The postpartum period involves substantial physical recovery, and questions about vaginal bleeding and blood clots are frequent. The body returns to its non-pregnant state, which includes a phase of uterine shedding. Understanding the difference between expected recovery and signs that require medical evaluation is important. This article clarifies the normal timeline of postpartum bleeding and details when blood clots two weeks after delivery are within a normal range.
Understanding Postpartum Bleeding (Lochia)
Postpartum bleeding, medically known as lochia, is the body’s mechanism for shedding the uterine lining that supported the pregnancy. This discharge occurs regardless of whether the birth was vaginal or by Cesarean section, and it consists of blood, mucus, and uterine tissue. The entire process typically lasts between four and six weeks, though it can extend up to eight weeks.
Lochia follows a predictable progression of color and consistency as the uterus contracts and heals. The first stage, lochia rubra, is bright or dark red and heavy, lasting about three to four days after delivery. This transitions into lochia serosa, a thinner, pinkish-brown discharge that continues for the next week.
By the two-week mark, many individuals are experiencing lochia alba, the final stage. This discharge is light, often yellowish-white or creamy, and consists mostly of white blood cells and mucus rather than fresh blood. The overall flow volume should have decreased significantly by this time.
When Clots Are Expected During Recovery
It is common to pass small blood clots during the first one to two weeks following childbirth. These clots form because blood pools in the uterus and vagina before expulsion, allowing it to coagulate. This pooling often occurs when a person has been lying down or sitting for an extended period, such as during sleep.
While the overall flow is much lighter than the first week, passing small clots remains a normal occurrence two weeks postpartum. Clots that are smaller than a quarter or dime are considered within the expected range. The passing of a small clot can also be triggered by physical activity or a sudden change in position, such as getting out of bed.
If the bleeding remains light and the clots are small and infrequent, it signals a normal healing process.
Identifying Signs of Concern
While small, occasional clots are normal two weeks postpartum, certain signs suggest the bleeding is abnormal and requires immediate medical attention. One primary indicator of excessive blood loss is soaking through sanitary protection too quickly. Soaking more than one maxi pad per hour for two or more consecutive hours is a warning sign of potential postpartum hemorrhage.
The size of the clot is also an important factor. Clots that are consistently larger than a golf ball are considered abnormal, even at the two-week mark. A sudden return to heavy, bright red bleeding after the flow had previously lightened suggests the healing process has regressed.
Other associated symptoms can point toward infection or retained placental fragments. These include a foul-smelling vaginal discharge, fever higher than 100.4°F (38°C), or severe abdominal pain that does not subside. Feeling dizzy and faint alongside heavy bleeding also indicates the need to contact a healthcare provider immediately.
Serious Clotting Risks Beyond Lochia
Beyond uterine bleeding, the postpartum period carries a separate risk of systemic blood clots, known as venous thromboembolism (VTE). This complication includes Deep Vein Thrombosis (DVT), a clot that forms in a deep vein, usually in the leg, and Pulmonary Embolism (PE), which occurs if a clot travels to the lungs. The risk for VTE is elevated in the six to eight weeks following delivery because the body increases clotting factors to prevent excessive blood loss during birth.
Symptoms of DVT typically affect only one leg and include pain or soreness, which may feel like a severe muscle pull. The affected area may also show swelling, warmth, and redness in the calf or thigh. Swelling in both legs is common postpartum, but swelling or pain isolated to one side is highly suspicious for DVT.
A Pulmonary Embolism is a medical emergency, and symptoms are often sudden and severe.
- Unexplained shortness of breath.
- Chest pain that worsens with a deep breath or cough.
- A rapid or irregular heartbeat.
- Coughing up blood.
Recognizing these symptoms quickly is important, as they are unrelated to the normal process of lochia.