After childbirth, the body undergoes a significant recovery period, which includes a process known as postpartum bleeding, or lochia. This discharge is a normal part of the uterus returning to its pre-pregnancy state. The presence of blood clots within this discharge is a common and expected aspect of this recovery.
Understanding Normal Postpartum Clots
Normal postpartum blood clots typically resemble small pieces of jelly, often appearing dark red or brownish in color. Their size usually ranges from that of a grape to a prune, or even slightly larger, up to the size of a golf ball, especially in the first few days after delivery. These clots form as the uterus sheds its lining, which includes blood, tissue, and mucus that supported the pregnancy.
The formation of these clots is also linked to the uterus contracting to shrink back to its original size. These contractions compress blood vessels in the uterine wall, helping to control bleeding. Sometimes, blood can pool in the vagina while lying down or resting, leading to larger clots being passed when a person stands up or moves. This pooling effect is a common reason for the sudden appearance of a larger clot.
Identifying Concerning Clots and Symptoms
While some clotting is expected, certain characteristics of clots and accompanying symptoms warrant immediate attention. Clots that are consistently larger than a golf ball, or an increasing number of large clots being passed, are considered concerning. Passing several large clots hourly could indicate a problem requiring medical evaluation. These concerning clots are often accompanied by other red-flag symptoms that signal a potential complication.
Timeline of Postpartum Bleeding
Postpartum bleeding typically lasts for several weeks, gradually changing in appearance and volume. Initially, for the first three to four days, the discharge, known as lochia rubra, is bright red and may contain small clots. Over the next week or two, the bleeding usually lightens, becoming pinkish or brownish and thinner in consistency, a phase called lochia serosa.
By about two to six weeks postpartum, the discharge further reduces and becomes yellowish-white, known as lochia alba, with minimal or no clotting. Clots are most common during the initial days and weeks when bleeding is heaviest. Their frequency and size should progressively decrease as the bleeding lessens.
When to Seek Medical Care
Promptly contacting a healthcare provider is important if any concerning signs develop after childbirth. Seek medical care if you experience:
Excessively heavy bleeding, defined as soaking through more than one sanitary pad per hour for two consecutive hours, or experiencing gushing blood that does not slow down.
Passing clots consistently larger than a golf ball, or an increasing number of large clots hourly.
The persistence of significant clots beyond the first few days or weeks of recovery.
A fever above 100.4°F (38°C) or chills.
Foul-smelling vaginal discharge.
New or worsening abdominal pain.
Dizziness or a feeling of lightheadedness.
These symptoms could point to conditions like postpartum hemorrhage or an infection within the uterus.