After childbirth, vaginal bleeding and the passage of blood clots are a natural part of recovery. This discharge, known as lochia, is an expected physiological event as the uterus returns to its pre-pregnancy state. Understanding what to anticipate regarding this bleeding, including the appearance of clots, provides reassurance. This information helps new parents distinguish between normal changes and signs that might require medical attention.
The Body’s Natural Process of Recovery
After birth, the uterus begins involution, shrinking back to its original size. This natural contraction helps compress blood vessels at the placental site, reducing blood loss. Involution involves shedding the uterine lining, known as the decidua.
Lochia consists of shed uterine tissue, blood, and mucus. As the uterus contracts, blood and tissue can coagulate, forming clots. These clots help clear out materials no longer needed after childbirth. The entire process of uterine involution typically spans about six weeks, with the uterus gradually decreasing in size and weight.
Identifying Normal Postpartum Clots
Normal postpartum blood clots vary over the days and weeks following birth. Immediately after delivery, bleeding is often heaviest and bright red. During this initial phase, it is common to pass small clots, usually around the size of a grape or a quarter. Some individuals may pass one or two larger clots, comparable to a plum or golf ball, particularly in the first 24 hours.
These clots typically have a jelly-like consistency and may contain mucus or tissue. Over the first week, the flow generally becomes moderate, and any clots passed should be smaller. By about two weeks postpartum, the blood flow lightens, transitioning from bright red to pinkish-brown or yellowish-white, and clots become less frequent or absent. You might notice an increase in discharge or small clots after lying down or upon first getting up, as blood can pool and then be released.
Warning Signs Requiring Medical Attention
While some bleeding and clotting are normal postpartum recovery, certain signs indicate a need for immediate medical attention. Soaking through more than one sanitary pad per hour for several consecutive hours is a warning sign. Passing blood clots larger than a lemon or golf ball after the initial 24 hours postpartum, or excessive clotting, warrants concern.
Other concerning symptoms include gushing bright red blood that does not slow, or a foul-smelling vaginal discharge, which could indicate infection. Fever, chills, or flu-like symptoms also indicate a potential complication. Dizziness, lightheadedness, faintness, or a rapid heart rate require prompt medical evaluation. Severe abdominal pain, pain that worsens or is not relieved by medication, or swelling and pain around the vaginal area should also be reported to a healthcare provider.
Coping with Postpartum Bleeding and Clots
Managing postpartum bleeding and clots involves several practical steps. Use large, absorbent maternity pads, and avoid tampons for at least six weeks postpartum to prevent infection. Rest when possible. Staying hydrated by drinking plenty of fluids is beneficial during this period.
Maintaining good hygiene, such as frequent pad changes and gentle perineal care, helps prevent infection. While some fluctuations in bleeding are normal, particularly with increased activity or breastfeeding, monitor the amount and type of discharge. If you have concerns about your bleeding, the size or frequency of clots, or any accompanying symptoms, contact a healthcare provider.