Postpartum Bleeding 101

High on the list of things about childbirth nobody warns you about is lochia, a pleasant-sounding name for the less-than-pleasant experience of bleeding after childbirth. Lochia is not unlike a regular period, but it can be heavier than a period, can contain large clots and can last four to six weeks. Here’s what to expect and how to know if you’re experiencing something outside the norm.

Lochia happens whether you’ve had a vaginal or c-section delivery. It will be heaviest for the first three days or so, and bright red, slowly lessening in volume and changing in color to pink, brown, and yellowish white. You may feel some cramping like with a regular period, especially early on as your uterus is contracting back to its regular size. It is not uncommon to think your bleeding is about to stop after a few weeks only for it to pick back up again before going away for good. This can be totally normal and out of your control, or it could be a sign that you are doing too much physically, too soon. Kick back and rest a bit!

Tips For Managing Bleeding

After having no period for nine months or longer, you might need a few tips for managing your lochia. A few things to keep in mind:

• If you have a hospital birth, the hospital will provide you with very attractive giant mesh underwear and pads, but you might want to bring some adult diapers with you as well to see if those are more comfortable for you.
• Tampons are off-limits for the first six months. Stick to some type of pad or diaper.
• Dealing with pain from a vaginal birth, perhaps some tearing? Make some soothing padsicles with maxi pads, aloe vera, witch hazel and (optional) lavender essential oil. Find instructions here: https://pregnantchicken.com/padsicles/

Signs and Symptoms of a Problem

Finally, make sure you know what signs to keep an eye out for that something is not right. Some symptoms you should discuss with your medical professional:

• A fever over 100.4 or severe chills
• Bleeding that soaks more than one sanitary pad per hour
• Bright red bleeding persisting past three days
• Extremely large blood clots larger than a plum
• Foul-smelling vaginal discharge
• Pain, burning or trouble urinating
• Severe cramping or abdominal pain that is not relieved by pain medication (some cramping is normal)
• Increased redness, swelling, bruising or pain on your perineum, or separation of your stitches
• Blurred vision
• Severe headaches or fainting

Before leaving the hospital or birth center, or before your homebirth midwife and assistant leave you, you’ll be given postpartum instructions and when to be concerned about bleeding and/or pain. Always contact your provider if you have a concern about your health.