Postpartum Bleeding: Normal or Cause for Concern?

by Melissa D. Jaramillo

Regardless of whether your delivery was via c-section or a vaginal birth, postpartum bleeding will be part of your reality. Immediately following delivery and for approximately 4- 7 days after, your discharge can be expected to be bright red. This bleeding is known as the lochia and is part of the natural cleansing process of the uterus.

Over the course of the next 10 days, and for some women, up through the next 6 weeks, this bleeding changes gradually -- first lightening to a pale pink, then more brownish and finally white before disappearing completely. This process varies from woman to woman, and even from pregnancy to pregnancy. Those that have had a c-section may find that their lochia is a bit heavier initially.

Normal Postpartum Bleeding

• Color: Bright red, tapering off to pink, then brownish, brownish-yellow and finally white discharge
• Flow: Heavier immediately following delivery for the first 4 days, then increasingly lighter over the course of 10 days to 6 weeks
• Sudden Change: A sudden increase in the amount of bleeding or a color change back to bright red may be normal if you have increased your activities too much -- too soon. If this occurs, back off completely and give your body a chance to recuperate fully before resuming your normal pace.
• Clots: Initially, you may find you are passing small clots. This is normal.
• Stops and starts: There are women that experience an almost complete end to their bleeding, only to suddenly start up again approximately two weeks after delivery. This may appear to be similar to a regular menstrual cycle but generally is an indication of the remainder of the uterine lining dissipating.

Important Note: If you normally use tampons for your menstrual cycle, you still need to hold off until after your 6-week postpartum check up before resuming their use. This is due to the higher risk of infection before your body has returned to normal.

Cause for Concern

You should contact your care provider with these symptoms:

• Color: Discharge remains bright red for extended period of time (beyond the first week) and you have not been overdoing activity
• Flow: Remains or becomes heavy (similar to immediately following delivery) or lingers for more than 2 weeks as a steady flow. After 2 weeks it should be more similar to spotting or the end of a normal period. (See Signs of an Emergency below)
• Odor: Extremely unpleasant odor

Emergency Situations

• Flow - Sudden "gush" of blood that won't stop or soaking several sanitary pads within a few hours of time
• Clots - Any clots that are larger than the size of a ping pong or golf ball

If the lochia is bright red and you notice either of the above symptoms, you must seek emergency medical intervention immediately! You could be experiencing a postpartum hemorrhage which is a medical emergency and requires immediate attention. If you do not have someone to drive you to the hospital then call an ambulance.

Melissa Jaramillo is mom to many. She's passionate about building, encouraging, and strengthening families on this adventure known as parenthood!

Copyright © Melissa Jaramillo. Permission to republish granted to Pregnancy.org, LLC.