Post pregnancy bleeding

What’s normal?

For women there are many adjustments to be made once their baby is born. There are the challenges associated with coping with a new baby and sleep deprivation. The body is also adjusting to and recovering from 9 months of rapid expansion. One of the factors women have to cope with is postnatal bleeding, which can often be a source of great concern. 

This is a completely natural event known as lochia. It will happen regardless of whether you delivered your baby naturally or by caesarean section. It is your body’s way of getting rid of excess mucus, placental tissue, and blood after giving birth. It is similar to your menstrual period but it is initially much heavier. 

Lochia usually begins in the hours immediately after giving birth and usually continues for 2 or 3 weeks. But, in some women it can last for up to 6 weeks. 

If you have any concerns, or any of the following symptoms you may wish to contact your healthcare provider:

• Abnormally heavy bleeding, soaking more than one pad an hour
• Your bleeding is bright red for 4 or more days after birth and does not get better when you lie down and rest
• You are passing large clots
• You feel dizzy or lightheaded
• Your heartbeat starts to race or become irregular 

If you have any of these symptoms you may have a postnatal haemorrhage. This is commonly caused by the womb not contracting after birth, allowing it to continue bleeding. Remember that a phone call is relatively cheap and can rapidly help settle any anxiety. It can help determine whether you should be seen straight away by your doctor, or whether you only need some reassurance. Do not hesitate to call for advice if you have any concerns about your bleeding. 

If it is diagnosed as a haemorrhage you will usually be treated in hospital with antibiotics or a minor procedure to remove any retained tissue. This only occurs in the minority of cases however, but it is important you are reassured at all times. 

Practical steps women can take to cope with lochia include stocking up on maternity pads before your baby is born. Two or three packs should do. It is crucial you do not use tampons for at least 6 weeks after pregnancy. Tampons can introduce bacteria in to the vagina and womb, causing infection. 

For any discomfort you may experience associated with this bleeding it is important to remember that each case is different and patients should follow the advice of their attending obstetrician. However, any pain not responding to simple measures of pain relief or applied heat should be followed up.