Postpartum Bleeding - Gynecology

What is Postpartum Bleeding?

Postpartum bleeding, also known as lochia, is the vaginal discharge that occurs after childbirth. It consists of blood, mucus, and uterine tissue. This bleeding is a normal part of the body's process of healing and recovering post-delivery.

How Long Does Postpartum Bleeding Last?

Typically, postpartum bleeding lasts between four to six weeks. The duration can vary depending on individual conditions and whether complications such as a retained placenta or uterine atony occur. Initially, the bleeding is heavy and bright red, gradually becoming lighter in color and flow.

What Are the Stages of Lochia?

Lochia progresses through three stages:

Lochia Rubra - The first stage, lasting 3-4 days, is characterized by bright red bleeding.
Lochia Serosa - The second stage, from about day 4 to day 10, involves pinkish-brown discharge.
Lochia Alba - The final stage, from day 10 onwards, features a yellowish-white discharge.

When Should You Be Concerned About Postpartum Bleeding?

While postpartum bleeding is normal, certain signs warrant medical attention:

Blood clots larger than a golf ball.
Bleeding that soaks a pad in an hour or less.
Foul-smelling discharge, which could indicate an infection.
Severe pain or fever.

If you experience any of these symptoms, contact your healthcare provider immediately.

What Causes Excessive Postpartum Bleeding?

Excessive bleeding, known as postpartum hemorrhage (PPH), can occur due to several reasons:

Uterine Atony - When the uterus fails to contract effectively.
Retained Placental Fragments - When parts of the placenta remain in the uterus.
Trauma - Tears in the cervix, vagina, or perineum.
Coagulation Disorders - Blood clotting issues.

How Is Postpartum Hemorrhage Treated?

Treatment for PPH depends on the cause and severity of the bleeding. Common interventions include:

Medications to help the uterus contract, such as oxytocin.
Manual removal of retained placental fragments.
Surgical procedures such as uterine artery embolization or, in severe cases, a hysterectomy.
Blood transfusions if significant blood loss has occurred.

Can Postpartum Bleeding Affect Future Pregnancies?

Generally, postpartum bleeding does not impact future pregnancies. However, complications from severe bleeding, like extensive surgical intervention, could potentially affect fertility. It is crucial to discuss any concerns with your healthcare provider.

What Can Be Done to Manage Postpartum Bleeding?

To manage postpartum bleeding effectively:

Use sanitary pads instead of tampons to reduce the risk of infection.
Stay hydrated and maintain a balanced diet to aid in recovery.
Avoid heavy lifting and strenuous activities until cleared by your healthcare provider.
Monitor the bleeding and report any concerning changes to your healthcare provider promptly.

When Can You Resume Normal Activities?

Most women can resume normal activities within six weeks postpartum, but this timeline can vary. It is essential to follow your healthcare provider's advice regarding physical activities, sexual intercourse, and returning to work.