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Postpartum bleeding, also known as lochia, is one of those icky parts about postpartum life that not a lot of people talk about. So, if you’re going through it, you’re probably wondering what’s normal…and what’s not. Read on for everything you need to know about it, from why postpartum bleeding occurs to when you should call the doctor.

How long does postpartum bleeding last?

“It’s normal for a new mom to bleed for up to six weeks after the baby arrives, even if she’s had a Cesarean Section,” says Tracy Donegan, a midwife, birth doula, and author of GentleBirthEvery woman’s experience as different, but as the weeks pass you can generally expect the lochia to change in color from red to pink to brownish in hue, and get lighter, too, she adds.

Why does postpartum bleeding occur?

Postpartum bleeding is your body’s way of shedding the uterine lining that cushioned your baby en utereo. You may also bleed more if you had a lot of tearing during your delivery.

What’s the best way to deal with postpartum bleeding?

In the first few days after delivery, many women experience a bright red heavy flow, so they often wear a hospital-grade sanitary pad, according to the Mayo Clinic. After the bleeding slows, you can use a normal store-bought pad (although it’s probably still good to stick with the overnight maximum coverage pads). There might be small blood clots in the bleeding which is normal. It’s also normal if you feel a gush of blood when you stand up after sitting for a while; the blood has been collecting/pooling and then pours out due to gravity. Avoid tampons for six weeks after you give birth, because they may introduce bacteria. Also, it’s best to use underwear that you’re okay with throwing away.

Is there anything that makes postpartum bleeding worse?

“Heavy postpartum bleeding can ease off after a week or so but it comes back with a vengeance if mom gets too active too soon,” says Donegan. So if you’re bleeding has slowed down, but then increased after you’ve tried to do too much, it may be your body’s way of telling you to slow down. Additionally, breastfeeding may cause heavier postpartum bleeding, because your hormones are making the uterus contract, she says.  Lastly, for some women the bleeding ends early but they experience what seems to be new red blood loss a few weeks later; Donegan explains that this could be your first period since before becoming pregnant.

What’s the difference between postpartum bleeding and postpartum hemorrhage?

“The first few days’ post-birth bleeding can be heavy, but if you find you’re soaking a pad in an hour then it’s time to call your health care provider,” says Donegan. It may be the result of a serious, but rare condition called Postpartum Hemorrhage (also called PPH). It happens to less than five percent of women after birth, but postpartum hemorrhage can be deadly if it goes untreated. It involves a sudden drop in blood pressure.

Symptoms of postpartum hemorrhage include:

  • Very heavy bleeding that doesn’t slow or stop
  • Signs of low blood pressure and shock including blurry vision; clammy skin; the chills; racing heartrate; feeling confused; feeling dizzy; and feeling like you’re going to faint.
  • Nausea
  • A very pale complexion
  • Pain or swelling in or around your vagina

“You should also call the doctor if you have large clots or if the blood smells offensive.” She explains that in rare cases moms can develop a uterine infection due to pieces of the placenta getting left behind.

Before you leave the hospital after giving birth, you should have booked an appointment for your six-week postpartum check-up with your ob-gyn. However, you should call or see your doctor any time after birth if you feel something isn’t right.

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