How does postnatal bleeding (lochia) normally progress, what counts as heavy bleeding, and when should you seek care without waiting? Balanced information.
The amount and colour of bleeding regarded as normal lessen and lighten over time; bleeding that increases or gets stronger again, contrary to what you would expect, needs attention.
What is postnatal bleeding (lochia) and how does it normally progress?
Lochia is a type of bleeding or discharge seen as the inner surface of your womb heals after birth. The amount and colour of this discharge lessen and lighten over time; the process differs from person to person, and an exact number of days cannot be given beforehand.
Which bleeding is regarded as "normal" and which as "heavy/abnormal"?
Bleeding heavy enough to fill a pad within an hour, and passing large clots or tissue, are counted among the urgent warning signs. A sudden or rapid increase in bleeding likewise needs attention. The seriousness of a clot or of the bleeding is assessed by a doctor or midwife together with any accompanying symptoms.
Does postnatal bleeding happen only in the first days?
Bleeding after birth can be seen straight after birth and can also appear on later days; the womb not contracting enough after birth is one of the known causes of this. For this reason do not assume that, because the first days have passed, there is no longer any risk; bleeding that lessens and then increases again or goes on for longer needs attention.
What does it mean if there are other symptoms with the bleeding?
Symptoms such as dizziness or fainting, when assessed together with the amount of bleeding, can point to a more serious picture.
Is lochia different after a caesarean?
Lochia is also seen in people who have had a caesarean; the general framework is similar.
How can you keep track of your bleeding?
Your health team assesses the course of your bleeding for you at your postnatal check-ups and gives you advice on monitoring that suits you. The general principle is that you note any increase or change beyond what is expected, and, if a situation matches the "heavy/abnormal" criteria listed above, contact your health team without delay. Do not rely on home or herbal methods that have not been proven to reduce bleeding.
What can you ask your health team when your bleeding is being assessed?
- What is the expected course of bleeding for me, and when can I expect it to lessen?
- How do you recommend I keep track of my bleeding?
- Which symptoms should make me contact you without waiting for my postnatal check-up?
- I had a caesarean; will my bleeding follow a different course?
Frequently Asked Questions
If bleeding stopped and then started again, what information should I give my doctor?
Making a note of when the bleeding started again, how its amount has changed compared with before, whether you have passed clots or tissue, and accompanying symptoms such as fever, bad-smelling discharge and dizziness, and passing this on, makes the assessment easier.
Is it important if I notice bad-smelling discharge without bleeding?
Bad-smelling discharge is regarded as a warning sign separate from the amount of bleeding.
Can it be said for certain when lochia will end?
No. The amount and colour of the discharge lessen and lighten over time; because the process changes from person to person, an exact number of days cannot be given.
Should bleeding that gets stronger again instead of lessening be taken seriously?
Yes. An increase beyond what is expected, getting stronger again or going on for longer needs attention. If the situation matches the heavy or abnormal criteria, contact your health team without delay.
Is a pad filling in an hour a warning sign?
Yes. Bleeding heavy enough to fill a pad within an hour is among the urgent warning signs. Passing large clots or tissue and a rapid increase in bleeding should also be assessed.
Once the first days have passed, does the risk of bleeding end completely?
No. Bleeding can happen straight after birth and can also appear on later days. Do not rely on the first days having passed.
Are dizziness or fainting with bleeding important?
Yes. These symptoms, when assessed together with the amount of bleeding, can point to a more serious picture.
Is there lochia after a caesarean too?
Yes. Lochia is also seen after a caesarean birth, and the general framework is similar.
Can I rely on home or herbal methods for the bleeding?
No. Do not rely on methods that have not been proven to reduce bleeding. Talk about monitoring and the advice that suits you with your health team.
Is it helpful to note changes in the amount of bleeding?
Yes. Making a note of when it changed, the amount, the passing of clots or tissue and accompanying symptoms, and passing this on, makes the assessment easier.
Can I tell how serious any bleeding is just by looking at the amount?
No. The seriousness of clots and of the bleeding is assessed by a doctor or midwife together with accompanying symptoms. Your own monitoring does not replace a health assessment.
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