You’ve just welcomed your new baby into the world. Regardless of whether you had a vaginal birth or C-section, there is one thing you can count on. Bleeding after pregnancy, also known as lochia. It’s your body’s way of return back to normal. Your blood loss can tell a lot about your labor recovery.
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Let’s face it; it can be a taboo subject among moms. So how do you know what to expect? I have developed this guide to give you the good, the bad and the ugly on postpartum bleeding. In this article I’ll discuss:
- Timeline of bleeding after pregnancy
- Factors Affecting Bleeding
- Manage the bleeding
- When to seek help
Timeline of Bleeding after Pregnancy
This timeline is for general reference. You may vary slightly for this, as each woman will recover differently. If at any time you are concerned about our bleeding contact your healthcare provider.
Immediately after birth
Normal: Heavy, Fresh red blood
After your baby is born, you will then need to deliver the placenta. This is known as the third stage of labor. An actively managed third stage involves an injection and pulling on the placenta to remove it quickly. A physiological third stage is when the placenta is delivered with no interference.
Bleeding in the third stage can be minimal or excessive. Postpartum hemorrhage is when you lose over 500ml of blood.
Women can lose a lot of blood very quickly after birth. Your birth attended will be very skilled in dealing with this. They may need to give you extra medication, fluids or medical techniques to stop the bleeding.
Your bleeding will be closely monitored for around 24 hours after birth.
Day 1-4 after birth
Normal: Heavy, Bright red/ dark red, fresh blood. Similar to a heavy period.
Your bleeding will continue to be somewhat heavy for the first day. It should be similar to an average heavy period for you. Expect to be changing a soaked pad every couple of hours.
It’s not uncommon to pass a few small clots. Anything smaller than an egg size is not unusual. Larger than this you should try to keep them and show to your doctor or midwife. They will then check them for any small pieces of placenta which can be left behind.
You will need to wear heavy flow maternity pads.
Day 5-8 after birth
Normal: Average, red/pink or brownish
Your bleeding will start to minimize slightly. You will notice that your pad is not as soaked when changing.
Over the days the volume should get less and less, just like when your period is finishing.
You can still experience clots at this stage, but they should be smaller than a dime. You may be able to change from heavy flow to normal flow maternity pads.
Day 9-14 after birth
Normal: light, pale pink or light brown
The bleeding will continue to lessen over time. Color should now be a pale, watery pink or brown. The amount should be similar to the end of a period.
Pads shouldn’t be soaking through, more like a minimal discharge than bleeding. See our factors below which may affect the blood flow during this time.
Most women change to thin panty liners around this time.
3-4 weeks after birth
Normal: None or minimal, pale pink, brown or cream
Bleeding continues to decrease and may minimize to nothing at all. Any loss you have is similar to discharge rather than a bleed at this stage.
You may be able to stop wearing any sanitary protection.
Up to 6 Weeks after birth
Normal: Regular vaginal discharge
By 6 weeks after birth, your bleeding should have stopped. If you start to notice an increase in minimal or average bleeding, it’s most likely the return of your period.
When you exclusively breastfeed, your period may be delayed, due to increased hormones.
If any problems persist at this time contact your health care provider for advice.
Factors Affecting Bleeding
Your hormones will remain at higher levels when you’re breastfeeding. This helps to control your bleeding, and tail it off at a more natural rate. You may feel your tummy tightening or pains as you feed your baby. Breastfeeding helps your uterus to contract and can cause small gushes of blood. This should settle after you have finished feeding.
You’ll want to start getting out and about when you feel ready. This is usually a few days after birth, and you’ve had plenty of rest. You may notice an increase in bleeding after you’ve been more active. If you notice a heavier loss consider if you’ve been out walling with the pram, upstairs or lifting the car seat. As long as the loss is not bright red and begins to settle then, this is normal.
You may have experienced some problems in the third stage of labor, which can affect your bleeding. Usually, these can make you bleed longer or cause more clotting. Longer recovery times usually occur in women who had an:
- Active third stage
- Incomplete placenta
- Retained placenta
You may be prescribed blood thinning medication to prevent clots after delivery. This can make your blood loss appear thin and watery. This medication should not affect how heavily you bleed or the color of the loss.
Lying flat can cause your bleeding to pool until you stand up. You will usually notice a heavier flow of blood after your wake from sleep or mobilise after a C-section.
Manage the bleeding
Bleeding after birth should not be treated the same as your normal period. Your body is at greater risk of infection, and you need to monitor your blood loss.
Your will need to wear maternity pads immediately after your baby is born. Maternity pads are thick and can absorb the heavy flow. Maternity pads are large and cushioned and more comfortable in such a tender area. They also make it easier to see any clots you pass.
After a week or two, you should be able to use regular flow sanitary pads. Once the bleeding minimizes, you can then use thin panty liners.
You should change your pad every 2-3 hours or more if soaked. Monitor the color, volume, clots or any funny smells. Any concerns should be discussed with your doctor or midwife.
Don’t use tampons for at least 6 weeks after birth. They increase your risk of an infection in your vagina or uterus. Tampons also make it difficult to monitor how much blood you’ve lost.
It’s important to regularly pass urine after birth. You should be emptying your bladder frequently and no more than 4-hour intervals between. Increase your fluid levels if you are passing small volumes. A full bladder will prevent your uterus contracting and may prolong your bleeding.
Don’t overdo it too early. New moms are often busy or want to get back to their routine. It’s important to find time to rest and let your body recover. You’re bleeding increases with activity, a sign your body is telling you to slow down.
When to Seek Help
Your blood loss can tell you if you are unwell or require medical treatment. Be vigilant for any of the following signs.
Sudden heavy bleeding
If you start to bleed heavily, feel faint or very unwell call 911 immediately.
If you are soaking a thick maternity pad every hour, this is not normal. Seek medical attention as this may be a delayed hemorrhage which needs to be treated immediately.
Bright Red Loss
Your bleeding should minimize by 5 days after birth. Any ongoing bright red loss should be discussed with your doctor or midwife for advice.
This is a sign that you may have a uterine infection. Your tummy may feel tender to touch. This is most common in women who had C-sections, forceps or and incomplete placenta. You need an immediate medical assessment for postpartum sepsis.
Another sign of infection is offensive smelling pads. This may be caused by an infection in your uterus, vagina or a urine infection. Contact your care provider as you will need antibiotics as soon as possible.
This can indicate problems with your uterus contracting. Often it is caused by small pieces of membrane left by the placenta. Without treatment, you may develop an infection or start to bleed heavily. Treat is usually oral antibiotics.