Postpartum bleeding – what causes it and should I be worried?

It’s normal to bleed from your vagina after having a baby. Discover what postpartum bleeding is, how long it lasts and how to deal with it – plus, when you should get medical help.

What is postpartum bleeding and how long does it last? 

After a vaginal delivery

After a caesarean delivery

How can I deal with postpartum bleeding? 

When to get medical help

Key points



You might feel surprised or worried by the blood, but you can rest assured that it’s a completely normal part of your body’s recovery.

Read on to find out what postpartum bleeding is and how to manage it – and when you should get medical advice.

## What is postpartum bleeding and how long does it last? 
Bleeding after birth starts when your placenta comes away from the wall of your womb (uterus). During a vaginal birth, this usually happens very soon after you’ve delivered your baby – within 5 to 30 minutes. You may notice a gush of blood from your vagina, followed by the placenta.

The bleeding that happens in the days and weeks after this is known as ‘lochia’. It’s similar to when you have a period, in that your womb is shedding its old lining and replacing it with a new one. 

Lochia is actually a mixture of blood, mucus and tissue from your womb – it’s your body’s way of getting rid of all the extra things it needed while your baby was growing inside you.

How long does postpartum bleeding last? This can vary, and also depends on how you delivered your baby. The bleeding goes through several stages, and lessens as your womb heals and returns to its pre-pregnancy size.

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## After a vaginal delivery

Your postpartum bleeding will be quite heavy at first. In the first week, it can range in colour from fresh red to dark brown or pinkish red. It will probably also contain a few clots, which will get smaller over time. 

Around 7 to 10 days after the birth, the blood flow will start to get lighter, and be darker brown or pinkish red. 

After a couple of weeks, the flow will be lighter still, and paler in colour. You may see creamy white or yellow discharge, as well as pinkish red or brown. 

Lochia usually stops about 4 to 6 weeks after the birth, but it can sometimes go on for longer.

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## After a caesarean delivery

If you had a caesarean, or C-section, you’ll probably have less lochia, but you’ll still see some blood for a few weeks after the birth. 

As with a vaginal delivery, this will change in colour over time, from red and brown to creamy white or yellow.

![iStock-1248789844](//images.ctfassets.net/iqo3fk8od6t9/3SV05QnuJWm2LjySuD5pWG/a7d1b2d89fd4a2e1a9745a218f11306b/iStock-1248789844.jpg)



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## How can I deal with postpartum bleeding? 

Postpartum bleeding can be quite heavy at first, so you’ll want to have plenty of maternity pads ready. These pads are much more absorbent than ordinary sanitary pads, as well as being softer and less likely to cause irritation. 

You should wash your hands before and after changing your pads and change them regularly, to reduce the chance of infection. You’ll probably need to change them every hour or 2 to begin with.

Avoid using tampons for postpartum bleeding, as they can increase your chances of picking up an infection. It’s best to wait until your postnatal check-up before considering tampons.

If you’re breastfeeding, you might notice the bleeding becomes heavier and redder when you feed your baby. This is because breastfeeding makes your womb tighten (contract). This can also cause a cramping sensation, similar to period pain. This is normal and painkillers may help – but it’s best to speak to your doctor or midwife about what’s suitable for you.

It’s worth noting that a small amount of the postpartum bleeding may also come from a cut or tear that happened during the birth. For example, you may have a wound between your vagina and bottom (perineum). If so, it’s important to keep the area clean to avoid infection – make sure you wash once a day, as well as changing your pad regularly. Talk to your midwife if your tear or stitches are sore or uncomfortable or bleeding heavily.

And bear in mind that any sort of exercise can make the bleeding heavier. This can also happen if you try to do too much, too soon. If you notice that your bleeding is getting heavier again in the weeks after the birth, it could be a sign that you need to slow down a bit.

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## When to get medical help
After you’ve given birth, it’s important to keep an eye on your body. If everything seems to be progressing well, you can leave any questions you might have for your 6-week check-up. 

If you notice certain symptoms with postpartum bleeding, you could need urgent treatment. Speak to your doctor or midwife if the bleeding is getting heavier. You should call for emergency medical help if you start to bleed heavily and:

- the blood is soaking through more than 1 pad in an hour
- the blood is getting fresher (bright red) and heavier, even after you rest
- you notice large clots of blood (the size of a large coin)
- you feel dizzy or faint
- you have a racing or irregular heart beat

You should also contact your doctor or midwife right away if you notice the following symptoms, as you might have an infection:

- lochia that smells unpleasant
- pain in your lower tummy and groin
- headache
- fever or chills

If you’re worried about your postpartum bleeding, or any other symptoms you’re getting after giving birth, it’s always best to speak to a medical professional.

## Key points
- postpartum bleeding is a normal part of giving birth
- it starts when the placenta comes away from the wall of your womb
- the bleeding is called ‘lochia’ and is a mixture of blood, mucus and tissue from your womb
- it usually lasts for 4 to 6 weeks after the birth, but can last longer
- it varies in colour, from red, brown and pink to creamy white and yellow
- bleeding may also come from cuts or tears that happened during the birth
- it’s important to keep clean, change your maternity pads regularly and look out for signs of infection 
- call for urgent medical help if you have sudden heavy bleeding with clots and you feel unwell

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References

Helen Prentice

Susie Parker

Dr Adiele Hoffman

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