Pressure on the stomach, as if a stone pressed downwards (170); Extraordinary pain in the abdomen, owing to which he did not know how to rest (182); Amid severe pains as if going to get a child, and like labour pains in the womb, frequent discharge of clotted blood, with tearing pains in the blood-vessels of the legs (228); Drawing from the anterior part of the sacrum, grasping and griping in the womb, and then large pieces of blood are always passed (229). Note that while the symptoms 228 and 229 are talking about menstrual discharges of blood, with afterpains, the discharge of lochia is often increased (the uterus contracting pushes out lochia), so these two symptoms fit the phenomenon of intense uterine contractions, followed by bloody uterine discharge.

Pulsatilla:

Pulsatilla patients are often timid, weepy, want company and fresh air (or an AC/fan) and are made much worse by heat. It’s a very common remedy during labor when labor ceases or the contractions are weak, especially if the person had a lot of back pain during labor and/or the after birth was delayed (Boenninghausen’s Characteristics). Afterpains may feel griping and feel better binding up the stomach (Hahnemann MMP 427) or feel like a downward pressure.

Sabina:

Sabina is a remedy known for passage of lots and lots of blood and clots. In the postpartum, this would look like increased amounts of lochia, which may be profuse enough to gush, especially after standing from sitting and when moving around(Allen’s Encyclopedia). The pains typically would feel like they go from the lower back or sacrum and go through to the pubic region (Boenninghausen’s Characteristics).

Rhus-Tox:

Rhus-tox is a remedy commonly needed after a lot of physical labor - think someone who lifts too much at the gym and gets super sore afterwards. If you had a very physical delivery, maybe the pushing phase lasted a really long time, for example, and you feel the physical effort took a lot out of you, and now you have severe afterpains, then consider Rhus-Tox. People who need this remedy are also commonly restless and feel much worse if they stop moving. For example, you may find taking short walks around the house or doing light cleaning helps you feel a bit better, rather than lying in bed all day.