Giving birth to a healthy baby is a terrifying experience yet one of the best moments for a mother especially for those having their first child. Vaginal bleeding is normal days after giving birth. This is due to the natural process after the placenta that has been supporting the baby is shed. Such an event is known as postpartum bleeding. Although postpartum bleeding is considered normal, knowing the differences between normal and abnormal one is important as medicine and treatment may be needed to prevent complications.
The menstrual period-like discharge during postpartum bleeding is also known as lochia. Either vaginal birth or caesarean delivery, a woman will experience postpartum bleeding. Normal bleeding discharge lasts about six weeks after the birth. Vaginal bleeding may be difficult to truly understand which colour, sizes and consistency that is normal. For instance, some women may get reddish-brown lochia (lochia rubra) in the first few days while some may only get small blood clots. These reddish-brown bleeding with small clots will then turn into a watery one (lochia serosa). It can be in brownish or pinkish colour which lasts for 2 to 3 weeks.
Eventually, this colour will change to whitish or yellowish pale shade (lochia alba). This lochia may be up to 6th week and some may be even until the 8th week after delivery. Lochia in the first two weeks after delivery is usually heavy and this amount gradually decreases as time goes by. Spotting or light bleeding may continue till the sixth week after delivery. Lochia typically become redder or heavier during breastfeed due to contraction of the womb. Nipple stimulation during breastfeeding causes the oxytocin hormone to be released into the bloodstream. Oxytocin causes contraction of the smooth muscle in the uterus. This explained why some breastfeeding women feel cramps as if having period pains. Increased lochia while being physically active or in the morning is entirely normal.
Wearing sanitary towels that are meant to absorb heavy blood flow is usually needed during the first few days after delivery. Regular change of these sanitary towels and practising proper hand washing before and after changing it is crucial to maintain good hygiene and avoid possible infection. Bath or shower is of course welcomed as this helps the area clean. Using tampons or menstrual cups at this time may not be a good idea as it could increase risk for infection. During this time, wounds from the placenta that was attached to the uterus and cuts or tears in or around the vagina are still not fully healed and susceptible to infections.
Although lochia in general is normal, some lochia may be a concern and need medical attention. If a woman experiencing any signs or symptoms below, do speak to a healthcare professional immediately:
- Super heavy bleeding that could be seen from a saturating pad in less than an hour
- The bleeding smells weird or off than usual
- Severe abdominal pain or cramp
- Worsening pain between the vagina and anus (the perineal area)
- Big clots in the blood that could be in size of a golf ball
- Increased heart rate
- Feeling weak or light-headed
- Blurry vision
- Fever or high temperature above 38 C
Postpartum bleeding in general should not pose worries as it is a condition that occurs at delivery or right after giving birth which usually have been assessed by healthcare professionals before discharging a woman to home. However, delayed postpartum bleeding causing a woman to bleed heavily after they are allowed to go home may still occur even if it is rare. Thus, a mother and those around her need to be aware of the signs or symptoms of an abnormal lochia.