Seems as if the worst is over, right?
Most postpartum bleeding is normal. Known as lochia, this happens because the womb is getting rid of the extra blood and tissue that helped your baby to grow, explains Dr Liana Koe, a gynaecologist at Thomson Medical.
“The heaviest bleeding is in the first two weeks after delivery, and the blood can be dark to bright red. It should not be too heavy, with only occasional small clots not larger than half your palm,” Dr Koe says.
In addition, it is normal for lochia discharge to increase during or right after breastfeeding, after exertion, or if you’ve been standing for long hours.
Dr Koe adds that the heaviest bleeding period should last about two weeks ― reducing significantly thereafter, and lasting a total of around six weeks post-delivery. “Bleeding is about the same, whether you go through a vaginal delivery or a C-section ― but it may be less in the first few days after a C-section.”
“The heaviest bleeding is in the first 2 weeks after delivery, and the blood can be dark to bright red. It should not be too heavy, with only occasional small clots not larger than half your palm.”
Ways to cope with postpartum bleeding
While the bleeding can cause some discomfort, it should not affect your daily routine and caring for your newborn.
Here are ways to cope:
* Avoid exertion Take it easy where ever possible. For instance, it’s best to wait four to six weeks before your start to exercise, Dr Koe notes. However, exercise is safe and you can start as early as a few days after a vaginal delivery if you feel ready, especially if you previously had an active lifestyle.
* Check the episiotomy Dr Koe adds that if you had an episiotomy, heavy exertion is not advised as it may affect external wound healing. Ensure that your obstetrician checks the incision and gives you the go-ahead to start.
* Good hygiene It’s important to keep yourself clean down there to improve healing and prevent infection. Change your sanitary pad regularly. Use a squirt bottle to wash off after you go to the bathroom ― then use clean toilet paper to pat dry gently.
* Eat well Nutrition is important so that you can build up your blood levels. Dr Koe advises new mums to take foods rich in iron, such as red meat, liver, and leafy green vegetables. Vitamin C can also help with wound healing. Your postpartum diet to help with breastmilk production and general health should also include a good amount of protein, calcium, folate, and DHA (fish-oils).
When to be concerned
If you have heavier-than-usual bleeding (for instance, if you need to change a pad every hour) with large clots, it’s not normal.
You could be experiencing postpartum haemorrhage ― a heavy loss of blood that happens before, during or after giving birth.
It is a rate but serious condition that can cause a severe drop in the new mum’s blood pressure. If not treated quickly, it could lead to shock and even death
“Postpartum haemorrhage can occur any time from 24 hours to 12 weeks post-delivery,” Dr Koe notes.
The most common reason: The womb’s inability to contract properly after delivery.
“Usually the womb will squeeze down on itself during uterine contractions, to prevent excessive bleeding from where the placenta was attached. In some patients, this does not happen adequately, resulting in heavy bleeding.”
Dr Koe explains, “Usually the womb will squeeze down on itself during uterine contractions, to prevent excessive bleeding from where the placenta was attached. In some patients, this does not happen adequately, resulting in heavy bleeding.”
Other causes include remaining placenta tissue in the womb after delivery or if you have an inherent bleeding disorder.
Some mums may be more susceptible to postpartum haemorrhage ― for instance, those who have a low-lying placenta, are pregnant after the age of 40, are carrying a big baby, or have given birth more than five times. Other risk factors include giving birth via a C-section, and if the mother had her labour induced.
Signs of postpartum haemorrhage may include:
* Excessive bleeding from the vagina that doesn’t slow or stop.
* A rise in heartrate.
* Extremely large clots (some mums reported clots as large as a small melon).
* Signs of low blood pressure – which can include blurry vision, feeling dizzy and having chills.
* Feeling nauseous and extremely tired.
* Pale and clammy skin.
* Bad smell (from the infection).
How postpartum haemorrhage is treated
If you suspect that you are experiencing postpartum haemorrhage, see a doctor immediately.
“If it is confirmed to be postpartum haemorrhage, medications to contract your uterus will need to be given as intramuscular injections or through the vein,” Dr Koe explains.
You may also need to be admitted to hospital for monitoring and treatment, and undergo several tests to learn about the cause of your postpartum haemorrhage.
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