Let's learn about how the uterus returns to normal after having a baby (uterus involution)?

After having a baby, do you feel a little pain in your lower abdomen, like when you have your period? Even though the baby is out, is your belly still a little big? Don't worry, mom, this is all normal. This is because your uterus is starting to shrink back to its original size. In medical terms, we call this 'uterus involution'. Today, we're going to talk about this important, natural process.

Simply put, what does this uterine restoration mean?

Uterine involution is the process by which your uterus, which has grown to accommodate your baby during pregnancy, shrinks back to its previous size after delivery. Think of it like a ball. Your uterus gradually grows larger over the months after you have a baby. It should shrink back down after delivery. That's why we call it involution. This process starts soon after delivery and lasts for about six weeks. This is when you experience postpartum bleeding and discharge called lochia.

This is a very important part of your body's healing process. Considering how big and how much your uterus has changed during pregnancy, it's normal for it to take a while to get back to its original size.

Why is this process important?

The main goal of this is to return the uterus to its pre-pregnancy size. During pregnancy, the uterus expands several times its normal size. It also develops extra blood vessels and tissue to provide nourishment for the growing baby. After the baby is born, the body no longer needs this extra space or tissue.

So what this ``(Involution)`` process does is remove that unwanted tissue, shrink the uterus, and prepare the body to start your monthly menstrual cycle again.

How does this process happen?

This process begins after you deliver the placenta, which is the third stage of labor. Then your uterus starts to contract again, or shrink. These contractions reduce the amount of blood flowing to the area where the placenta was attached to the uterus. This is actually the body's defense mechanism. This is what prevents excessive bleeding (Postpartum Hemorrhage).

These contractions are what cause the uterus to shrink and the unwanted tissue I mentioned earlier to pass out of the body as ``Lochia''. These contractions are often regular and a bit strong within the first 12 hours after the baby is born. You may feel a cramp in your lower abdomen during this time. We call these "afterpains".

The complete ``involution`` process takes about six weeks to complete. Day by day, the weight of the uterus decreases, and its space in the pelvic cavity also decreases. This is why your belly is still a little big for a while after the baby is born. Even though the baby is now outside, the uterus still takes up a lot of space in your abdomen.

How does breastfeeding affect this?

If you breastfeed your baby, your uterus contracts more quickly. This is because when your baby sucks or you pump, your body produces a hormone called `(Oxytocin).` This hormone helps your uterus contract more effectively. That's why you feel a little more sore when you breastfeed. But it also means that your body is healing properly.

How do doctors check if this is going to work?

While you are in the hospital, a doctor or nurse will come regularly to check that this process is going well.

• They will place their hands on your belly and press down on it to look at the top of your uterus (fundus). This is called checking the fundal height.
• They also check to see if the uterus feels hard and lumpy.
• The amount and color of your vaginal discharge (Lochia) will also be checked at this time.

For example, if your uterus is not contracting as expected, or if it feels soft to the touch, you are at increased risk of postpartum hemorrhage. If this happens, your doctor may massage your abdomen with their hands to help your uterus contract. Sometimes, they may also give you a medicine called Pitocin, which contains the hormone oxytocin, to stimulate contractions.

How does the uterus change during this time?

Most of the time, everyone's uterus loses weight and size in a similar time frame. However, the size of your uterus may vary slightly depending on factors such as whether you have had children before, whether you had twins, and where you gave birth during your pregnancy.

Here's how the uterus typically loses weight.

Also, here's how the uterus moves back into the pelvic cavity and shrinks.

What problems can arise in this process?

There are two main problems that can occur: Subinvolution and Postpartum Hemorrhage.

1. Subinvolution (the uterus does not contract properly)

This means that your uterus is not shrinking as quickly as we would like. Sometimes this can happen because the blood vessels where the placenta was attached are not closing properly.

If your doctor suspects this during an abdominal examination, they may recommend an ultrasound scan. Also, if you experience dark red bleeding for more than a week after delivery, this could also be a sign of this condition. There are several reasons for this:

• Infections of the uterus, for example `(Endometritis)`.
• Things like pieces of the placenta remaining inside the uterus.
• The pain of childbirth has become too much.
• Having had a cesarean section (C-section).

2. Postpartum Hemorrhage - PPH (Postpartum Hemorrhage)

This is a serious, potentially life-threatening condition. PPH is excessive bleeding from the uterus after delivery. It often occurs when the uterine contractions are not strong enough after delivery.

PPH usually occurs within the first 24 hours after delivery, but sometimes the risk can persist as long as 12 weeks.

How should you take care of yourself during this time?

The time after having a baby, that is, the postpartum period, is a time when you need to take care of yourself as well as your baby. Get plenty of rest. Get help from your family and husband to take care of the baby.

Those "afterpains" that I mentioned earlier can sometimes be a bit intense, especially when breastfeeding. You may feel a sharp pain for about 5 minutes, then it may feel like it gradually subsides. Here are some things you can do to help manage this pain:

• Do breathing and relaxation exercises used for labor pain.
• Place a pillow under your stomach and lie flat on your back.
• Take a walk.
• Take a pain reliever that your doctor recommends. Something like ibuprofen may work better than paracetamol, but be sure to talk to your doctor before taking anything.

The uterus returning to its normal shape is a very important, natural process. But sometimes, the uterus needs a little help on this journey. That's why the medical team will check you regularly in the hospital after you have your baby. These checks may seem like a hassle to you, because you want to be free with your new family member. But these checks are essential to detect complications like PPH early.