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Bleeding after birth

Bleeding after birth

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Does every woman experience bleeding after birth?

Every woman will experience postpartum bleeding regardless of their birthing method. This post-birth bleeding is known as lochia, which is a mix of mucus, tissue, and blood that is discharged as the uterus sheds its lining after childbirth.

Do women who have had a caesarean still experience bleeding?

In some cases, women who have had a caesarean birth may notice less bleeding.

Why do women bleed after birth?

During pregnancy, blood vessels develop between the uterus and placenta. After the placenta detaches from the uterine wall following delivery, these blood vessels remain open and bleed.

What are the stages of postpartum bleeding?

- Rubra: bright or dark red, lasting 3-4 days

- Serosa: pinkish-brown, lasting 4-10 days

- Alba: whitish-yellow, lasting 10-28 days

What postpartum bleeding is considered normal?

Day 0-4 bright red in colour, small/medium clots with flow similar to that of a period

Day 5-8 pink/red in colour, small clots with a medium flow that is heavier with activity

Days 9-14 pink/brown in colour, no clots with a light flow and minimal loss

Weeks 3-4 light brown/yellow in colour, no clots with blood changing to discharge that is now tapering off

How much blood is too much after birth?

If you have lost more than 500ml of blood during your birth, this is considered a primary postpartum haemorrhage. This can happen immediately following birth or within 24 hours after your birth. Additionally, there is a possibility of experiencing a secondary postpartum haemorrhage which is defined by further blood loss still totalling 500ml or more between 24 hours to six weeks after your birth.

When does postpartum bleeding stop?

The uterus contracts to close the blood vessels, and over the course of 7-10 days, it continues to contract, heal, and reduce the bleeding. If the uterus does not contract as well as it should, this is when we will see a postpartum haemorrhage.

Postpartum bleeding can last up to 12 weeks, but typically lasts around 4-6 weeks. Initially, the bleeding is heavy and bright red to brownish red in colour, gradually becoming lighter in flow and colour over time.

Does breastfeeding affect postpartum bleeding?

It is normal for blood loss to increase while breastfeeding, as oxytocin released during breastfeeding causes the uterus to contract and expel lochia more rapidly. Activities like exercise and cleaning can also temporarily increase blood flow, especially during the first two weeks postpartum. You may also notice an increase when you get up in the morning due to the blood pooling overnight.

What postpartum bleeding is not normal?

  • Soaking through a pad in an hour or less
  •  Passing large clots
  •  Foul-smelling discharge

If you are passing big clots, your midwife wants to know. Keep any pads to show your midwife if possible. Passing large clots can indicate something more serious.

It is important to monitor the heaviness of postpartum bleeding, as any abnormal or excessively heavy bleeding between 24 hours and 12 weeks after birth could indicate an infection.

When should you seek help for postpartum bleeding?

Seek medical assistance if you experience fevers, feeling generally unwell, foul-smelling discharge, or unexpectedly heavy or increasing bleeding.

If you have concerns or are unsure about your postpartum bleeding at any point, do not hesitate to contact your local maternity department for guidance.

 References

Cleveland Clinic. (2022, March 11). Lochia (postpartum bleeding): How long, stages, smell & color. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/22485-lochia

Is vaginal bleeding normal after birth? (n.d.). https://www.health.qld.gov.au/__data/assets/pdf_file/0033/706587/c-pph-bleeding.pdf

Postpartum haemorrhage. (n.d.). Www.pregnancybirthbaby.org.au. https://www.pregnancybirthbaby.org.au/amp/article/postpartum-haemorrhage

Trust), N. (National C. (2019, July 15). Bleeding after birth: 10 things you need to know. NCT (National Childbirth Trust). https://www.nct.org.uk/life-parent/your-body-after-birth/bleeding-after-birth-10-things-you-need-know

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