Every new mum bleeds after having her baby (lochia), whether the birth was vaginal or by caesarean section. It’s how your body gets rid of the lining of your uterus (womb) after birth. The blood may come out in gushes, or flow more evenly, similar to a heavy period.
The bleeding will change colour and become lighter as your uterus heals and returns to its pre-pregnancy size. At first, the flow of lochia will be heavy and bright red, and may have clots in it. Gradually, it will change to pink then brown, and eventually to yellow-white.
You may bleed for as little as two weeks to three weeks, or for as long as six weeks after having your baby. The flow will gradually become less. Red lochia usually tapers off within the first couple of weeks, though if you try to do too much too soon, it may start flowing again. If you see bright red blood, it’s a sign that you need to slow down.
Do I need to do anything about the bleeding?
Not really. Just stock up on maternity pads. Two or three packs of 12 should do. Don’t use tampons for the first six weeks or so after you have your baby, as this can introduce bacteria into your still-healing uterus, causing an infection.
You may need to change your pad every hour or two to start with, then every three or four hours in the coming days and weeks. Always wash your hands before and after changing your pad.
You may also have a wound between your vagina and back passage (perineum). You’ll need to keep this part of your body clean to prevent infection there as well. Take a bath or shower at least once a day, and change your maternity pad regularly.
Some mums like to add salt to their bath water, but your wound will heal just as well with clean water alone.
When should I call my midwife or doctor?
Call your midwife or doctor if you develop the following symptoms, as you may have an infection:
☛The lochia has an unpleasant smell.
☛You come down with a fever and/or chills.
☛The bleeding stays heavy, and is bright red, after the first week.
☛Your tummy feels tender low down on one or both sides.
Sometimes, bleeding that’s much heavier than normal lochia happens. This is called postpartum haemorrhage (PPH).
PPH may happen within 24 hours of giving birth (primary PPH), or between 24 hours and 12 weeks after the birth (secondary PPH). It may be caused by a piece of membrane or retained placenta, or when your uterus doesn’t contract down properly after you’ve delivered the placenta.
Call an ambulance if:
☛The bleeding suddenly becomes very heavy, and soaks more than one pad an hour.
☛The bleeding becomes persistently fresher (bright red) and heavier four days or more after giving birth, even after you rest.
☛You pass lots of large blood clots that are bigger than a 50p piece.
☛You start to feel faint or dizzy.
☛Your heartbeat starts to race, or becomes irregular.
You can be treated with antibiotics, or you may need a minor operation to remove the rest of the placenta. Once you are receiving the right treatment for postpartum haemorrhage, you should be fine. But it may take a little time, good care and rest for you to recover fully. Make sure you know all the postnatal symptoms you should never ignore.