Postpartum bleeding: What to expect

Postpartum bleeding is normal after childbirth and is a temporary condition. Here’s what you can expect depending on the type of delivery you had and when to seek your healthcare provider.

What is Postpartum Bleeding?

During pregnancy, a woman’s body goes through a lot of changes. You may experience certain changes after delivery including breast engorgement, back pain, and lochia (bleeding).

Postpartum bleeding also known as “lochia,” is the discharge of blood and mucus through the vagina after the delivery. It consists of mucus, extra blood, and tissue needed during pregnancy. Lochia is a similar type of discharge as menstrual discharge and has a stale, musty odour. This is a common and natural condition after childbirth, irrespective of your delivery type.

Postpartum bleeding is usually heavier in the early days and of a dark red colour for up to ten days after delivery. After this, it turns out to be lighter bleeding and spotting, which last for four to six weeks post-delivery. However, depending on the woman’s health condition, the bleeding may end sooner or later.

STAGES OF LOCHIA

There are three different stages of lochia including;

• LOCHIA RUBRA

The very first stage of lochia is when you experience dark-coloured blood that lasts up to three or four days. You can also have symptoms like cramping and heavy leaking during this period.

• LOCHIA SEROSA

This is the second stage of lochia, where you can expect a pinkish-brown discharge, less bloody and more watery with moderate blood flow. This condition lasts for four to twelve days.

• LOCHIA ALBA

The third stage of lochia is known as lochia alba, which lasts from about twelve days to six weeks. In this stage, you experience little to no blood and a yellowish-white discharge.

Why does vaginal bleeding happen after childbirth?

Postpartum bleeding is the result of the uterus replacing its lining after delivery. To keep the fetus healthy and safe during pregnancy, the womb releases extra blood and tissue. The hormonal changes in the mother’s body thicken the lining of the uterus to support the placenta.

Post-delivery, the uterus shrinks and gets back to its normal size and sheds the extra tissue which is of no use in the form of vaginal bleeding. This bleeding is known as lochia.

Bleeding also happens during the delivery. Through vaginal delivery, a woman typically loses 500 ml of blood and twice as much in caesarean delivery.

What causes postpartum bleeding?

After childbirth, every woman has vaginal bleeding, which is called lochia in medical terms. Through this, your body gets rid of extra blood and tissue in your uterus that helped your baby grow. Bleeding is most severe in the first few days after delivery, but if it persists, you are at risk of postpartum haemorrhage.

Certain things increase the chance of postpartum haemorrhage; some of them are mentioned below:

• Uterine atony
• Retained placenta or membranes
• Tears in the vagina or cervix post-delivery
• Uterine rupture

What can you expect?

A few days after you give birth, you discharge dark red blood with some clots. For that, you have to wear hospital-grade pads, as you are having heavy flow. After that, when you are at your home with the baby, you will experience little blood as you are moving around a lot.

After 10 days, you should see some bleeding and clotting that lasts up to six weeks after the delivery. However, the amount and type of bleeding vary from pregnancy to pregnancy, but it should change and become lighter over time.

Symptoms of postpartum bleeding

The most common symptoms of postpartum bleeding include heavy bleeding, a decrease in blood pressure, an increase in heart rate, swelling and pain in the vagina and nearby areas, and a decrease in the red blood count.

When should you contact your doctor?

Postpartum bleeding is normal, but heavy or painful bleeding needs medical attention.

You should see a doctor if you are experiencing:

• Severe cramping

As your womb contracts to its usual size, you can have cramps. But, if you are feeling severe pain after several days of delivery, seek medical help.

• Postpartum haemorrhage

If you are losing around 470 ml of blood in the first twenty-four hours after delivery, then it is known as postpartum haemorrhage. This is a serious condition and can lead to a big drop in your blood pressure. If it gets low, you won’t get enough blood. This is a condition of shock that can cause death. 

If postpartum bleeding occurs with many clots, fever, dizziness, and an irregular heartbeat, it is important to contact your healthcare provider.

• Uterine atony

In this condition, the womb does not contract after delivery because some of the placentae may be left in the womb or due to a muscular problem. This issue can lead to postpartum haemorrhage in new mothers.

How do you manage postpartum bleeding?

Postpartum bleeding can be managed by women by taking rest and practising good hygiene. Other than this, for the first six weeks, you should use only pads and avoid tampons, as they may develop a bacterial infection in the genital tract. Try to get a massage to help the uterus contract.

During your postpartum recovery period, you need to slow down as doing too much after the delivery can start the bleeding again.

CONCLUSION

Pregnancy brings a major transformation to your life. Many changes affect your body and mind after giving birth, and it will take time to fully recover.

The uterus sheds excess tissue and blood after childbirth because it is no longer required. This is known as postpartum bleeding, which takes more than six weeks to recover. However, there are several ways to manage the bleeding, such as using extra-absorbent pads, getting a massage for contraction of the uterus, and taking rest so you can get some sort of relief.

If you are experiencing heavy flow accompanied by severe pain, reach out to your doctor for any medical help and advice.