After giving birth, you may have a heavy flow of blood, tissues, and bacteria, known as "lochia." This blood loss is completely natural and must equal a heavy menstruation. To be sure that postpartum bleeding is normal, you need to know what to expect, when to contact a doctor, and recognize the symptoms of postpartum hemorrhage, a serious but rare condition.
Steps
Method 1 of 3: Understand what to expect
Step 1. Expect to bleed heavily for three to ten days
For about the first week after giving birth, you will experience a heavy, bright flow of blood. During this time, you may also pass several small or medium blood clots.
- During this early stage of postpartum bleeding, you will probably fill a sanitary pad with blood about every three hours.
- You will probably also pass one or two large clots (the size of a quarter) and several smaller clots (the size of a grape).
- In case you gave birth by cesarean section, expect to bleed a little more.
- You will begin to notice a slight change in the color of the lochia after two to four days after delivery.
Step 2. Pay attention to the color of the flow
In the first three to ten days, the lochia will be a deep, bright red color (and will become slightly lighter after about four days). After three to ten days, its color should change from red to pink. After a few days later, the lochia will appear brown and finally yellowish-white.
Step 3. Expect that you will continue to bleed
Although you should only bleed heavily for three to ten days after giving birth, you will continue to have a light to medium flow for several weeks (up to six). During this time, the bleeding will slowly decrease and become lighter in color.
- If you breastfeed your baby, you may notice a slight increase in bleeding and cramping when you breastfeed (or immediately after). Breastfeeding causes the uterus to contract slightly, so this is perfectly normal.
- If you've started hormonal birth control, irregular bleeding may continue after six weeks. Talk to your healthcare provider about it.
Step 4. Find out about what happens to your body
Understanding what goes on inside your body after delivery can ease some of your fears. After giving birth, the placenta separates from the uterus and the blood vessels to which it was attached open, causing bleeding inside the uterus. After expelling the placenta, the uterus continues to contract and expel blood, as well as any debris from tissues, fluids, and bacteria. As the uterus contracts, it also seals the blood vessels. In short, during the first six weeks after delivery, the uterus cleans itself and restores its normal condition.
- During pregnancy, the amount of blood in the body increases by about 50%, so your body is well prepared for this postpartum blood loss.
- If you experience a tear during labor or have an episiotomy, you could also bleed in this area.
Method 2 of 3: Know When to Contact a Doctor
Step 1. See if you pass large blood clots
While some small to medium clots are expected and normal, contact your healthcare provider if you pass clots larger than a golf ball.
Step 2. Monitor the use of sanitary napkins
One way to monitor the amount of blood you have lost is by paying attention to how often you change your sanitary napkin. Contact your doctor if you soak one or two sanitary pads per hour, for three or more consecutive hours.
- During this time, it is not recommended that you use tampons, as doing so could introduce bacteria into the vagina.
- The bleeding will be heavier for the first few days, and then it will slowly begin to diminish. Contact a doctor if you notice that the bleeding does not decrease.
Step 3. Take into account the color of the blood
For the first few days after giving birth, your blood will be a very bright red color. After about four days, the color will lighten. Talk to your doctor if the blood is still bright red for more than four days after giving birth.
Step 4. Pay attention to unusual odors
If the blood has a foul and rotten odor it could be a sign of postpartum infection. The lochia should have a typical menstrual blood odor. If the blood has a bad odor, contact your healthcare provider.
Postpartum infection is usually associated with severe pain and a fever of 100 ° F (38 ° C)
Method 3 of 3: Recognize a postpartum hemorrhage
Step 1. Be aware that this condition occurs rarely
Postpartum hemorrhage (PPH) is a rare but serious condition that affects only 4% to 6% of postpartum women. Although it occurs rarely, it continues to be the number one cause of postpartum death. Therefore, it is important that you recognize the risk factors that make you more prone to postpartum hemorrhage, as well as their symptoms.
Step 2. Learn about the medical conditions that increase the risk of postpartum hemorrhage
You are very likely to experience it if you have been diagnosed with medical conditions that affect the uterus, the placenta, or the way your blood clots.
- Conditions that affect the uterus include uterine atony, inverted uterus, and uterine rupture.
- Some conditions that affect the placenta are premature detachment of the placenta, placenta accreta, placenta increta, placenta percreta, and placenta previa.
- Conditions that affect blood clotting include von Willebrand disease, disseminated intravascular coagulation (DIC), and taking anticoagulants (warfarin, enoxaparin, etc.).
Step 3. Learn about other risk factors
Several factors can put you at high risk for postpartum hemorrhage. Keep in mind that none of these conditions indicate that you will experience postpartum hemorrhage (this condition happens rarely). They just point out that the risk is slightly higher. You could be at risk if you experience the following:
- obesity
- prolonged labor (more than 12 hours)
- emergency cesarean section
- anemia
- preeclampsia or high blood pressure
- postpartum hemorrhage in a previous delivery
- uterine infections (endometritis)
Step 4. Recognize the symptoms
Postpartum hemorrhage most likely occurs within a day of giving birth. However, it may happen up to two weeks after delivery. It is crucial that you treat this health problem immediately, so contact your healthcare provider if you experience any symptoms. Among the symptoms that you could present are the following:
- vaginal bleeding that does not decrease or stop
- decreased blood pressure or symptoms of shock (blurred vision, chills, clammy skin, fast heart beat, feeling confused, extreme dizziness or fainting)
- pale skin
- swelling and pain around the vagina or perineum