After-pains (Afterbirth Pains) are cramping uterine contractions experienced after delivery:

Mechanism: During breastfeeding, infant suckling stimulates posterior pituitary to release oxytocin (Ferguson reflex). Oxytocin acts on uterine myometrium → contractions → promotes uterine involution.

\[\text{Suckling} \rightarrow \text{Posterior pituitary} \rightarrow \text{Oxytocin release} \rightarrow \text{Uterine contraction}\]

Key facts:

• More intense in multiparae (uterine muscle more stretched, needs stronger contractions)
• More noticeable during first few days postpartum
• Normal duration: \(2{-}7\,\text{days}\) postpartum
• Management: reassurance, NSAIDs (ibuprofen) if severe (compatible with breastfeeding), warm compress

Uterine involution:

• Immediately after delivery: fundus at umbilicus
• Day 1: \(1\,\text{cm}\) above umbilicus
• Descends \(1{-}2\,\text{cm/day}\)
• By day 10: not palpable abdominally
• Returns to pre-pregnancy size by \(6\,\text{weeks}\)