The body changes in a variety of ways after delivery. One common change is postpartum bleeding.
Postpartum bleeding is similar to menstrual bleeding, although it lasts for much longer and is generally much heavier.
The characteristics of the bleeding can vary, and it may involve passing tissues that are not present in menstrual blood.
After giving birth, vaginal bleeding is common. This bleeding is temporary and the medical name for it is lochia.
Lochia contains mucus, tissue, and blood that is shed by the womb in order to replace its lining after delivery.
The following activities may cause the bleeding to increase:
- getting out of bed in the morning
- doing light exercise
- straining when urinating or passing stool
Postpartum bleeding, or lochia, is a result of the uterus replacing its lining after childbirth. The womb releases the extra blood and tissues that it needed to keep the fetus healthy during pregnancy.
During pregnancy, hormonal changes thicken the lining of the uterus to support the placenta. After delivery, the uterus shrinks to its regular size and sheds the extra tissue that it no longer needs.
Bleeding can be expected during delivery, as well. During a vaginal delivery, a woman typically loses approximately 500 milliliters (ml) of blood and twice as much during a cesarean delivery. Regardless of the type of delivery, a woman may also experience postpartum bleeding.
According to the National Childbirth Trust, bleeding usually lasts 24–36 days, though it can last longer than 6 weeks.
The amount and type of bleeding varies from pregnancy to pregnancy, but it should change over time.
In the first 6 weeks after delivery, postpartum bleeding may change in the following ways:
- Day 1: The blood may be red or brownish, there may be some clotting, and the maternity pad may need to be changed regularly.
- Days 2–6: The clots may be smaller, the flow may be lighter, and the blood may be dark brown or pinkish-red.
- Days 7–10: The flow and the color may become lighter.
- Days 11–14: There may only be light bleeding, and the blood may still be dark brown or pinkish-red.
- Weeks 3–4: The fluid that passes may be creamy white and the flow may be much lighter than before.
- Week 5–6: There may be brown or pinkish-red bleeding or creamy yellow discharge, and it may happen sporadically for several weeks.
While postpartum bleeding is normal, very heavy or painful bleeding can indicate an issue that requires medical attention.
Healthcare providers will assess whether a woman is experiencing:
Postpartum cramping is common as the womb contracts to its usual size.
However, if severe cramping or pain lasts for several days after delivery, it is a good idea to let a doctor know.
Let a doctor know if it is necessary to change maternity pads more often than once an hour due to postpartum bleeding.
It is especially important to receive medical care if postpartum bleeding occurs with:
- a fever or chills
- tenderness in the stomach
- feeling faint
- an irregular heartbeat
- a large number of clots
These issues can indicate hemorrhaging, which can be serious, but a range of treatments can help.
A doctor can also describe ways of reducing risk factors for postpartum hemorrhaging.
- wash the hands thoroughly before and after going to the toilet and changing maternity pads
- keep the nails short
- wear no jewelry on the hands or wrists during this period
- avoid touching any stitches or dressings
Significant risk factors for postpartum infection include:
- prolonged labor
- cesarean delivery
- meconium during delivery
- postpartum hemorrhage
It may be a good idea to let a doctor know about any concerns related to infections.
Uterine atony refers to the womb not contracting after delivery. The cause may involve some of the placenta being left in the womb or an anatomical or muscular problem.
This can be a serious issue and can lead to postpartum hemorrhaging.
A woman can often manage regular postpartum bleeding as if it were a period. Resting, practicing good hygiene, and addressing each symptom individually can help.
If a doctor believes that the bleeding might indicate a problem, they may:
- offer or recommend massage to help the uterus contract
- administer or prescribe medication that limits blood flow from vessels that supply the womb
- check that the placenta passed fully during delivery
The doctor may instead recommend a surgical option, such as:
- a Bakri balloon, a device inserted into the uterus to control and reduce the bleeding
- uterine artery embolization, which creates a temporary obstruction in the blood vessels supplying the uterus
- a procedure to remove any placenta left in the womb after delivery
- a laparotomy, to examine the uterus
- a hysterectomy
After delivery, the uterine sheds extra tissue and blood that it no longer needs. It also changes its lining and shrinks to its regular size.
This process commonly results in postpartum bleeding, which may last about 6 weeks, though it can take longer to finish. The flow and the color of the blood vary from woman to woman and from pregnancy to pregnancy.
If the flow is very heavy, however, or if it accompanies pain or other symptoms, a woman should receive medical care right away.