All You Need to Know About Postpartum Bleeding
Postpartum bleeding is one of the natural consequences of childbirth. If the bleeding is light, then you can treat it at home. However, if the bleeding is heavier, then there may be certain complications.
Also called postpartum lochia, this expulsion of blood is heavy in the first two or three days and usually decreases as time passes. This heavy bleeding shouldn’t last longer than two weeks.
It’s a totally natural process. The body discards what remains in the uterus after birth: the cervical mucus, the remains of the placenta and other secretions.
In order for this expulsion to be more efficient, your body generates afterpains. These are intense contractions that occur a day or two after giving birth. Their purpose is to aid the “cleaning” process.
Three phases of postpartum bleeding
We can divide postpartum bleeding into three stages:
- First phase: In this phase there is a reddish-colored lochia. It contains epithelial cells leukocytes and, sometimes, hair belonging to the fetus. It occurs in the first two or three days after giving birth. The blood can flow steadily, or at intervals, and it may also contain clots.
- Second phase: The body expels serous fluid, a rosy-colored lochia. It occurs between day three and ten after giving birth. It contains erythrocytes and leukocytes and serous exudate.
- Third phase: Finally, in this phase, there will be white or yellowish lochia. This occurs after the second week after giving birth. The color is due to the fact that it mainly contains leukocytes.
Care during postpartum bleeding
If you’re wondering what you should do to cope with this stage, here are some recommendations:
- Take showers and not baths. In this way you can prevent possible infections. Make sure you apply plenty of water.
- Use postpartum compresses to sanitize the area.
- You shouldn’t use tampons.
- Be very attentive to symptoms such as fever or malaise, as this may mean you have some type of infection.
- When going to the hospital or to check-ups, take a bag with personal hygiene items. After birth, we recommend that you bring special towels or dressings for pregnant women in order to avoid accidents.
“Postpartum bleeding is a totally natural process. During this period, the body discards remains that are left in the uterus after birth”
When bleeding becomes a hemorrhage
When the amount of bleeding after giving birth exceeds the equivalent of 2 cups, specialists refer to it not as postpartum bleeding, but as postpartum hemorrhage. In cesarean sections, this increases to 4 cups.
It can occur in the first 24 hours of the postpartum period. This is called early postpartum hemorrhage. If it occurs after this period, it goes by the name of late postpartum hemorrhage. The latter usually occurs less frequently than the earlier.
Causes of postpartum hemorrhage
One cause of postpartum hemorrhage – perhaps the most worrisome – may be what is called uterine atony. This is the loss of muscle power in the uterus after the baby is born and the placenta is expelled. If this happens, what that organ does naturally is have contractions. In this way, bleeding is kept to a minimum.
When this doesn’t happen, the risks to the mother are quite high. Doctors must act quickly to stop the bleeding. If the bleeding is very severe, then the new mom’s life could be at risk.
On the other hand, it could also be due to other factors such as the following:
- Injuries: If tissue or blood vessels tear during birth then bleeding is a very likely consequence.
- Tissue retention: This occurs when fragments of placenta or even the fetus remain attached to the uterus.
- Coagulopathies: This is the failure in the coagulation process. It can be caused by conditions such as preeclampsia.
Excessive bleeding immediately after giving birth is highly preventable. The method for this consists of uterotonic drugs such as oxytocin or carbetocin that are administered intravenously. This should be a simple and routine task for medical specialists.
Complications with postpartum bleeding
As we mentioned before, certain situations can cause a slight postpartum bleeding to turn into hemorrhage. That’s when everything becomes far more complex.
Unfortunately, statistics from the World Health Organization in relation to deaths after childbirth aren’t encouraging. Worldwide, 830 women die from complications in childbirth or pregnancy every day.
Most of them – 99% to be exact – lived in developing countries or rural areas. However, it’s noteworthy that this mortality rate went down by 44% between 1990 and 2015.
Medical advances have been very helpful. Specialist care can save the lives of both women and babies. Today, developed countries hardly ever experience this type of problem.
“Apart from exceptional situations, postpartum bleeding is something that no longer generates problems”
During postpartum bleeding you should always remain calm. In most cases, postpartum bleeding is something that no longer causes problems.
Just try to put all our recommendations into practice regarding personal hygiene, and don’t hesitate to contact your doctor if you feel any sort of discomfort or other symptoms.
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Protocolo de Atención del Puerperio Fisiológico. Ministerio de Salud. [Documento en línea].
- Visness, C.M., Kennedy, K.I., Ramos, R. The duration and character of postpartum bleeding among breast-feeding women. Obstet Gynecol. 1997;89:159–163.
- Oppenheimer, L.W., Sherriff, E.A., Goodman, J.D., Shah, D., James, C.E. The duration of lochia. BJOG. 1986;93:754–757.