Bringing a new life into the world is a miraculous journey, and your body goes through significant changes to make this miracle happen. Just when you think you can catch a break after childbirth, you’ll find yourself facing the challenges of postpartum recovery.
One aspect of postpartum recovery that every mother experiences is postpartum bleeding, also known as lochia. While this bleeding is entirely normal and expected, it's crucial to understand what's considered normal and what might signal a cause for concern.
In this blog, we'll walk you through the intricate details of postpartum bleeding, from what's typical to what may require medical attention, and look at the common ways it’s treated.
What is Lochia?
Whether you’ve had a vaginal delivery or C-section delivery, you can expect a lot of vaginal discharge and postpartum bleeding in the weeks following childbirth.
Lochia, or postpartum bleeding, is your body’s way of shedding the excess blood, mucus, and tissue it developed during pregnancy to sustain your child. It typically begins in the first few days after childbirth and can last for up to 6 weeks, or even 10 weeks in some cases, gradually changing in colour and flow. While it might not be the most pleasant part of the postpartum experience, it's entirely normal and plays a vital role in your body's healing process.
Understanding Normal Postpartum Bleeding
Even though the time and flow vary from person to person, here’s what to expect from postpartum bleeding:
Passing small clots (about the size of a grape) can be normal during the first week or two. However, large clots or consistently passing them after the first two weeks may be a sign of concern.
Friends Maternity Pads for Postpartum Bleeding
Choosing the right maternity pad for postpartum bleeding is crucial for your comfort, hygiene, and postpartum recovery. Friends Maternity Pads are specially designed for this purpose. Friends Maternity Pads:
- Are made with a soft, non-woven top sheet that is gentle on the sensitive, inflamed skin, leaving no lint on stitches.
- Can soak 2.5 times more than regular pads and last up to 6-8 hours.
- Suitable for all post-pregnancy fluid leaks, including urine leakage after delivery.
- Are anti-rash and anti-bacterial and promote faster healing of stitches with their breathable and skin-friendly design.
- Free of any chemicals and artificial fragrances that might hinder your recovery.
Understanding Abnormal Postpartum Bleeding
While lochia is absolutely normal, there are instances where it might signal a problem. Here are some signs of an abnormal postpartum bleeding:
1. Excessive bleeding
If you soak through one to two maxi pads per hour for several hours in a row, this could be a sign of postpartum haemorrhage. Postpartum haemorrhage is one of the leading causes of maternal death in India, with about 1-5% of women experiencing it. It usually occurs within the first day of giving birth, but it can also happen anytime during the 12 weeks after childbirth. The most common causes of postpartum haemorrhage are:
- Uterine atony: This is when the uterus doesn't contract effectively after childbirth, leading to heavy bleeding. It can be caused by factors like a large baby, multiple pregnancies, or a prolonged labour.
- Retained placental tissue: Sometimes, a small piece of the placenta can remain in the uterus, causing heavy bleeding. This usually requires medical intervention to remove.
Additionally, be on the lookout for excessive bleeding symptoms such as pale skin, shakiness, chills, dizziness, and light-headedness.
2. Bright red bleeding
If your bleeding remains bright red and heavy after the first few days postpartum, it’s worth mentioning to your doctor as lochia typically changes colour and tapers down in the course of a few days to weeks. Prolonged bright red bleeding can be due to:
- Cervical or vaginal tears: Tears or lacerations during childbirth can cause continued bright red bleeding. These may need sutures or medical attention.
- Infection: Infection in the uterus can lead to continuous bright red bleeding. It's important to address any potential infection immediately.
3. Foul odour
Lochia should have a mild, slightly metallic smell. If it becomes foul-smelling, it might indicate an infection. Infections can occur when bacteria enter the uterus during childbirth or if there is a retained piece of placental tissue.
4. Fevers or chills
Fever and chills are another sign of infections.
5. Passing clots
Passing clots is normal as long as they are on the smaller side and only last a few days. But clots larger than a golf ball, or consistently passing smaller clots with increased bleeding could be a sign of a retained placenta.
If you notice any of the above mentioned abnormal postpartum bleeding symptoms, contact your doctor immediately.
How is abnormal postpartum bleeding treated?
There are several ways to treat abnormal postpartum bleeding or postpartum haemorrhage. The choice of postpartum haemorrhage treatment, however, depends on the cause and severity of the bleeding. Some treatment options for abnormal postpartum bleeding include:
- Medication: Medication to help the uterus contract is typically the first line of treatment when it comes to postpartum haemorrhage.
- Uterine massage: Massaging the uterus helps it to contract, which consequently stops the heavy bleeding.
- Balloon tamponade: In this method, a device known as Bakri balloon is inflated inside the uterus to compress the bleeding vessels and stop the bleeding.
- Uterine artery embolization: In this method, the bleeding vessels are identified with a special form of x-ray that captures moving images, and then tiny particles is injected into the bleeding vessels to stop the bleeding.
- Dilation and curettage: In this surgical procedure, the cervix is opened, and a thin instrument is inserted into the uterus to remove remaining pieces of placenta from the uterus.
- Hysterectomy: As a last resort, hysterectomy is a surgical operation to remove the uterus.
Abnormal bleeding after delivery can be potentially life threatening. Consult your doctor and decide on the best treatment option for you.
During your recovery from postpartum haemorrhage, get lots of rest and avoid any strenuous activity or exercise. When your body loses a lot of blood, it can result in iron deficiency anaemia. So, load up on foods rich in iron, such as green leafy vegetables, beans and peas, lentils, etc. Also, include foods rich in vitamin C to your diet as it helps the body absorb iron.
And don’t neglect your mental health and well-being. Many people who have had abnormal postpartum bleeding often experience postpartum depression. If you experience postpartum depression, talk to your loved ones or your doctor, or join a support group of people who’ve had a similar experience. Love and support are crucial for recovery, both physically and mentally. See you in another blog!
What is the cause of postpartum haemorrhage?
Postpartum haemorrhage can occur due to factors like uterine atony (ineffective uterine contractions), retained placental tissue, tears or lacerations during childbirth, blood clotting disorders, infections, conditions like placenta accreta, or even rare events like uterine inversion.
How long does postpartum bleeding typically last?
Typically, postpartum bleeding (lochia) lasts for approximately six weeks. It begins as bright red blood and gradually transitions to pink or brownish discharge within the first two weeks. Afterward, it continues as a yellowish-white discharge, though the duration can vary among individuals.
Is it normal to bleed 3 months postpartum?
No, any type of postpartum bleeding should stop within 12 weeks. If you notice any spotting or bleeding 12 weeks postpartum, consult your doctor for evaluation and guidance.
When do periods start after delivery?
The return of menstrual periods after childbirth varies widely among women. Some may resume their menstrual cycles within a few weeks, especially if they are not breastfeeding. However, for many breastfeeding mothers, periods may not return until they gradually wean their baby or introduce solid foods, which can take several months after delivery.
How can I stop postpartum bleeding faster?
Postpartum bleeding, or lochia, is a natural part of the post-birth recovery process. It's essential for your body to heal. While you can't speed it up, getting plenty of rest, staying hydrated, and maintaining a balanced diet can support your overall recovery. If you have concerns about the bleeding, consult your healthcare provider for guidance and reassurance.