After childbirth, it is possible to experience conspicuous blood losses called "lochi", which are made up of blood, tissues and bacteria. It is a natural phenomenon comparable to a copious menstruation. You can be sure your bleeding is completely normal by knowing in advance what to expect, when to contact a doctor, and by recognizing the symptoms of postpartum bleeding (a rare but serious condition).
Steps
Part 1 of 3: Understanding What to Expect
Step 1. Expect consistent bleeding for 3-10 days after delivery
During the first week after giving birth, you will have copious losses of bright red blood, as well as small to medium sized blood clots.
- In this early stage of postpartum bleeding, you will likely need to change a sanitary pad every 3 hours or so.
- You may also notice one or two large clots (about the size of a coin) and several smaller clots (about the size of a grape).
- If you have had a caesarean section, expect slightly more losses.
- After 3-4 days of delivery you should begin to notice a slight change in the color of the lochi.
Step 2. Pay attention to the color of the leaks
For the first 3-10 days the losses will be a deep red color (becoming a little lighter after the first 4 days); after which the color should change from red to pink. After a few more days they should be brown and finally white-yellowish.
Step 3. Expect continued losses
Although there should be copious losses for only 3-10 days after delivery, a light or medium blood flow will continue to be present for several weeks (up to 6): over this period the losses should gradually decrease and become more clear.
- If you are breastfeeding, you may notice a slight increase in discharge and cramping while breastfeeding or soon after: breastfeeding produces a slight contraction of the uterus, so this phenomenon is perfectly normal.
- If you have started taking the contraceptive pill, you may have discharge for more than 6 weeks - discuss with your doctor.
Step 4. Understand what is happening in your body
Knowing what happens may alleviate some fears. After delivery, the placenta detaches from the uterus and the blood vessels to which it was attached remain open and begin to bleed inside the uterus. After releasing the placenta, the uterus continues to contract releasing excess blood as well as waste tissues, fluids and bacteria. By contracting, the uterus helps to close blood vessels: in a nutshell, in the first 6 weeks after delivery, it cleans itself and returns to normal conditions.
- During pregnancy, the amount of blood in your body increases by about 50%, so your body is perfectly prepared for this postpartum blood loss.
- If you've had a laceration or episiotomy during childbirth, you may also be bleeding from this.
Part 2 of 3: Knowing When to Contact a Doctor
Step 1. Pay attention to large blood clots
While some small or medium-sized clots are normal and to be expected, contact your healthcare provider if you notice any that are larger than a golf ball.
Step 2. Make a note of the amount of sanitary napkins you use
One way to track the flow of blood loss is to pay attention to how often you change sanitary pads. Contact your doctor if you change a sanitary pad (or more) per hour for 3 or more consecutive hours.
- The use of tampons should be avoided during this period, as they could introduce bacteria into the vagina.
- The losses should be more conspicuous during the first days, and then decrease; contact your doctor if they don't mention doing so.
Step 3. Check the color of the blood
In the first few days after delivery, the blood should be bright red; around the fourth day it should become a lighter color. Contact your doctor if it is still bright red after the fourth day.
Step 4. Pay attention to unusual smells
If the blood smells foul and fetid, it could be a sign of a postpartum infection - the lochi should smell like menstrual blood. In this case, contact your doctor.
Postpartum infections are also usually associated with severe pain and fever above 38 ° C
Part 3 of 3: Recognizing Postpartum Bleeding
Step 1. Know that this is a rare disorder
Postpartum hemorrhage (EPP) is a rare but serious disorder that affects only 4 to 6% of women. Although very rare, it remains the leading cause of death after childbirth, so it is important to recognize the risk factors that make it more likely, as well as its symptoms.
Step 2. Learn about medical disorders that increase risk
You are more likely to have PEP if you have been diagnosed with a medical disorder involving the uterus, placenta, or blood clotting.
- Among the disorders affecting the uterus are: atony, inversion and uterine rupture.
- The disorders affecting the placenta are: detachment, placenta accreta, increta, percreta and previa.
- Disorders affecting blood clotting are: von Willebrand's disease, disseminated intravascular coagulation (DIC) and the use of anticoagulants (such as warfarin, enoxaparin and others).
Step 3. Learn to recognize other risk factors
Several other factors can increase the risk of developing postpartum bleeding. Remember that none of these necessarily imply the development of bleeding, as this is a very rare disorder, but only indicate an increased likelihood. The risk is greater in the case of:
- Obesity;
- Prolonged labor (more than 12 hours);
- Emergency caesarean section;
- Anemia;
- Pre-eclampsia or high blood pressure
- EPP in a previous birth;
- Uterine infection (endometriosis).
Step 4. Recognize the symptoms
Postpartum bleeding is more likely to occur within the first day after delivery, however it can occur up to two weeks later. It is vital that it is treated immediately, so contact your doctor if you have any symptoms, including:
- Conspicuous bleeding that shows no signs of stopping;
- Drop in blood pressure or shock symptoms such as blurred vision, chills, sweating, rapid heartbeat, feeling confused, dizzy or faint
- Pallor;
- Swelling and pain around the vagina and / or perineum.
