Bleeding After Birth: What's Normal and What's Not.

Bleeding after birth is normal.

Whether you give birth vaginally or via cesarean section, you will experience some bleeding after birth.  This postpartum bleeding, called lochia, is just one way your body sheds some of the "extras" of pregnancy and restores balance to your healing body.

Mesh panties are synonymous with postpartum healing and bleeding.  -   Birth Story   by Steph Hayes 

Mesh panties are synonymous with postpartum healing and bleeding.  - Birth Story by Steph Hayes 

Why do we bleed after birth?

When you bleed after birth, much like when you menstruate, your body is letting go of more than just blood.  So what is lochia?

Blood: When your placenta separates from your uterus after baby is born there is, in essence, a wound left on the inner uterine wall which bleeds until healed.

Sloughed off endometrium: Just like when you menstruate, after your baby is born, the endometirum (uterine lining) that developed to support baby while in-utero is no longer needed and is shed as the uterus recovers.

Mucus: What stage of pregnancy and birth doesn't involve mucus? This mucus comes from both the endometrium and the cervix.

Dead (necrotic) tissue:  Once your placenta separates from the uterus, there is a wound on the inner uterine wall.  As your uterus heals and returns back to its normal size, this wound heals and a sort of scab forms which is them shed and released with the rest of the lochia.

What kind of bleeding are we talking about?

Basically, lochia will look like your menstrual blood but there will be more of it and it will be “chunkier“; at least in the beginning.  It will start out quite red (bright or dark) and after a few days will begin to slow and change colour to more of a rust or brown.  By the end of a few weeks it may only look like tinged or streaked discharge and eventually will simply taper off entirely.  

How long will this bleeding last?

Generally, people experience lochia after birth for anywhere from 4-6 weeks though for some people, this part of the healing process wraps up much sooner.  Typically, the first 7 to 10 days is when you will see bleeding that looks and feels like a heavy menstrual flow.  After that first week, things will start to taper off and both the amount and the colour of the lochia will begin to fade.

Peterborough doula postpartum bleeding lochia

How do I know if something is wrong?

Bleeding after birth is totally normal but you should still know what to watch out for! Remember that the days and weeks postpartum are best spent relaxing, healing, and taking good care of yourself and your baby. Talk to your healthcare provider IF:

  • Your bleeding has slowed and become faint in colour but then suddenly increases in flow and becomes red again; you are likely doing too much!  Slow down.
  • Your lochia smells bad/foul; this could be a sign of uterine infection
  • You are passing clots larger than the size of a prune or are passing clots frequently; this could indicate that healing is not progressing as expected and your health care provider will want to investigate
  • You suddenly begin to bleed heavily, experience a “gush” of blood, or are soaking through a menstrual pad in an hour or less

Tips for Care & Healing

For most of us, bleeding after birth is a bit of a messy inconvenience and that is about it.  We rock a pair of mesh underwear, maybe throw an absorbent sheet down on the bed “just in case” and start a collection of peri-bottles. It really is nothing to worry about.  That being said, there are a few things you can do to help the healing process along.

Rest. Slow down and go easy on yourself.  No matter how you gave birth, your body has been through a lot and needs time to heal.  Running and crunches can wait a while – for now, walking and swaying with baby will do nicely.

Stick with pads. Using tampons while you are healing from birth is not a great idea.  Besides the fact that you will very likely be sore or waiting for stitches to heal, inserting tampons into your vagina can introduce bacteria and cause infection which is not something you want!

On the subject of pads… if you can, invest in pads that have as little plastic as possible and are unscented. This will help minimize irritation and maximize air flow. Also, change them often.

Meet Peri.  Your peri bottle will be your new best friend.  Get close.  Fill your bottle with warm water and squirt yourself liberally after going to the washroom or when changing pads.  Not only does it feel great, but it will keep your vulva and vagina clean and fresh.

Bleeding after birth is nothing to worry about.  Know what to look for and take good care of yourself in the days and weeks after baby arrives and you will be just fine!  If you are feeling bold, share a picture of yourself rocking your "meshies" or other postpartum healing tools with us on Instagram at @hellobabyptbo