What is the bleeding you experience after birth?

The bleeding you experience after birth is called ‘Lochia’.

This bleeding is often a mixture of blood, cervical mucus, uterine tissue and residual amniotic fluid. There is typically heavy for the first few days after birth (similar to having a heavy period) but tapers off over time. Bleeding may last up to 6 weeks, although it is important to know what is considered ‘normal’ and ‘not-normal’ when it comes to bleeding after birth.

How much should you be bleeding after birth?

While every person and birth are different (and our bodies recover differently!) here is the common progression of bleeding after birth for most women:

In the first week after birth, you may experience the following types of bleeding:

• Bright red or dark red blood
• Flows like a heavy period
• May have to change a heavy pad every 3-4 hours
• May pass small clots
• May experience a ‘gush’ of bleeding when breastfeeding or holding your baby
• May experience mild period pain (for first time mothers)
• May experience painful contractions of the uterus, afterbirth pains (more common to mothers who have had a baby or multiple babies previously)

In the second week after birth, the bleeding you may experience are:

• Pinkish or brown coloured discharge
• Thinner or more watery texture than the first week after birth
• Lighter flow, no clots

Do you bleed after a Caesarean?

If you have had a Caesarean, you will still bleed for several weeks however it may be less than if you had delivered vaginally.

What bleeding after birth is NOT normal?

• Very heavy bright red bleeding (particularly if this is after the first week)

• You should not be filling a maxi pad in an hour or less

• Large, golf-ball sized blood clots (these should be checked by your healthcare provider!)

• Foul smelling or green coloured vaginal discharge

• Fever, chills or flu-like symptoms

How can you manage your bleeding in the first 6 weeks after birth?

• Only use maxi pads or liners during the first 6 weeks and change them often

• Don’t use tampons or insert anything into your vagina as this can be an infection risk

• Avoid intercourse as recommended by your healthcare provider

• Give yourself time to heal and avoid strenuous exercise

Written by Keryn Thompson, RM & IBCLC

References:

Akazawa, M., Hashimoto, K., Katsuhiko, N., & Kaname, Y. (2021). Machine learning approach for the prediction of postpartum hemorrhage in vaginal birth. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-02198-y

Al-Muzrakchi, A., Jawad, N., Crofton, M., Ahmed, S., Dick, E., Gedroyc, W., & Bharwani, N. (2017). Imaging in the post-partum period: clinical challenges, normal findings, and common imaging pitfalls. Abdominal Radiology, 42(5), 1543–1555. https://doi.org/10.1007/s00261-017-1090-y

Sultan, P., & Carvalho, B. (2020). Postpartum recovery. Current Opinion in Obstetrics & Gynecology, Publish Ahead of Print. https://doi.org/10.1097/gco.0000000000000684

Sward, L. B., & Tariq, S. G. (2019). Maternal-Fetal Physiology, Intrapartum Care, Postpartum Care: A Team-Based Learning Module for Normal Obstetrics. MedEdPORTAL, 15(1), 10856. https://doi.org/10.15766/mep_2374-8265.10856

Weeks, A. (2014). The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next? BJOG: An International Journal of Obstetrics & Gynaecology, 122(2), 202–210. https://doi.org/10.1111/1471-0528.13098

Woodd, S. L., Montoya, A., Barreix, M., Pi, L., Calvert, C., Rehman, A. M., Chou, D., & Campbell, O. M. R. (2019). Incidence of maternal peripartum infection: A systematic review and meta-analysis. PLOS Medicine, 16(12), Article e1002984. https://doi.org/10.1371/journal.pmed.1002984

Zandvakili, F. (2017). Maternal Outcomes Associated with Caesarean versus Vaginal Delivery. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2017/24891.10239