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Bleeding After Birth: What’s Normal and What’s Not

Monday, February 15, 2021

Whether you deliver vaginally or by C-section, you will have period-like bleeding after birth. Healthcare professionals refer to bleeding after birth as ‘flow’ or ‘lochia’.

Why do women bleed after birth?

The bleeding comes from a raw area inside your body where the placenta was attached. Your body controls the bleeding by squeezing down or ‘contracting’ the uterus.

Breastfeeding helps to control this bleeding. As your baby nurses, the hormone oxytocin is released, causing the uterus to contract. These contractions can be quite painful in the first few days after birth and are referred to as ‘afterpains’.

If you have had an episiotomy or tear, there may also be a little bleeding from that area, but it is typically insignificant. The majority of the bleeding after birth comes from the uterus.

How long can you expect bleeding after birth?

For the first three or four days

You can expect to have bright red bleeding, about as heavy as a menstrual period.

By three or four days after birth

The bleeding typically becomes more watery and pinkish in color. You may go back and forth between the pinkish and the more blood-like flow for a few days, especially if you are more active. If your bleeding becomes bright red and heavy again, you may be overdoing it. Try resting to see if it subsides. Bleeding that stays bright red past the first week is unusual.

Around 8-10 days after birth

The pinkish flow typically gives way to a thicker yellowy white discharge.

A little bit of flow or spotty bleeding may occur for 6 weeks after baby’s birth, but for most women, it will resolve sooner.

Seek medical attention immediately by going directly to the closest emergency room if you entirely soak a large maxi pad (from front to back) in less than an hour.

Consult with your healthcare provider if you:

  • have bright red heavy bleeding for more than a week after birth.
  • pass a clot larger than a loonie ($1.00 Canadian coin).

Can tampons be used for bleeding after birth?

Tampon use is not recommended for at least 6 weeks after both C-section and vaginal births, as it increases the risk of infection in your uterus. Give your body to time to heal.

Are blood clots normal?

It is not unusual to pass a few small blood clots after giving birth. Blood can pool and jell inside the vagina when you are sitting or lying down. Changing your position causes the clots to pass.

Blood clots are usually dark red or maroon in color and have a jelly-like appearance. Clots the size of a $1.00 Canadian coin (“loonie-sized”) or smaller are considered normal.

If you pass a whitish stringy clot, it may be a piece of placenta that was left behind when you gave birth. If more bits are left inside your uterus, you can develop heavy bleeding or infection.

Notify your healthcare provider if you notice any of the following:

  •     Increased cramping or pain in your lower abdomen or back
  •     Fever or chills
  •     A ‘rotten’ odor to your flow. (Note: If you are unsure if your flow has a foul odor, chances are it doesn’t; it is usually quite obvious!)

Whether you have delivered vaginally or by C-section, your body needs time to heal. Please don’t rush your recovery.

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References:
  1. “After-Birth Care for You and Your Baby.” BC Women’s Hospital, 2019, www.bcwomens.ca/our-services/labour-birth-post-birth-care/after-the-birth#Information–after–you–go–home.
  2. “Postpartum Bleeding.” HealthLink BC, 2017, www.healthlinkbc.ca/health-topics/tn9119.
  3. Staff, Familydoctor.org Editorial. “Recovering From Delivery – Postpartum Recovery.” Familydoctor.org, Familydoctor.org, 26 Sept. 2018, familydoctor.org/recovering-from-delivery

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