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|What Is Postpartum Bleeding?
After childbirth the lining of the uterus is shed over 3 to 6 weeks in the form of vaginal bleeding called lochia. It will start out as a heavy flow, typically within a few hours of birth, which is bright red in color and may contain small clots (about the size of a grape). Gradually the color will change to pink, then brown and finally a creamy yellow as it subsides. One sign that you are overexerting yourself (by exercising too much for example) is a sudden increase in flow. Breastfeeding on the other hand can reduce flow by encouraging uterine contractions. Don't be alarmed if you find you suddenly gush blood when you stand up.
The vagina is shaped like a cup and while you are lying down the blood pools in the cupped area. When you stand up, it may feel like the blood is pouring out. Lochia is a completely normal part of the postpartum period. Every woman who delivers a child, either vaginally or by cesarean section will experience it. It is the way your body expels excess placenta tissue, blood and mucus which is no longer needed. It is similar to a menstrual period but much heavier and may initially be scary. For the first few days you will need to wear a hospital grade pad but as bleeding slows down you will be able to switch to a commercial pad.
Tips For Coping With Lochia
Lochia is usually heaviest in the hours after delivery. Try not to panic if bleeding seems to worsen when you go home. Simply being up about can increase bleeding. If you soak a pad completely within an hour, go to bed and rest. Typically lochia is not considered a postpartum complication and it will cease when your body has dispelled all the material it needs to. If the bleeding continues at the same rate for several hours however, or if you pass clots larger than the size of golf balls, call your doctor or return to hospital. Other signs that require medical attention are:
Usually lochia turns pale pink or brown by the second week after delivery. Don’t be alarmed however if you find bright red bleeding reappears from time to time throughout the first 6 to 8 weeks. Exercise or increased activity can cause red bleeding and a heavier flow to reappear. If bleeding and cramps increase, lie down for a few hours. If it does not slow down when you are off your feet, it is time to call your doctor.
Postpartum hemorrhaging is a severe type of bleeding after childbirth. If you lose more than 1,000 ml of blood after a c-section or more than 500 ml after a vaginal birth, you are classified as hemorrhaging. Between 1 and 10 percent of all pregnancies in the U.S. result in hemorrhages. It usually begins within 24 hours of childbirth (early postpartum hemorrhage), but it can occur any time within 6 weeks (delayed postpartum hemorrhage). After childbirth the most common cause is failure of the uterus to contract as it should, leading to uncontrolled bleeding from the site where the placenta was attached. Occasionally it can result from unrepaired tears to the vagina or cervix. Delayed hemorrhaging can occur as the result of placenta fragments sticking to the uterus; or due to infection. Both types of hemorrhaging are dangerous and can (rarely) lead to the death of the mother.
If you are not breastfeeding your first period may come within 4 to 8 weeks of delivery - but it can take up to 12 weeks. If you are nursing, your period may come a few weeks later, although many mothers who breastfeed don’t have a period until the baby is weaned or beginning to nurse less. When you get your first period it may be different to previous flows. It can be heavier or last longer than normal. Or it may stop and start and have clots in it, there may also be spotting between bleeds. If you need to change a pad more than every hour, lie down until it subsides. It if doesn't subside within a few hours, call your doctor.
|Related Articles on Bleeding After Childbirth
For more postnatal advice, see the following:
• Losing weight after childbirth: Diet and nutrition advice.
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