How Long Does It Take for the Uterus to Shrink After Birth?

Our bodies are designed to carry babies, but pregnancy still puts a lot of pressure on the uterus and abdominal wall. After giving birth to my second child, I knew it’d take a while for my lower belly to shrink. I was still dismayed when, two years on, it remained noticeably puffier than before I had kids.

But what I was noticing wasn’t my uterus. Rather, it was my weakened ab muscles, which were less able to hold my insides in. As for my uterus? It had shrunk back to its normal size all on its own. So how long does it take for the uterus to shrink after birth—and how does it happen? Read on to learn more from experts.

What Is Involution of the Uterus?

Uterine involution (involution of the uterus) is the shrinking of the womb back to its pre-pregnancy size. It happens naturally within the first few weeks of delivery.

Does Uterine Involution Hurt?

Involution of the uterus can be uncomfortable or even painful, since it involves uterine contractions. The larger the uterus, the more painful the contractions—which means the discomfort will be greatest right after you give birth. “It’ll start off feeling like very mild labor contractions and then become more like menstrual cramps, with lessening severity over time as the uterus gets smaller,” explains Mahino Talib, MD, an ob-gyn and clinical assistant professor at NYU Grossman School of Medicine’s department of obstetrics and gynecology. If you had a C-section, you may experience pain from both involution and the C-section incision itself.

That said, call your doctor immediately if you have uterine pain accompanied by:

• fever
• nausea
• vomiting
• dizziness
• foul-smelling discharge
• very heavy bleeding (soaking through two pads in an hour)

To relieve the pain, your doctor will recommend ibuprofen (Advil) or acetaminophen (Tylenol). "Ibuprofen is great for muscle pain, and the uterus is a muscle,” says Alessandra Hirsch, MD, an ob-gyn at NewYork-Presbyterian/Columbia University Irving Medical Center. Abdominal binders, warm compresses and soaking in the bath may also help (along with abdominal massage, as long as you didn’t have a C-section).

How Long Does It Take the Uterus to Shrink After Birth?

The uterus will gradually shrink back to its normal size during the first six weeks after delivery—around the time when you’ll see your provider for a follow-up. At this visit, your doctor will usually palpate your abdomen to feel for the uterus and make sure that everything is back to normal, says Hirsch. The timing, however, varies from person to person, says Talib. It may take up to 12 weeks for the uterus to return to its pre-pregnancy size, especially if you carried multiples.

If this isn’t your first pregnancy, your uterus may be a bit more stretched out immediately after birth. Any difference in size should be minimal within 24 hours post-delivery, says Talib.

How long does it take the uterus to shrink after C-section?

While you might think surgery would impact the uterus’s ability to shrink, the body is incredibly adept at healing after pregnancy. It takes the same amount of time for the uterus to shrink after C-section—generally around six weeks—as it does for a vaginal delivery.

Are There Ways to Help the Uterus Shrink Faster?

Breastfeeding and pumping breast milk cause the uterus to shrink a bit faster, since nipple stimulation stimulates the release of oxytocin. This hormone “causes more uterine contractions and faster involution,” explains Talib. Don’t stress if you can’t or decide not to breastfeed. “The uterus is a small organ and shouldn’t be noticeable from the outside by six weeks postpartum,” says Hirsch.

Does the Uterus Continue Shrinking Years After Birth?

The uterus doesn’t continue shrinking years after birth; it should be back to its pre-pregnancy size within 12 weeks. That said, the uterus might be larger than before with age due to conditions such as fibroids and adenomyosis, says Talib.

You may also notice your lower belly looks puffier even years after pregnancy. But this isn’t because of your uterus. It’s usually due to weakened ab muscles as well as diastasis recti, a condition where the ab muscles separate down the midline. “This is because the fascia below the muscles that is attached to it has stretched to accommodate the growing pregnancy,” explains Talib.

The best way to prevent diastasis recti is to regularly exercise during pregnancy, “though there’s some evidence that shows abdominal exercises in the postpartum period can help," says Hirsch. Your practitioner will tell you when it’s safe to start working out again—generally within six weeks of delivery. Core exercises can help you to regain strength and stability of the pelvis.

The weeks after giving birth are tough, and your body may not feel fully back to its new “normal” until at least two years postpartum. So be kind to yourself. “Your body just did the most phenomenal and amazing thing and should be celebrated for it,” says Talib.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.