Postpartum bleeding, or lochia, is a normal physiological process after childbirth. This discharge is the body’s natural way of healing and shedding the uterine lining built up during pregnancy. Lochia happens whether a person delivers vaginally or via a C-section, signifying the uterus’s return to its pre-pregnancy state.
Understanding Postpartum Bleeding After C-Section
Lochia consists of blood, tissue, and mucus from the uterus as it heals from pregnancy and the placental attachment site. After a C-section, this discharge is expected to last for several weeks, typically lasting four to six weeks. The initial bleeding after a C-section can be substantial, especially in the first few days following surgery.
The characteristics of lochia change over time, progressing through distinct stages. Initially, lochia rubra is present for about one to two weeks, characterized by bright red bleeding that may contain small blood clots. As healing progresses, the discharge transitions to lochia serosa, appearing pinkish or brownish, thinner, and with a reduced flow, usually around 4 to 10 days postpartum. The final stage, lochia alba, typically begins around 10 days to two weeks postpartum and can continue for up to six to eight weeks. This discharge is whitish-yellow, very light, or presents as spotting.
While a C-section involves the surgical removal of the placenta and some immediate uterine cleaning, the uterus still needs to contract and shed its lining, leading to lochia. The initial heavy flow might be slightly less compared to a vaginal birth due to the surgical cleaning.
Factors Influencing Bleeding Duration
Several factors can influence the duration, amount, and characteristics of postpartum bleeding after a C-section. Increased activity levels can temporarily lead to an increase in bleeding, with too much physical exertion causing a temporary resurgence in brighter red bleeding or a heavier flow.
Breastfeeding also plays a role in uterine recovery and lochia. The release of oxytocin during breastfeeding stimulates uterine contractions, which helps the uterus return to its pre-pregnancy size and expel lochia more efficiently. This can sometimes result in a temporary increase in bleeding or stronger uterine cramps during feeding sessions. The way the uterus was massaged during and immediately after the C-section can also influence the initial bleeding.
When to Seek Medical Advice
Recognizing signs that warrant medical attention is important. Seek immediate medical advice if bleeding becomes excessively heavy, defined as soaking more than one maxi pad per hour for several consecutive hours, or passing blood clots larger than a golf ball. A return to bright red bleeding after the discharge had already lightened or changed color can also indicate a concern.
Other warning signs include foul-smelling vaginal discharge, which may suggest an infection. A fever, particularly a temperature over 100.4°F (38°C), chills, or flu-like symptoms, should prompt a call to a healthcare provider. Persistent or worsening severe abdominal pain or tenderness also requires evaluation. Symptoms like dizziness, lightheadedness, or fainting, along with signs of infection at the C-section incision site such as increasing redness, swelling, or pus, necessitate prompt medical attention.
Caring for Yourself During Postpartum Bleeding
Managing postpartum bleeding effectively involves several self-care practices. Always use maternity pads or large sanitary pads, and refrain from using tampons or douching, as these can increase the risk of infection.
Maintaining good hygiene, including frequent pad changes and gentle perineal care, is important. Prioritizing rest and avoiding strenuous activities, such as lifting anything heavier than your baby, aids healing and prevents increased bleeding. Staying well-hydrated and consuming a healthy, balanced diet supports recovery. Wearing comfortable, loose-fitting clothing enhances comfort. Follow all instructions from your healthcare team regarding C-section incision care to promote healing.