Is postpartum bleeding normal?
Yes, vaginal bleeding is totally normal, natural and a good thing for your body (even though it kinda sucks—we know!). The technical term is called lochia, and it refers to the discharge that follows after delivery, mostly stemming from where the placenta was attached. This applies to both C-sections and vaginal deliveries.
The warm, protective world of your womb is created, in part, by amniotic fluid and an excess of mucus, blood cells and tissue that lines the uterus for the duration of pregnancy. Once baby arrives, your body starts ridding itself of the lochia it no longer needs.
Lochia presents differently in every woman and can be affected by different factors. For example, a mom who delivered via a cesarean section may have less bleeding after a day or two than a mom who had a vaginal birth.
On another hand, mothers may notice a temporary increase in lochia when first waking up in the morning, while physically active or while breastfeeding. (This is why you’ll hear health care providers tell new moms to avoid stairs or any kind of physical activity after birth. More lochia can mean you’ve overdone it and need to take a break!)
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How long does the bleeding last?
You should expect to shed lochia for about four to six weeks post-delivery. It starts out as heavy bleeding with some blood clots and can be bright-or dark-red in coloring for the first seven to 10 days, then gradually tapers off in blood flow amount and coloring, fading from red to pink, to brown, to yellow or white.
The three stages of lochia are characterized by the following, but remember each stage will vary from person to person.
- Days two to five post-delivery
- Heaviest bleeding with smaller clots (about the size of a quarter and no larger than a golf ball)
- Blood is bright red or dark red
- Noticeable sensations of a gush when changing positions (like standing up or lying down)
- Begins around day four post-delivery and lasts about two weeks
- Medium bleeding that includes noticeable mucus and discharge; waterier consistency
- Blood is more pink or brown
- Begins around week two and lasts until about six weeks (starting from the day you delivered)
- Light bleeding or spotting that mostly consists of white blood cells
- Blood is yellow or white
Can postpartum bleeding stop and start again?
While the general timeframe for vaginal discharge to end is about six weeks postpartum, it’s normal for there to be periods of active bleeding as well as times where you don’t notice as much. While lochia shouldn’t stop altogether until it’s complete, light spotting is normal.
Part of what causes a sudden gush of lochia are the uterine contractions (also called after-pains that you’ll physically feel for the first few days following birth, and yes, they can be painful) that work to restore the uterus back to its pre-pregnancy size and shape. As the uterus contracts, you’ll likely notice larger volumes of blood. This means your body is doing what it needs to for proper healing and restoration.
What are warning signs?
We know you’re a busy new mom now, but you should contact your OB/GYN or seek medical attention right away if you notice any of the following signs or symptoms, which could point to a potential infection or postpartum hemorrhage:
- A very heavy flow that can bleed through one maxi pad per hour
- Large blood clots (think the size of an egg, a lime or larger)
- Fever, chills and severe cramping or pain that lasts more than a few days after delivery
- Foul-smelling lochia (It should smell like a regular menstrual period.)
- Swelling and sensitivity around the vagina or perineum (the area in between the vagina and rectum)
- Headache, blurred vision, faintness, dizziness or breathlessness
- Decreased blood pressure
- Increased heart rate
How does lochia differ from a postpartum period?
The main differences include appearance, volume and most of all, timing.
Typically, your first normal period after baby will show up in six to eight weeks if you’re not breastfeeding. If you are nursing, the return of your period will vary, and it’s common for mothers to not have a period at all while exclusively breastfeeding—even up to a year or more.
Regardless, the return of bright red bleeding after your lochia has gone through the stages mentioned above would likely indicate your first period. Additionally, your period should stay consistent in flow amount no matter your level of physical activity, which differs from lochia patterns.
Best practices for managing lochia.
Postpartum bleeding is a normal part of women’s health and doesn’t require special treatment (unless there’s an infection), but these tips can help with coping for the full six or more weeks:
- Use sanitary pads, not tampons: Nothing should be inserted into the vagina until cleared by your physician at your six-week checkup. You can opt for adult diapers for the first week while bleeding is the heaviest to prevent leakage. These offer better protection and absorbency and are easier to wear than the mesh undies provided by the hospital (though we don’t hate those either).
- Once bleeding subsides, using period underwear is a great alternative to get you through the remainder of the transition. (It helps you feel more human, too.)
- Stick to dark, comfortable clothing: Navigating changing out pads/underwear/cooling packs/etc. may end in a few stains upfront. Black leggings or bottoms will be a forgiving friend of accidental messes until your bleeding gets lighter and more manageable.
- Try to take it easy: We know it’s the most cited advice—and often most difficult to implement, but staying off your feet for long periods of time or avoiding overexerting yourself will keep excess bleeding at bay.
Remember that the detaching of the placenta left a plate-sized wound inside your body that needs time to heal. That’s not only grounds for relaxing as much as possible, but some pretty impressive bragging rights, too.