7 Revealing Truths About Postpartum Bleeding

Postpartum bleeding, in light to moderate amounts, is natural after giving birth. While most bleeding is normal, it’s essential to distinguish between regular vaginal bleeding after giving birth and postpartum hemorrhage, a potentially life-threatening condition.

This comprehensive guide explores the various aspects of normal vaginal bleeding after birth, from what it is, what is expected, the different types of lochia, postpartum hemorrhage, its cause, treatment, and prevention.

Please allow me to share my story.

During the birth of my first baby, I endured an intense 3-hour delivery. Utterly exhausted, I faced significant blood loss after finally bringing my little one into the world. Thankfully, medical intervention resolved the issue, and to replace the blood loss, I received two units of red blood cells in the form of a blood transfusion.

However, the days following the delivery have been immensely challenging. My face, hands, and feet were swollen, and sitting became nearly impossible.

A third-degree laceration from the vaginal delivery made my recovery slow and painful. Adding to the difficulties, I experienced a substantial decrease in my breast milk supply due to the postpartum hemorrhage.

Every woman’s experience is unique, so it’s important to note that not all women will go through the same thing I did. It is more likely that a woman will experience regular postpartum bleeding. 

And on that note, let’s explore what it is.

1. What is normal postpartum bleeding?

After a baby is born, a woman’s body begins a recovery and healing process that is both natural and crucial for her well-being. A significant part of this process involves a discharge called lochia. 

Lochia is a normal vaginal discharge after the birth of a baby that comprises a combination of blood cells, fluid, tissue, and microbes originating from the endometrial lining where the placenta was attached during pregnancy. 

It’s a bodily function all new mothers will experience, and it can continue for several weeks post-delivery. The volume of this discharge can range significantly, with some women experiencing up to half a liter over a month.

Any significant deviation from the expected pattern of this discharge should warrant further medical examination.

2. What are the three different shades of lochia?

Lochia, the postpartum vaginal discharge, changes color, texture, and volume over time. During the early days after childbirth, you may notice an increase in flow, especially when you wake up, engage in physical activities, or while breastfeeding.

However, if your pad becomes saturated within an hour due to heavy lochia flow, it’s advisable to seek medical guidance. Excessive lochia could potentially signal postpartum complications, such as substantial bleeding related to uterine atony or retained placental fragments.

The color of the lochia is also a valuable indicator of your recovery progress. Under normal circumstances, it begins as bright red, known as lochia rubra, and later transitions to a pink or brownish shade, referred to as lochia serosa. Eventually, it evolves into a whitish or yellowish discharge, termed lochia alba, signifying the body’s healing process.

Should you notice a return to red lochia, it may suggest factors like excessive physical activity, uterine atony, or the presence of an infection.

While it’s not unusual to encounter blood clots in lochia, smaller clots are typically considered normal. However, if you come across large blood clots, it’s essential to discuss this with your healthcare provider to ensure no underlying issues.

3. How can I differentiate normal bleeding from postpartum hemorrhage?

Postpartum hemorrhage is a serious concern that requires prompt diagnosis and treatment. It is defined as heavy bleeding following childbirth and can have severe consequences, including a drop in blood pressure and, in extreme cases, shock and death.

In obstetrics, postpartum hemorrhage is classified as blood loss exceeding 1,000 ml, whether from a vaginal birth or a cesarean section.

Consequently, it is crucial for nurses to precisely assess any instances of significant bleeding following childbirth to ensure appropriate management.

4. What causes postpartum hemorrhage?

Postpartum bleeding can be a concerning issue for new mothers, and understanding its causes is crucial for early detection and prevention.

Several factors can contribute to postpartum hemorrhage, and here’s a breakdown of these causes:

causes-of-postpartum-hemorrhage

1. Uterine Atony. A condition where the uterus loses its firmness and fails to contract effectively. Identifiable signs of uterine atony include an abnormally soft uterus or an indistinct uterine fundus.

2. Bladder Distention. A bladder full of urine can press on the uterus, displacing it from its central position and impeding proper uterine contraction. This situation can result in a soft, boggy uterus that doesn’t contract as it should, leading to severe bleeding.

3. Retained Placental Tissue. Following the baby’s delivery, the placenta should be expelled entirely. Incomplete placental removal, where small pieces of the placenta remain in the uterus, can also lead to postpartum bleeding.

4. Lacerations and Hematomas. During childbirth, lacerations can harm blood vessels, and hematomas can develop when blood vessels break or the surrounding tissue is injured. If hematomas are not quickly identified and treated, they can press on nearby blood vessels and tissues, leading to heavy bleeding after giving birth.

5. Bleeding Disorder. In cases of postpartum bleeding, coagulopathy can be caused by factors like clotting disorders, the use of clotting factors during childbirth, or conditions like preeclampsia. When coagulopathy occurs, the body’s ability to form blood clots and prevent bleeding is weakened.

6. Placenta Accreta. This is a rare condition where the placenta is implanted too deeply or beyond the uterine lining. A planned cesarean section ensures safe delivery of the baby, necessitating the expertise of skilled obstetric providers throughout the procedure.

Your nurse plays a pivotal part in making sure you are not excessively bleeding after you give birth. Timely recognition and appropriate measures can help prevent and manage this condition effectively.

Your health and well-being during the postpartum period should never be taken lightly, so seek medical advice immediately if you experience abnormal bleeding.

5. What are the treatment options for postpartum hemorrhage?

Treatment of postpartum hemorrhage aims to stop the bleeding and address its underlying causes. Immediate actions may include putting pressure on the bleeding vessels, administering medications, or, in extreme cases, surgery.

Healthcare providers strive to find and treat the root cause of the bleeding, which may involve removing any retained placental tissue or repairing uterine injuries.

Timely and effective treatment is crucial to ensure the safety and well-being of the mother.

6. How to Prevent Postpartum Hemorrhage?

Preventing postpartum hemorrhage is a critical aspect of postpartum care. While some risk factors, such as c-section birth, are beyond an individual’s control, some steps can be taken to minimize the risk.

Early recognition of postpartum hemorrhage risk factors and close monitoring by healthcare providers are essential.

Some women are at greater risk due to medical conditions or other factors, and understanding these risks is vital to providing appropriate care.

7. What is the Importance of Postpartum Check-Ups?

Regular postpartum check-ups with healthcare providers are crucial to monitor postpartum bleeding and ensure a healthy recovery. These check-ups help healthcare professionals assess the progress of lochia and provide guidance on what to expect during the postpartum period.

The postpartum period typically lasts four to six weeks or more, and healthcare providers play a significant role in helping women navigate this phase. They can address any concerns and provide support for a smooth recovery.

FAQ

Q: How long does postpartum bleeding typically last?

A: Postpartum bleeding can last for about 4 to 6 weeks, with the heaviest flow occurring in the first few days after delivery.

Q: What is postpartum bleeding, and is it normal?

A: Regular postpartum bleeding, also known as lochia, is the discharge of blood and tissue from the uterus after childbirth. It is a normal part of the postpartum period and can last a few weeks.

Q: When should I be concerned about the amount of bleeding postpartum?

A: If you saturate a pad within an hour or experience heavy, persistent bleeding and passing multiple large blood clots, contact your healthcare provider immediately.

Q: Is it normal to have blood clots in postpartum bleeding?

A: Small blood clots in postpartum bleeding are common and usually not a cause for concern. However, large blood clots should be discussed with your healthcare provider.

Q: Can postpartum bleeding be affected by the type of delivery (vaginal or cesarean)?

A: Yes, the type of delivery can impact the amount and duration of postpartum bleeding. Vaginal births often result in more significant bleeding than cesarean sections.

Q: Are postpartum hemorrhage and postpartum bleeding the same thing?

A: No, they are not the same. Postpartum bleeding is a normal part of recovery, while postpartum hemorrhage is an excessive and potentially life-threatening bleeding that requires immediate medical attention.

Q: Why does my postpartum bleeding keep stopping and starting?

A: It’s common for postpartum bleeding to vary in intensity and consistency. This starting and stopping pattern often occurs as the body goes through different stages of healing. Initially, the bleeding may be heavier and continuous, but as your uterus contracts and heals, it can temporarily slow down or even stop.

However, this is generally part of the normal healing process. If the bleeding stops for an extended period and then restarts, or if you have any concerns, it’s always a good idea to consult your healthcare provider for reassurance.

Conclusion

In conclusion, postpartum bleeding, or lochia, is a normal part of the postpartum experience. It typically involves transitioning from bright red to yellow or white discharge and may include small blood clots.

However, it’s vital to differentiate between normal postpartum bleeding and postpartum hemorrhage, which requires immediate medical attention.

Understanding the causes, diagnosis, and treatment of postpartum bleeding is essential for a safe and healthy postpartum recovery.

Regular postpartum check-ups and open communication with healthcare providers ensure a smooth transition to postpartum life.

If you want to learn more about the best optimal guide for postpartum care, whether you have a spontaneous vaginal birth or c-section, check this out.

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