Lochia: Everything You Need to Know About Postpartum Bleeding

In the first week to several weeks after delivery, it’s normal to experience vaginal postpartum bleeding that happens due to bleeding blood vessels.

If this is your first child, the amount of bleeding might alarm you.

Although bleeding after birth can be quite heavy and even include blood clots, it is important to know what’s normal and when you should call your doctor.

Find out about postpartum bleeding and postpartum bleeding stages, what to look for in postpartum blood clots, danger signs, and what to expect in the weeks after giving birth.

What’s postpartum bleeding and is it normal?

First off, postpartum bleeding is completely normal, whether you’ve had a vaginal birth or a cesarean.

Postpartum bleeding is uncontrolled bleeding similar to your period, and it is your body’s way of shedding and repairing the uterus after giving birth by having its blood vessels bleed freely.

Your body is designed to naturally push out the placenta and then clear the uterus of old tissue through bleeding vessels.

When you breastfeed, your body produces oxytocin, which among other things, causes your uterus to contract and go back to its original size.

It also squeezes the uterus to stop blood flow to the placenta.

The bloody discharge is called lochia.

Lochia isn’t just blood. It’s also a combination of mucus, parts of the uterine lining, amniotic fluid, and white blood cells.

That’s why it’s normal to see blood clots after birth ranging from the size of a grape to a prune.

Having postpartum bleeding after birth is going to feel like having an extremely heavy and much longer-lasting period.

The smell should be like that of your period, but the consistency of lochia will be thicker and heavier.

How long does postpartum bleeding last?

Postpartum bleeding could last as little as a week or as long as six weeks.

The important thing is that the excessive bleeding becomes less with each passing day rather than more, and you do not bleed heavily every day.

Although each woman is different, the next section gives a general outline of the stages of postpartum bleeding.

Your experience may be different in terms of length of time, but this will give you an idea of what to look for and indicators if something isn’t right.

Postpartum Bleeding Stages

Bleeding after birth will last longer than a menstrual period and will be much heavier.

The bloody discharge will be thicker, as well, with a prevalence of postpartum clots.

In the first roughly 3-10 days, lochia will be a bright to deep red color, and you’ll likely see blood clots after birth ranging from the size of a grape to a prune.

As the postpartum bleeding tapers off, the color of the bloody discharge will also change.

It should go from red to more of a pink color, then to brown, and finally to a yellowish cream color.

You’ll also see fewer and smaller clots as time goes on.

It’s not unusual to experience random spotting in the weeks following delivery, even up to six weeks. You might stop bleeding entirely for a few days and then suddenly have some brown spots.

This is nothing to worry about.

The difference in bleeding between vaginal and cesarean birth of a baby

Whether you’ve had a cesarean or vaginal delivery, you will still experience postpartum bleeding, and there won’t be a big difference in the appearance of lochia.

This is because, no matter which way you deliver your baby, your body still needs to clean and repair your uterus after carrying and growing the baby.

However, with cesarean delivery, bleeding after birth might subside more quickly than with vaginal delivery.

You might also have a lower quantity of lochia and see mostly blood for up to a few weeks.

The color should still go from red to brown to eventually clear, though, and you should follow any indications of more serious problems just as you would with a vaginal birth.

When to call a doctor about postpartum vaginal bleeding

Postpartum bleeding is normal, and quantity and duration vary from woman to woman. However, some warning signs could indicate a more serious issue that requires medical attention.

If you have any of the following common symptoms, call your doctor right away:

• Fever or fever-like symptoms include body shakes, chills, and clammy skin
• Racing or irregular heartbeat
• Feeling dizzy or like you’re going to faint
• Foul-smelling discharge
• Pain or tenderness in one or both sides of your abdomen
• Pelvic pain. A urinary infection or constipation could also be happening at this time. In either case, drink plenty of water.
• Weakness, blurred vision, or confusion
• Bright red blood after the first week
• Increasing amounts of blood rather than decreasing
• Blood clots that are larger than a plum
• Heavy bleeding that soaks a hospital pad within an hour and doesn’t seem to be letting up
• Cramping – In tandem with bleeding, postpartum cramping is normal and very common as the womb contracts to its pre-pregnancy size. If severe cramping continues, or increased pain lasts for several days to weeks after delivery, it is best to let your doctor know.

Any of these symptoms can signal you may be experiencing postpartum complications, so it’s crucial to let your doctor know as soon as it happens.

Treatment for postpartum bleeding and postpartum hemorrhage

For normal postpartum bleeding, you’ll likely need to use hospital pads for the first few days and then gradually taper off to regular menstrual pads and then pantyliners.

You can decide this at your discretion. The important thing is that you use pads only for your postpartum bleeding.

Do not use tampons or menstrual cups until your body is completely healed and your doctor gives you the okay to do so.

You might experience more bleeding when you’re up moving around a lot.

You may also notice that after sitting for a long period, or when you first get up in the morning, you’ll feel a sudden rush of a large quantity of extra blood.

You could also experience more bleeding when straining to urinate or passing a stool.

Due to the shape of your vagina and nearby area, the blood pools inside your body and then drains when you get up.

If you find that you’re bleeding more when you’re moving around, try to stay off your feet and rest more.

Using internal sanitary products like tampons and menstrual cups before the 6-week mark when the wound has healed could increase your chance of getting an infection.

If you’re bleeding more than is normal, or you’re experiencing abdominal pain, your doctor may give you one or more of the following treatments:

• Abdominal massage and uterine massage stimulate the uterus to contract
• Drugs to contract the uterus
• An injection to stop the bleeding
• Possible need to remove pieces of the placenta that remained in the uterus after childbirth
• In more serious cases of postpartum hemorrhage, you might even need medical procedures like surgery or other methods to stop the bleeding.

Suppose you have more serious postpartum bleeding after birth, like postpartum hemorrhage.

In that case, you’ll need urgent medical treatment as this can quickly decrease your blood pressure, cause blood loss and cause your body to go into shock, even result in death.

It is imperative to get postpartum hemorrhage treated.

When treating postpartum hemorrhage, the doctor will check your pulse and blood pressure.

Once you get postpartum hemorrhage diagnosed, the treatment for postpartum hemorrhage includes sealing bleeding blood vessels and decreasing the blood pressure, and increasing the blood pressure to get your blood pressure to its normal levels, as well as replacing lost blood by blood transfusion.

So if something does not feel right and the blood loss feels like too much, don’t hesitate to advise a healthcare professional and seek medical advice.

To reduce the risk of infection be sure to:

• Try to avoid touching any stitches or dressings
• Thoroughly wash your hands before and after using the restroom, and changing pads
• Keep the nails short (for now) – Shorter nails are less likely to scratch yourself by accident and will make it easier for you to care for your baby.
• It’s also better to avoid sex until lochia has finished, as it can put you at risk of infection. Instead, wait until 6-8 weeks.

Conclusion

Bringing a tiny human into the world is nothing short of miraculous, and your body goes through myriad changes as your baby grows inside of you.

Although it would be great to be done with all those changes after delivery, your body continues to do amazing things as it naturally cleans and repairs itself.

Postpartum bleeding is just one of the many marvels of the human body, and although it can seem scary and confusing, you can relax in knowing what’s normal and embracing it as a part of motherhood.