Postpartum bleeding is a normal and expected part of recovery after childbirth. Many new parents wonder about its patterns, especially when it seems to stop and then restart. This fluctuating pattern is common as your body adjusts. Understanding its typical progression and influences can ease concerns.
Understanding Postpartum Bleeding
The vaginal discharge experienced after childbirth is known as lochia. It is composed of blood, mucus, and uterine tissue, which are shed as the uterus contracts and heals following delivery. This discharge occurs whether you had a vaginal birth or a C-section, as it is related to the healing of the site where the placenta was attached.
Lochia typically progresses through three distinct stages, each with characteristic changes in color and consistency. The first stage, lochia rubra, lasts for about three to four days after birth and appears as bright or dark red blood, similar to a heavy menstrual period, sometimes with small clots.
This is followed by lochia serosa, which usually occurs from day four up to two weeks postpartum. During this stage, the discharge becomes thinner and turns a pinkish-brown color. The final stage is lochia alba, which can last from approximately two to six weeks after delivery. In this phase, the discharge becomes yellowish-white and is much lighter in flow, consisting mostly of white blood cells and mucus.
Factors Influencing Bleeding Patterns
This is often due to various physiological factors as your body recovers. For instance, blood can pool in the uterus or vagina when you are lying down or resting. Upon standing or moving, this pooled blood may then gush out, giving the impression of a sudden increase in bleeding.
Physical activity can also influence the amount of lochia. Increased movement or exertion may temporarily intensify the flow as your body expels more uterine contents. Breastfeeding is another common factor that can lead to heavier bleeding or cramping. This occurs because the act of nursing releases oxytocin, a hormone that stimulates uterine contractions, which helps to compress blood vessels and shrink the uterus back to its pre-pregnancy size, thereby expelling more blood.
When to Be Concerned
While fluctuations in postpartum bleeding are common, certain signs indicate a need for immediate medical attention. Excessive bleeding is a primary concern, defined as soaking through more than one sanitary pad in an hour, or two pads in two hours, for several consecutive hours. Passing large blood clots, particularly those larger than a golf ball or plum, also requires prompt medical evaluation.
Other symptoms that signal a potential complication include a foul-smelling vaginal discharge, which can suggest an infection. A fever of 100.4°F (38°C) or higher, chills, severe abdominal pain, or increasing pain that does not respond to pain relief are also red flags. Feelings of dizziness, lightheadedness, or a rapid heart rate can indicate significant blood loss. If bleeding that had previously lightened suddenly returns to a heavy, bright red flow, contact your healthcare provider.
Managing Postpartum Bleeding
Managing postpartum bleeding involves practical steps to support your recovery and maintain hygiene. Use sanitary pads instead of tampons, as tampons can introduce bacteria and increase the risk of infection. Frequent pad changes, at least every three to four hours, help prevent bacterial buildup and discomfort.
Proper perineal care is also important. Using a squirt bottle filled with warm water to rinse the area after using the bathroom can promote cleanliness and healing. Resting as much as possible is beneficial, as overexertion can increase bleeding. Avoiding heavy lifting and strenuous activities allows your body to dedicate energy to healing. Maintaining a balanced diet and staying well-hydrated also support your body’s recovery process. Lochia typically resolves within four to six weeks.