During pregnancy, the uterus grows to accommodate the fetus, causing cramps and occasional ruptures or bleeding. The uterus returns to its normal size after delivery through contractions and involution.
Many changes happen to the uterus during pregnancy. Grows much larger to accommodate the growing fetus; can cause menstrual cramps; and, on very rare occasions, the uterus may rupture or bleed heavily. In most cases, the uterus returns to its normal state once the pregnancy is over.
The first change in the uterus occurs when the egg implants in the first week. The implantation itself is not obvious, but is usually accompanied by some light bleeding five to 10 days later. The amount of blood is so small that most women are unaware of it.
Pregnancy cramps are another common symptom. The sensation is similar to menstrual cramps and is caused by the uterus expanding to accommodate the growing fetus inside. Sharper, but similar pains can be attributed to round ligament pain. The uterus is held in place by ligaments that need to stretch to help stabilize the growing uterus during pregnancy. This stretch can cause temporary pain, especially with sudden movement.
Over the course of nine months, the uterus will grow from about 2.5 ounces (71 g) to about two pounds (91 kg). By the end of pregnancy, a woman’s uterus will extend from the pelvis to the bottom of the ribcage. It will weigh 15 times more than it did before pregnancy – not including the fetus – and can hold 500 times more than it did before conception. The larger uterus is one reason why many women often need to urinate frequently during pregnancy, as the larger uterus puts pressure on the bladder while simultaneously suppressing its capacity.
Rarely, a uterine rupture can occur during pregnancy, usually during early labor. This most commonly happens through the incision from a previous C-section, which is why many doctors recommend that a woman who has had a C-section should have subsequent children in the same way. A rupture can be life-threatening for both the mother and the baby. It can also result in the need for a hysterectomy.
Any changes that occur in the uterus during pregnancy should fade within about six weeks after delivery. Contractions after birth cause the uterus to shrink to its normal size in a process called uterine involution. The pains associated with these contractions are called afterpains and feel like cramps.
One week after birth, the uterus should be reduced to about one pound (45 kg). After two weeks, it will weigh about 11 ounces (311 g). By four to six weeks after delivery, your uterus should be back to its pre-pregnancy weight.
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