Postpartum bleeding refers to vaginal bleeding in the three to six weeks following childbirth. Women’s bodies are designed to anticipate this massive blood loss by increasing overall blood volume (by about 50%) during pregnancy itself. Postpartum bleeding is observed both after vaginal delivery and after a C-section and to the same degree. The bleeding comes from the injured and healing uterus which is the same in both scenarios.
If you’re pregnant and are anxious from rumors you’ve heard about postpartum bleeding or if you’ve just had a baby and are swooning at the sight of huge volumes of blood you seem to be heedlessly losing, here are some questions and answers that may put your already-stressed mind at ease.
1. Why Does It Happen?
Placenta is a cushion-like mass of blood vessels between the uterus and fetus that supplies oxygen and nutrients to the fetus while removing fetal excreta. When you give birth, the placenta detaches from the uterus leaving open-ended blood vessels in a very expanded uterus. This manifests as vaginal bleeding. In an attempt to resume normalcy, your uterus contracts and closes up some of these blood vessels. This, however, is a slow process that may take several weeks, up to six to be precise.
Furthermore, if you’ve had an episiotomy, till the surgical cut is stitched up you may continue to bleed.
2. What Does It Consist Of?
Postpartum vaginal discharge or lochia is a hodgepodge of blood, patches of uterine lining, mucus, and white blood cells. As your blood flow decrements into spotting, the blood content of lochia decreases and is then mostly composed of mucus and WBCs.
3. How Long Does It Last?
Think of it as an extended period, anywhere between 3–6 weeks instead of the regular 4–7 days. While six weeks of menstruation may sound daunting to the faint-hearted, rest assured that the worst of it is restricted to the first week only.
4. What Should You Expect?
Lochia is bright red the first four days with maximum blood flow and intense cramps, resembling your normal period. Your cramps may worsen if you’re nursing as oxytocin produced during breastfeeding stimulates uterine contractions. This, however, is meant to help you heal sooner – pain for gain.
Sitting for a long time or lying down may cause some blood to collect and coalesce in your vagina. Standing up thereafter, you may be startled with the release of a grape-sized clot. It is absolutely normal. Larger clots, however, are not. The size of clots is expected to dwindle with time.
After the first week, lochia lightens in color and decreases in volume, transitioning from red to brown to pink to a normal white discharge for the rest of your cycle. Heavy blood flow diminishes into spotting and uterine cramps also slacken with time.
5. How Can You Best Cope With It?
- Breastfeeding your little one not only benefits him or her but yourself as well. The breastfeeding-triggered oxytocin stimulates uterine contractions that are required for healing.
- For the first week, use heavy-duty sanitary pads (like the ones you get at the hospital). As your flow tapers off, switch to regular mini pads and finally panty liners. Maintain proper hygiene with regular vaginal washes (you may use warm water) and timely pad changes.
- Do not use tampons for at least six weeks after your delivery. Tampon usage may encourage uterine and vaginal infections.
- Take it easy. Your body has been through a roller coaster and needs sufficient time to rehabilitate. Premature indulgence in physical activity, more than your body is ready to take on, can retard uterine healing.
- Childbirth reduces the sensitivity of your urinary bladder. So, even though your bladder may be full, you may not feel the urge to urinate – a potential cause for urinary problems. Remember to urinate often to empty your bladder, even when you don’t feel like it, and avoid further complications.
6. When Is It Abnormal?
Don’t hesitate to seek professional medical advice if:
- Bright red bleeding persists after the first four days following delivery
- Your bleeding doesn’t slow down and a fresh maxi pad (the huge ones) gets completely soaked within an hour
- Your discharge tapers off in color and intensity to a mild spotting and then reappears as bright red spotting or heavier bleeding (You may have overexerted yourself too soon)
- You continue to discharge blood clots or ones that are the size of a golf ball
- Your lochia has a foul odor or you come down with fever or experience shivering (It may be indicative of a postpartum infection that needs some medical attention.)
As you have now gained the understanding that postpartum bleeding is normal, pay keen attention to recognize symptoms that are out of the normal. The vaginal area and uterus is fragile and extremely sensitive postpartum, so ensure you keep your privates clean and do all you can to feel comfortable in the midst of this life-changing event.