Postpartum Bleeding: What’s Normal vs What’s Not

You learn all about what to expect during pregnancy, labor, and childbirth – but why does no one talk about the fourth trimester and the physical changes that happen during the immediate postpartum period? Whether you’ve had a vaginal birth or a cesarean birth, you will experience some degree of postpartum bleeding, also called lochia.

Normal Postpartum Bleeding

It is normal to bleed after you’ve had a baby – this is your body’s way of getting rid of extra tissue that helped support your baby while they were in the womb! Bleeding should be heaviest in the first few days after giving birth, and it will be bright red. You may also see some clots, but they shouldn’t be larger than a golf ball. When you bring your baby home, you might see heavier bleeding from excess movement. This is your body’s way of telling you to rest and relax. If you are breastfeeding, you may experience gushes of bleeding when your baby latches – this is how it all comes full circle. Your body’s hormones work with your baby’s feeding mechanisms to help to heal your body. Over the first 6 weeks, your bleeding should get lighter and more brown. Avoid putting anything in the vagina, including tampons, unless otherwise instructed by your care provider.

Abnormal Postpartum Bleeding

Heavy postpartum bleeding is also called postpartum hemorrhage. While postpartum hemorrhage is most likely to occur within the first 24 hours after giving birth, it can occur anytime in the first 3 months postpartum. Here are some warning signs to look out for (tell your care provider or call 911 if any of these symptoms occur):

·        Blood clots larger than a golf ball

·        Bright red, heavy bleeding that isn’t getting lighter past day 3 postpartum

·        Bleeding that soaks through more than 1 maxi pad in one hour

·        Blurred vision

·        Chills

·        Dizziness, weakness, faint feeling

·        Clammy skin

·        Rapid heartbeat

·        Nausea

So what causes postpartum hemorrhage?

The uterus is a muscle that continues to contract immediately after your baby and your placenta are born. The uterus contracts to help to repair the space where your placenta was (it is essentially an open wound). You are at a higher risk of postpartum hemorrhage if you’ve had it before, are in labor for a long time, have a larger baby, give birth to multiples, or if you’ve had a baby before. Other situations that increase the risk for postpartum hemorrhage include uterine rupture, giving birth via cesarean, having general anesthesia or Pitocin during birth, being obese, having preeclampsia, or having issues that affect the placenta.

Treatment options of postpartum hemorrhage include…

Medications, surgery and other procedures, blood transfusion, and uterine massage. Postpartum hemorrhage often happens because of reasons that are beyond your control, but keeping an eye out for warning signs can help you to catch it early. Prioritizing rest and relaxation can also help your body heal and recover faster. Another option for assisting in the prevention of postpartum hemorrhage is placenta encapsulation – read more about it here!