Postpartum Bleeding

Pregnancy comes with a lot of changes that leave you feeling somewhat rough on the edges. Changes like pains, aches and swollen feet are common. After 40 or more weeks of pregnancy, most women are left feeling a bit bruised and battered because their vagina and uterus have undergone the physically challenging experience of child birth. Other than the bundle of joy, you will also experience different postpartum symptoms. Amongst the many things women will experience after childbirth is bleeding. Depending on the individual, the blood may come out in small gashes or flow evenly like a normal period. Read on to learn how to deal with postpartum bleeding and when you should worry.

Is Postpartum Bleeding Normal?

It is a fact that all women bleed during and post delivery. During pregnancy, the amount of blood in a woman’s body rises by 50%, and this prepares her body for the blood loss.

Here is how it happens: When the uterus and the placenta separate, the area that had attached them together is left with open blood vessels and these vessels start bleeding into the uterus. Once the placenta has been delivered, the uterus continues contracting, closing off the blood vessels and in the process, dramatically reduces the bleeding. If the woman giving birth has a tear or an episiotomy, she may bleed from that site until the tear is stitched.

What Is Postpartum Bleeding Like?

Lochia is the term given to that discharge from the vagina in the postpartum period. Lochia consists of sloughed-off tissues from the uterus’ lining, bacteria and blood.

Right After Birth

The first couple of days after childbirth, it is bright red as it mostly contains blood thus resembling heavy menstrual period. Lochia may come out sporadically in gashes or it might flow evenly. If you lie down for some time, the blood will collect in your vagina, and you may see some clots when you stand/get up.

2-4 Days After Birth

If all goes normally, the discharge will reduce by-the-day and in about two or four days after childbirth, then lochia starts taking a pinkish color and is more watery. About ten days later (i.e. after childbirth), the lochia will be small amounts of yellow-white or white discharge that are mostly made of uterus lining cells and white blood cells.

2-4 Weeks After Birth

In another 2 to 4 weeks, the lochia will decrease as it stops. However, there are women who experience intermittent spotting or scant lochia for some more weeks. If you have had the Depo-Provera (birth control) shot or started on the “minipill” (progestin-only birth control pill), you are likely to spot for about a month or more. This is normal.

How to Deal with Postpartum Bleeding?

• Sanitary Pads. First, use heavy duty sanitary pads given by the hospital and if you have not stocked up yet, make sure you buy more pads when you go home.
• Minipads. As time goes by, the postpartum bleeding tapers off and that is when you can start using minipads. Do not use any tampons for about six weeks as tampons increase the chances of getting an infection in the healing uterus and vagina.

To start with, you may have to change your pad after every hour or two, then after every three or four hours in the coming days and weeks. Always wash your hands prior to and after changing the pad.

• Urinate frequently. Take a short-call as much as possible even if you do not have the urge to. The first couple of days after child-birth, your bladder may seem less sensitive than before. Therefore, you may not feel frequent urges to urinate even when full. Other than urinary problems, having a full bladder makes it hard for your uterus to contract thus causing more bleeding and after-pains.
• Rest. Also, get as much rest as possible. Overworking yourself may result in bleeding for longer or trigger bleeding after the lochia has gone away or lightened.
• Clean. The space between your perineum (back passage) and vagina may have a wound. This is why you need to keep that area clean to prevent infection. Shower or bath at least once each day and change the maternity pad on a regular basis.

There are mothers who like adding some salt to the bath water, but the wound will equally heal just as well when you use clean water only.

When to Worry

Call your doctor or midwife if you experience the following symptoms because you may have an infection:

• You have chills and/or fever
• The postpartum bleeding has an unpleasant smell
• The bleeding remains bright-red and heavy the second week
• One or both sides of your tummy feel tender

Sometimes, a woman experiences much heavier bleeding than the normal postpartum bleeding. Such a condition is referred to as postpartum haemorrhage (PPH). PPH may happen a day after child-birth (primary PPH) or between a day and 12 weeks (secondary PPH). PPH may be caused by a piece of retained placenta or membrane, or when the uterus fails to contract properly after delivery of the placenta.

Call for an ambulance when:

• The postpartum bleeding suddenly becomes too heavy such that it soaks more than a pad an hour.
• The bleeding is persistently bright-red and heavier four days or more after child-birth even when resting.
• The blood clots you pass are large and/or bigger than 50p piece.
• You start feeling dizzy or faint.
• Your heartbeat becomes irregular or starts racing.

You may need a minor surgery to have the rest of the placenta removed. You can also be treated using antibiotics. Once you get the correct treatment for the postpartum haemorrhage, you will be fine. However, it will also take some time, rest and good care for a full recovery.