Postpartum Bleeding

Now that baby has arrived, you are probably waiting for your body to begin to go back to normal. Well, your body is on its way, but "normal" may take some time to achieve. For the first few weeks, for instance, you will have to deal with postpartum bleeding. Postpartum bleeding is a completely normal part of the postpartum period and, for the most part, goes away on its own. However, bleeding during the postpartum period can sometimes indicate underlying health complications.

Lochia

Lochia is the name given to postpartum bleeding. Every woman who delivers a child, either vaginally or through cesarean section, will experience this type of bleeding. It is the way in which your body expels excess mucus, placental tissue, and blood after giving birth.

Lochia is very similar to the bleeding you experience during your menstrual period, however, it is much heavier. It typically begins in the hours immediately following birth and usually continues for two or three weeks. However, in some women lochia can last for up to six weeks.

How Much Bleeding After Birth Is Too Much

Symptoms of Lochia
Lochia usually begins as a bright red discharge from the vagina. This blood typically continues to be bright red in color for between four and ten days. After ten days, your lochia will become a pink color, eventually changing to a yellowish-white color. This blood flow may be constant and even, or it may be expelled in intermittent gushes. Lochia may also be accompanied by numerous small blood clots, about the size of a grape.

Dealing with Lochia
Postpartum bleeding can sometimes be annoying to contend with, however, there are some ways to make the going easier:

  • Rest as much as you can, and avoid excess standing and walking (this will exacerbate the blood flow).
  • Use heavy duty maxi pads to soak up the blood.
  • Do not use tampons for at least six weeks after pregnancy. Tampons can introduce bacteria in to the vagina and uterus, causing infection.

Warning Signs
Typically, lochia is not the result of any health complication and will end on its own when your body is ready. However, some women do experience problems with their postpartum bleeding. If you experience any of the following signs, call your health care provider or visit your nearest emergency room:

  • bright red discharge for more than seven days after birth
  • discharge that smells bad
  • fever and chills
  • abnormally heavy bleeding (in which a maxi pad is soaked in less than one hour)

Postpartum Hemorrhaging

Postpartum hemorrhaging is a more severe type of post-pregnancy bleeding. If you lose more than 500 mL of blood after a vaginal birth, or more than 1000 mL after a cesarean section birth, you are classified as having postpartum hemorrhaging. Postpartum hemorrhaging can be a very dangerous condition, and is associated with various complications including heavy blood loss and even maternal death.

Postpartum hemorrhaging occurs in between 1% and 10% of all pregnancies in the United States. It usually begins in the 24 hours immediately following childbirth (early postpartum hemorrhage), however, it can occur anytime during the six weeks following delivery (delayed postpartum hemorrhage).

What Causes Postpartum Hemorrhaging?
The most common cause of postpartum hemorrhage occurs when the uterus does not contract after birth. This allows the uterus to continue bleeding, and can result in massive blood loss. Other causes of postpartum hemorrhage include:

  • failure to pass all of your placenta
  • forced removal of the placenta
  • trauma to the uterus, cervix, or vagina during delivery

Who's At Risk for Postpartum Hemorrhaging?
Every woman is at risk for developing postpartum hemorrhage. However, there are certain factors that will increase your risk. These include:

Symptoms of Postpartum Hemorrhaging
It is extremely important that every new mother knows how to recognize the symptoms of postpartum hemorrhage. Quick treatment is essential in order to prevent excessive blood loss and death. Symptoms include:

  • massive blood loss
  • passing large clots
  • dizziness, lightheadedness, or fatigue

Treating Postpartum Hemorrhage
Postpartum hemorrhage is usually taken very seriously. If you are suffering from this type of bleeding, you will likely be treated in hospital. Treatment includes:

  • uterine massage to stimulate contractions and stop blood flow
  • the medication Pitocin, which stimulates uterine contractions
  • the removal of excess placenta, typically by hand to prevent further bleeding
  • blood transfusion (if there is massive blood loss)
  • hysterectomy (if there is damage to the uterus)
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