When will it stop bleeding after childbirth? Bloody discharge after childbirth

Bleeding after childbirth is a normal physiological process. It allows the female body to return to its previous state: the uterus is cleansed of afterbirth, lochia and pieces of the placenta. Discharge begins immediately after the birth of the child and continues for about a month and a half.

But sometimes this process becomes pathological. The main criterion for its assessment is the nature and volume of blood loss. It is especially important for women in late pregnancy and those who have recently given birth to know what kind of bleeding is considered normal and what measures to take to prevent complications.

The question of how long postpartum bleeding lasts arises for almost all young mothers. The duration of this process can be from 2 to 6 weeks or even a little more. The duration depends on several factors: the ability of the uterus to contract, blood clotting, the rate of tissue regeneration, etc. In women who are breastfeeding, recovery occurs faster.

It is important to evaluate not only the duration of bleeding, but also the general nature: it should gradually become less profuse. In the first day after birth, the discharge is strong, then it becomes less and less and eventually turns into a brownish “smudge.” This sequence is the norm.

Causes of bleeding after childbirth

Heavy pathological bleeding in the early postpartum period, lasting about 2 hours after the birth of the baby, is caused by the following reasons:

Insufficient blood clotting. With this complication, it flows out in a stream without the formation of clots and lumps (thrombosis disorder). To prevent the situation, before giving birth it is necessary to donate blood for a general analysis and stop all medications with anticoagulant effects.
Rapid labor activity. It is accompanied by ruptures of the birth canal: the cervix, vagina, and, in rare cases, the uterus are damaged.
Placenta accreta. With this complication, the reverse development of the uterus is difficult, which leads to heavy bleeding.
Insufficient ability of the uterus to contract. Most often this happens when the walls are greatly stretched (,);
The presence of fibroids and myomas in the uterus.

The causes of postpartum hemorrhage in the period from 2 to 6 are:

The release of placenta particles remaining in the uterine cavity.
The release of blood clots, difficult due to spasmodic contraction of the cervix after surgical delivery (caesarean section).
Slow recovery due to inflammation in the pelvic area (high fever is also noted).

Features of postpartum hemorrhage

Symptoms of postpartum hemorrhage can be described in two parameters: the volume and nature of the discharge. There may also be disturbances in heart rhythm, changes in arterial and venous pressure, and deterioration in general well-being.

A blood loss of 0.5% or less of a woman’s body weight is considered physiologically acceptable. If this indicator is higher, then pathological postpartum bleeding is diagnosed. Massive blood loss is its release in a volume of 0.5 to 1% of the mother’s weight. This may lead to a decrease in blood pressure, weakness and dizziness.

When the rate exceeds 1%, critical blood loss develops. It may be accompanied by hemorrhagic shock and DIC (coagulation disorder). These complications lead to irreversible changes in organs.

Heavy postpartum bleeding develops with decreased or absent uterine tone. The more pronounced the atony, the less amenable to treatment. Drugs that cause myometrial contraction eliminate bleeding only for a while. The condition is accompanied by arterial hypotension, tachycardia, pale skin, and dizziness.

Diagnostic procedures

The diagnostic process begins during pregnancy. In modern obstetric and gynecological practice, assessment of the risk of postpartum hemorrhage is based on data from monitoring changes in the level of hemoglobin, red blood cells, and platelets in the blood at different stages of gestation. Coagulability indicators (coagulogram) are taken into account.

Hypotonia and atony of the uterine muscles are diagnosed in the third stage of labor. These conditions are indicated by flabbiness and weak contractions of the myometrium, an increase in the time of the afterbirth stage.

Diagnosis of bleeding after childbirth includes a thorough examination of the integrity of the released placenta, membranes, and examination of the birth canal to identify possible injuries. If necessary, the woman is given a general anesthetic and the doctor manually examines the uterine cavity to determine if there are ruptures, placenta, blood clots, malformations or tumors that could interfere with myometrial contraction.

For bleeding in the late postpartum period, diagnosis is carried out using ultrasound. On the 2nd or 3rd day after the birth of the child, the condition of the pelvic organs is examined. The procedure allows you to identify the remains of the placenta and membranes in the uterus.

Normal bleeding after childbirth

Normal bleeding in the postpartum period is caused by the release of remnants of the placenta and membranes from the uterus. This process is divided into several periods, each of which is characterized by certain characteristics: color and intensity of discharge.

The first three days after the birth of a child, bleeding is profuse, the volume is more than during menstruation. Color - bright red. Blood comes out of those vessels that were at the placenta attachment site. This condition develops due to insufficient contractility of the uterus in the first days after childbirth. It is considered normal and does not require medical intervention. Postpartum bleeding after a cesarean section may be longer because the incised uterus contracts less well.

Over the next two weeks, the intensity of discharge decreases noticeably. They turn light pink, brown or yellowish white. The uterus gradually contracts, and by the end of the second week the bleeding completely disappears. This option is considered the norm.

In some cases, bleeding is observed in the late labor period. It can be either normal or pathological, requiring medical intervention. If, in the period from 2 to 6 weeks after the birth of the child, light discharge from the uterus with impurities of blood appears, then there is no need to worry. This symptom may be present constantly or may appear and disappear for several days. This intermittent regimen is typical for women who quickly return to sports training or other physical activity.

Sometimes the bleeding disappears by the end of the second week, and then appears for a few days between 3 and 6 weeks after birth. The discharge is insignificant and painless and is normal.

Pathological bleeding after childbirth

A deviation from the norm that requires the help of a doctor is late bleeding with the following features:

duration more than 6 weeks;
scanty discharge with ichor is replaced by scarlet blood;
the woman’s general condition becomes worse;
bleeding is accompanied by pain in the lower abdomen;
signs of intoxication appear (fever, dizziness, nausea, etc.);
The discharge becomes brown or yellow-green in color and has an unpleasant odor.

If there is an intense flow of blood, especially if it is scarlet, you should immediately call an ambulance. Pain, fever, change in color of discharge indicate the development of complications: infectious diseases, etc. Such conditions require the earliest possible diagnosis and treatment.

Treatment methods

Acute postpartum hemorrhage requires first of all establishing its cause, as well as prompt cessation. Treatment uses an integrated approach and often drug therapy must be combined with invasive methods.

To stimulate uterine contractions, a catheter is inserted into the urethra to empty the bladder, and ice is applied to the lower abdomen. Sometimes gentle external massage of the uterus is performed. If all these procedures do not bring results, then uterotonic drugs, for example, Methylergometrine and Oxytocin, are administered intravenously, and injections with prostaglandins are given into the cervix.

Replenishing the volume of circulating blood and eliminating the consequences of its loss is carried out using infusion-transfusion therapy. Plasma replacement drugs and blood components (primarily red blood cells) are injected into a vein.

If examination with the help of mirrors reveals ruptures in the birth canal and perineum, then a local anesthetic is applied and the doctor stitches up the damage. Manual examination and manual cleansing of the uterus is indicated for violations of the integrity of the placenta and hypotonic processes in the myometrium. The procedure takes place under general anesthesia.

If a uterine rupture is detected during a manual examination, then emergency laparotomy, suturing or complete removal of the uterus is necessary. Surgical intervention is also required for placenta accreta and in cases where the bleeding is massive and cannot be stopped. Such procedures are carried out with simultaneous resuscitation actions: blood loss is compensated, hemodynamics and blood pressure are stabilized.

Preventive actions

Prevention of postpartum hemorrhage helps reduce its duration and intensity, and also avoid complications.

Uterine spotting and actual bleeding after childbirth are two very different things. Some women in labor perceive any bloody discharge, even the slightest, after childbirth, as a dangerous condition that threatens life.

However, is this so? What should women giving birth know, and when should they really worry about their health? What is the norm for natural uterine discharge, and what color should it be? Read more about discharge after childbirth.

Uterine bleeding after childbirth, according to the World Health Organization, is an emergency obstetric pathology that complicates every tenth birth in the world. Every 4 minutes in the world, regardless of the degree of development of the country, one woman in labor dies due to abnormal uterine bleeding in the early (including) postpartum period.

Severe (heavy) bleeding after childbirth is almost always associated with complications; it is observed with caesarean section almost twice as often. However, this does not mean that minor bleeding immediately after childbirth should be perceived as a threat to life. The main thing is to know the reason for this manifestation, the volume of permissible blood released and its color.

A woman’s uterine arteries deliver from 500 to 700 per minute to the placenta during the entire period of pregnancy. After delivery, this amount of blood may remain in the uterine cavity. Bleeding in the afterbirth (early postpartum) period occurs due to natural contractions of the uterine cavity.

The myometrium, if all is well and the birth took place naturally, contracts very quickly in the first three days. That is why the most abundant discharge is observed during this period. Then, discharge for one month is considered normal. However, this is a scanty, non-constant discharge of a brownish, smeared tint.

After cesarean and natural birth, the volume of blood released should be the same.

Caesarean section, although considered a safe and frequently performed operation, due to the fact that an incision is made on the body of the uterus, can provoke late postpartum hemorrhage if the woman in labor was not given additional Oxytocin to improve uterine contractions. Additionally, anti-tetanus injections are given (in the abdomen) and droppers with Oxytocin are placed directly in the delivery room after the baby is removed from the uterus.

The most dangerous condition in obstetrics of the postpartum period is uterine hypotension. In simple words, this is the passivity of the uterine body to contraction; it is in a kind of “paralyzed” postpartum state (period), and therefore the process of bleeding after childbirth in the first period is most often associated with just such an anomaly.

Postpartum hypotonic bleeding is the cause of death in mothers in the postpartum period; even experienced obstetricians cannot stop this process. If the task is complicated by large blood loss (more than 1.5 liters) of the rare blood group of the woman giving birth (4.3 negative Rh), then the lethality of the birth outcome is very high.

All natural processes for the female reproductive organs should end by the end of the second month. This is why obstetricians warn against early sexual intercourse. You can begin sexual activity only 2 months after giving birth. Violation of this rule can provoke increased discharge from the uterine cavity. Dangerous signs (symptoms) in this case:

stomach ache;
heaviness in the lower back;
putrid odor in intimate places;
greenish or distinct yellow discharge;
temperature;
loss of consciousness.

In this case, the doctor conducts additional research, because if not all of the blood has come out, then a fatal disease may develop - endometritis.

After three months there should be no discharge. If there is red discharge and the woman in labor is breastfeeding, you should consult a doctor. Any delay could threaten your life.

Causes of bleeding after childbirth

Bleeding in the postpartum period has a different etiology of origin, differing in intensity, clinical manifestation (picture) and complexity for the woman in labor (emergency, pathological). The most common bleeding after childbirth is associated with such a manifestation as uterine hypotension. In particular, it is for this reason that doctors recommend administering specific drugs for prevention that help accelerate the contraction of the uterine muscles (Oxytocin, Carbetocin or Pabal). Reasons why bleeding associated with hypotension occurs:

age under 18 years;
abnormalities of labor and placenta;
anaphylactic shock;
embolism;
gestosis;
malformations of internal organs (sidoloid, horny uterus;
previously cesarean uterus, and subsequent births are natural;
polyhydramnios;
a large number of fruits;
chronic extragenital diseases.

However, there are other reasons for bleeding in the early postpartum period:

Violation of placental abruption. The most important thing after childbirth is to “give birth” to the baby’s place, the so-called placenta. Postpartum bleeding and its most common causes are tissue debris inside the uterine body. In any case, there is accumulated blood, which the obstetrician squeezes out from the uterus immediately on the obstetric table when the child lies on the mother’s chest. Such a process does not bring pain to the woman in labor, and a competent professional will do everything in such a way that all the clots come out in large quantities during this period. Late postpartum bleeding (after a month), as a rule, is associated with precisely this process, when the body of the uterus is not completely freed from the remains of the placenta. At the same time, the discharge was normal throughout the subsequent period, and the condition of the woman in labor did not cause concern. The best prevention of such an unsightly situation is an ultrasound scan upon discharge from the maternity ward.
Traumatization during childbirth. This pathology is observed in the same early births and multiple pregnancies. The situation is complicated by the so-called rapid labor with increased intoxication of the body. Tears or cuts can be on the body of the uterus (caesarean), on the cervix, and in the vagina (during natural childbirth). The severity is determined by category (from 1 to 4). The more severe the severity, the higher the risk of blood loss. The causes of this condition can be early multiple abortions (more than 5), early births with complications, difficult previous births (cesarean), and obstetric illiteracy. Rupture on your own is much worse than an obstetric incision, so if the obstetrician during the birth period sees that the baby’s head does not pass, then it is advisable to make an obstetric incision, as the mother will then lose a lot of strength and blood.
Blood diseases. The most rare conditions that should be investigated in advance.

Dangerous diseases that can cause complications and bleeding include:

hemophilia;
hypofibrinogenemia;
von Willebrand's disease.

Bleeding during childbirth (and/or the postpartum period) and its causes are provoked, first of all, by pathological conditions. Pregnant women at risk include those who are primiparous at an early age, multiple pregnancies, natural birth after cesarean, a child weighing more than 4 kg or less if the mother's weight is below normal, abnormalities of the uterus and a narrow pelvis. Recommendations for the postpartum period must be strictly followed.

Bleeding in the placenta and early postpartum period can be prevented if you provide all the information about your health, follow your doctor’s recommendations and understand the need (if indicated) for a cesarean section. Prevention of postpartum hemorrhage is the introduction of additional amounts of the hormone oxytocin and other drugs that will help increase uterine contractions. Early postpartum hemorrhage is considered a dangerous condition that leads to the death of mothers in the first three months after delivery.

Blood after childbirth: how long does it flow, and what does the duration depend on?

Bleeding in the first postpartum period occurs in the first two hours, maximum four hours after birth. This process is started under the influence of a natural hormone that is released during childbirth and contractions - oxytocin. The entire further period (1 day or more) is designated as late bleeding.

Second-time mothers already know how long it takes to bleed after childbirth, and what the discharge should actually be like, and what should cause concern. However, for those who give birth for the first time, it is very important to know when the bleeding stops, how long it lasts, how many days are considered normal, and what to do if it bleeds longer than the prescribed period.

Blood clots form in the uterine cavity after any birth. And this process is considered normal if the clots come out before 5 days after the baby is born. Actually, for this purpose, an additional ultrasound examination is carried out, and if it is discovered that some piece remains, then additional curettage is performed (under local anesthetic).

Natural, normal blood loss during childbirth is 0.5-0.6 liters. Up to one liter is allowed for caesarean section, however, to stabilize the condition, a blood transfusion is always performed in parallel with anesthetics (with spinal anesthesia), regardless of the patient’s condition. Anything above the specified volume is an anomaly that requires additional treatment. But how can you independently determine that very norm? Is it possible to somehow determine it without measuring the liquid?

To do this, you need to know the process of blood secretion, its intensity relative to childbirth. The average duration (duration) of normal early bleeding is the first five days, that is, the time when the woman in labor is in the maternity hospital. This is an abundant scarlet discharge that literally does not flow, but “squishes” at the slightest movement, and this is normal.

From about the third or fifth day, the discharge becomes less intense, and from the second week it is identical in quantity to a simple period. They may be larger in volume at one time and smaller at a second time, but this is a natural process that should not cause fear in the mother. The situation is considered not normal when, a month after giving birth, blood of a bright scarlet or burgundy color begins to flow. This may indicate a postpartum complication that requires immediate hospitalization.

Approximately one and a half to two months after birth, such discharge should completely stop. If even spotting does not stop in the third month, it is necessary to undergo additional examination. To monitor the woman in labor and her condition, the obstetrician sets a time for a mandatory visit to the doctor after childbirth:

all days when the woman in labor is in the ward of the maternity ward (doctor monitoring);
last day of discharge (mandatory with ultrasound procedure);
two months after birth;
6 months after birth;
subsequent mandatory gynecological examinations in terms of regular examination.

If suddenly the bleeding occurred in a normal volume for the first month, and then sharply continues to increase in volume, the color and smell change, and the woman in labor feels apathy, fatigue, drowsiness and loss of appetite, then hospitalization with treatment with antibacterial and anti-inflammatory therapy is necessary.

It is important to understand that the entire process of cleansing the uterus is a necessary period of cleansing from stagnant blood clots, and if everything proceeds normally, there are no changes in color, smell and well-being, then there is no need to worry. The amount of blood in the first month may increase one-time due to increased weight, nervous condition, depression, or decreased hemoglobin levels. However, all these symptoms are easily eliminated. As a rule, the most voluminous (squelching) discharge ends within the first 10 days.

Features of postpartum hemorrhage

Bright scarlet blood in the first month of labor, namely in the first two weeks, is a natural process of cleansing the uterus, which, by contracting, gets rid of accumulated excess blood. A small blood loss during childbirth, up to 0.6 liters, is the norm; anything higher is an issue that requires attention.

Emergency care in the postpartum period may only be required in the following situations:

increase in body temperature (usually no faster than the third day);
blood loss more than one liter;
disorientation;
vomiting, nausea, headache at the same time;
acute pain in the abdomen (not in the lower part, where natural spasms of the uterus occur);
constricted pupils and loss of consciousness, partial loss of memory;
cessation of discharge in any quantity (not even smeared). Additional methods of stopping bleeding are considered as an inflammatory process, which further provokes uterine hemostasis;
rapid breathing, pulse, heartbeat;
putrid, rotten smell of copious discharge;
hot, tight to the touch abdomen, difficult to palpate.

Obstetric bleeding in the early period after delivery does not cause concern if the woman feels well, and the abdomen is well palpated, there is no hardening, and the woman in labor does not respond to all the doctor’s examinations with a painful perception.

Complications, on the contrary, after childbirth (early or late) are a very big risk for a woman’s health. All manifestations can develop at lightning speed; in just a few hours, sepsis provokes complications and death of the patient.

Therefore, in the maternity ward, women in labor are asked to systematically measure body temperature, show the nature of the discharge, and palpate at least twice a day. This is a natural process that prevents postpartum complications.

Late postpartum bleeding

Late bleeding is considered to be discharge from one day (obstetric). However, in practice, for women in labor, all discharge after one month is considered late. The discharge ends within a month after birth in almost 60% of women in labor.

If there are weak brownish secretions that appear after physical activity, there is no need to worry. If contraction of the uterine body occurs according to the postpartum period, then such discharge will be short-lived and will end in a few hours.

However, if the above-mentioned pathologies associated with heavy discharge and poor health occur, then you should not hesitate to visit a gynecologist. Every minute of extension complicates the situation.

Treatment of postpartum hemorrhage

Treatment of postpartum hemorrhage is a mandatory set of measures that prevents the occurrence of dangerous situations:

Hospitalization. The first thing to remember is no self-medication, lie down and wait it out. Every drop of blood is a risk and mortal danger. Hospitalization can be carried out either in the maternity ward (if the baby is under one month old) or in a gynecological pathology hospital. The duration of treatment depends on the degree of complexity and the amount of blood lost.
Withdrawal of urine using a urethral catheter. Complete bowel movement is a necessary measure that counteracts the formation of urinary pressure on the body of the uterus, contractions occur more intensely.
Inspection of the birth canal and placenta. To exclude injuries that were possible during childbirth, as well as uterine rupture (during caesarean section), it is necessary to conduct a complete examination of all internal organs. A life-threatening condition is blood entering the abdominal cavity.
An ultrasound examination is also a mandatory event, which is carried out in parallel with all examinations. Only with such a device can one see the absence or presence of a clot and additional lobules of placenta.
Prescription of drug treatment. Based on the research and data obtained, the doctor prescribes effective and urgent treatment that will counteract the formation of uterine atony. The main thing is to establish the cause of this condition, the degree of the process and its complexity. The medications that are used in any case are intravenous injections of Oxytocin or methylergometrine-containing drugs. Additionally, anti-inflammatory and antibacterial therapy is prescribed, which eliminates the possibility of life-threatening situations developing for the mother.

The postpartum woman and her relatives must understand that the postpartum period is the most difficult moment for the female body, which has just learned to be a mother. At this moment, all important changes in the body occur: the girl becomes a mother. In order for the entire recovery process to occur without complications, it is important to follow the doctor’s recommendations and follow all his instructions.

Prevention of postpartum hemorrhage

Prevention of postpartum hemorrhage means following the recommendations and prescriptions of the maternity ward staff. Contraction of the uterus is a natural process that can be accelerated using natural procedures for women that nature has provided:

Breastfeeding your baby helps increase the production of your own happiness hormone – oxytocin and endorphin. Under the influence of such hormones, the uterus contracts faster, and the recovery process does not drag on for a long period.
Lie on your stomach- a simple recommendation that also allows you to further stimulate the uterus to contract.
Applying cold to the lower abdomen immediately after childbirth. As a rule, such procedures are carried out by nurses who help mothers in the ward immediately after delivery. It is not recommended to carry out such activities on your own.
Feeding the baby frequently (on demand). The first months of a baby’s life, he requires not only increased attention from the mother, but also needs to replenish his own strength, which is partially compensated by mother’s milk. This process is inherent at the genetic level, and therefore nature itself allows you to avoid all sorts of complications after childbirth; for this you just need to feed the baby as soon as he demands it.
Walks in the open air. Restoring red blood cells and increasing hemoglobin is a mandatory measure for all women in labor. However, this task is especially relevant for those who gave birth by cesarean section. The stitches that were placed during childbirth will pull, heal and cause discomfort and pain. But walks in the fresh air are mandatory for everyone, regardless of the condition and degree of difficulty of the birth.
Emptying your bladder regularly. Stagnation of urine is a risk for the mother, who, under the pressure of a filled bladder, is unable to contract normally and intensively. Therefore, the main task of a woman in labor is to constantly monitor emptying and under no circumstances tolerate it.

Personal hygiene rules during this period

It is worth considering separately such a process as personal hygiene after childbirth. Many girls who have given birth are afraid to take a shower, leave the baby, or perform water procedures. However, personal hygiene in the postpartum period is the key to quick recovery and prevention of complications.

In addition to the fact that it is necessary to carry out shower procedures every day, it is important to carry out preventive washing of the seams, especially if we are talking about several external seams on the labia. The cleaner the fusion site is, the faster the healing process. Remains of blood and secretions contribute to the development of pathogenic flora, which in the future will lead to suppuration.

After the birth of a child, lochia is secreted from the woman's genital tract for several weeks. Their number gradually decreases, which indicates wound healing after separation of the placenta. Many women are interested in the question: how long does bleeding last after a normal birth?

This is a very important factor, since it can be used to determine the degree of recovery of the body and deviations from the norm. Over time, lochia changes its composition and color. At first the woman is in the maternity hospital, but then discharged home.

If at first medical personnel monitor her condition, then in the future she must do this independently. The amount and nature of discharge indicates the state of health, so you need to notice deviations from the norm in time.

How long does it take to bleed after childbirth?

For 2 hours, the woman and the newborn are in the maternity ward. At this time, normal discharge is quite copious and bloody, but its total amount should not exceed 400 ml. To prevent complications such as bleeding, they can drain urine through a catheter, put ice on the stomach, and administer drugs intravenously to speed up uterine contractions.

These few hours are the most dangerous, because the muscles of the uterus are relaxed and contractions may not occur, and the onset of blood loss may not manifest itself in anything other than dizziness and weakness. So if these symptoms appear and the sheet/diaper gets wet quickly, you should urgently call a nurse.

Complications can also arise from ruptures of the tissues of the birth canal, so the obstetrician carefully examines the vagina and cervix, and if their integrity is damaged, take the necessary measures, that is, suturing the wounds. If the tear is not sutured completely, a hematoma may form, which is subsequently opened and re-sutured.

How long does bleeding last after childbirth?

The recovery process is successful if in the first 2-3 days the lochia is bloody in nature and quite abundant (up to 300 ml in 3 days). At this time, the gasket should fill completely in just 1-2 hours.

Lochia may have blood clots after childbirth, a musty odor similar to menstrual odor. Gradually their number decreases, and they acquire a brownish-red hue, intensifying with movement. They also appear on palpation of the abdomen.

To prevent bleeding, you must follow certain rules:

Go to the toilet immediately when you have the urge to urinate. During the first 24 hours, you need to visit the restroom at least every 3 hours. An overfilled bladder interferes with the contraction process;
Attach the baby to the breast at his first request. The fact is that when the nipples are irritated, oxytocin is released, the hormone responsible for contractions. Blood leaking after childbirth may increase during breastfeeding and be accompanied by cramping pain in the lower abdomen;
Sleep and rest lying on your stomach. This position promotes the release of blood clots. The uterus may tilt posteriorly, but lying on your stomach will bring it closer to the abdominal wall. This way the outflow will improve;
Place ice on your stomach several times a day, which will improve the condition of blood vessels and speed up contractions.

When the uterus is overstretched and labor is complicated, oxytocin injections are prescribed to stimulate contractions.

It is worth noting that an increase in the amount of discharge should be a reason to consult a doctor, because it may indicate late bleeding. This phenomenon can occur not only in the first days, but also several weeks after birth. So even at home you need to pay attention to how much fluid is released.

Late bleeding is usually caused by a stuck piece of placenta. Sometimes it is not diagnosed immediately after birth, then it leads to complications that can be detected during a vaginal examination or ultrasound. If the diagnosis is confirmed, the remains are removed under general anesthesia. At the same time, infusion and antibacterial therapy are carried out.

Sometimes this phenomenon occurs due to a blood clotting disorder, which can be caused by various diseases. Stopping such blood loss is the most difficult thing.

Most often, complications arise due to insufficient contraction of the uterine muscles. Bleeding after childbirth in this case is also painless, but very profuse. To stop it, reducing agents are administered, and blood loss is also replaced with intravenous fluids or blood products. If necessary, resort to surgical intervention.

Early cessation of lochia is also a reason to visit a doctor. Perhaps there is lochiometra - an accumulation of secretions in the uterine cavity. This pathology occurs when the organ is overstretched or bent backwards.

If this condition is not eliminated in time, endometritis will appear - inflammation of the uterine mucosa, because lochia is a good breeding ground for microbes. Treatment mainly consists of taking Oxytocin and No-shpa.

Blood after childbirth at home

So how much does one bleed after childbirth? The average time is 6-8 weeks. This is exactly the period required for the uterus to develop back after pregnancy and childbirth. The total amount of lochia ranges from 500 to 1500 ml.

In the first week, they can be compared to normal menstruation, only more abundant and with clots. With each subsequent day, their volume will decrease and their color will approach yellowish-white. By the end of 4 weeks they are very scanty, one might say spotty, and after another 14 days they should become the same as before pregnancy.

For those who breastfeed, they end earlier, since the uterus contracts much faster. But for women who have had a caesarean section, recovery is slower because the stitch interferes with the normal reverse process, and bleeding takes longer than usual.

What to do if there is bleeding after childbirth?

It is important to follow special rules of personal hygiene during the postpartum period. Lochia contains microbial flora, which, under favorable conditions, can contribute to the development of the inflammatory process. That is why it is necessary that the discharge does not linger in the uterus and comes out of it.

Reading time: 6 minutes. Views 5k.

Bleeding after delivery, or lochia, is a natural physiological process that does not require treatment. Medical assistance may be needed if vaginal discharge does not go away for a long time, or other symptoms appear that indicate the development of a pathological process.

A woman who is pregnant should know how much blood bleeds after childbirth, what daily volume of discharge is considered normal, and what reasons should prompt her to see a doctor.

Why is there blood?

Bleeding after childbirth occurs as a result of damage to the vessels of the uterus in the place where the placenta was attached. Lochia contains:

scraps of uterine mucous tissue;
remnants of the fetal membrane;
mucus and ichor from the cervical canal.

As the cavity of the reproductive organ contracts, cleanses, and the wound surface heals, the intensity of bleeding decreases. The discharge also changes color. Severe bleeding in the early period can be caused by:

poor blood clotting;
injury to the birth canal;
rapid labor;
remnants of placental tissue that have not separated from the uterus;
myoma, fibroma, and other gynecological diseases.

The cause of bleeding after childbirth may be poor contraction of the uterus caused by its overstretching. This pathology often occurs as a result of multiple pregnancies, polyhydramnios, or a large fetus.

How often do you get your blood tested?

Poll Options are limited because JavaScript is disabled in your browser.

Only as prescribed by the attending physician 32%, 111 votes

Once a year and I think that’s enough 18%, 64 vote

At least twice a year 13%, 46 votes

More than twice a year but less than six times 12%, 42 vote

I monitor my health and rent once a month 7%, 24 vote

I'm afraid of this procedure and try not to pass 5%, 16 votes

21.10.2019

If a woman has bleeding in the late period (2 hours or 6 weeks after delivery), its causes may be as follows:

remnants of the placenta (may be present in the organ cavity, even if the woman has undergone cleaning);
spasm in the cervix;
inflammatory processes localized in the reproductive organs.

How long does bleeding last after childbirth?

After childbirth, there is blood, which can be compared to heavy menstruation. Its volume at the time of discharge should not exceed 400 ml. Otherwise, the woman may develop anemia. Intense bleeding lasts no more than 2-3 days. In the first 7-10 days, the blood flows scarlet. Gradually, the lochia change. They turn brown, yellow, white and then clear. Scanty black discharge is also not pathological. Such changes indicate healing of the wound surface of the uterus.

If the patient has discharge for 2 to 6 weeks, and its volume gradually decreases, this is normal. The duration of bleeding in a woman in labor will depend on:

Method of delivery. After a caesarean section, lochia lasts longer than after a natural birth. This process is explained by the slow restoration of the reproductive organ. After a cesarean section there should be no bleeding for longer than 60 days.
Contractility of the uterus. The weaker the muscle tissue of the reproductive organ, the longer the lochia does not go away.
Physical activity. Exercising, lifting heavy objects, etc., contribute to an increase in the volume of discharge. The duration of those who actively engage in sports may exceed generally accepted norms by 1-1.5 weeks.
Sexual intimacy. Intimate relations are not recommended until the uterus stops bleeding.
Breastfeeding. Putting a baby to the breast helps contract the uterus and cleanse its cavity of lochia.
Having constipation. When bowel movements are abnormal, the intestines put pressure on the uterus, which prevents its contraction.

Bleeding ends faster if the woman empties her bladder in a timely manner. You can speed up the process of cleansing the reproductive organ by sleeping on your stomach (provided there are no individual contraindications).

What is a deviation

The process of restoration of the body begins immediately after childbirth and continues until the uterus returns to its previous size. When performing a cesarean section or damage to the birth canal, time is required for the sutures to heal.

Not only bleeding that lasts longer than 2 months is considered a pathology. If a woman’s lochia stops, for example, after 4-5 days, then this is a reason to consult a doctor. In most of these cases, when the blood stops flowing in the first few days after labor, it accumulates in the uterine cavity. If the cause of the outflow disturbance is not eliminated, the inflammatory process begins.

Deviations from the norm include:

Intense bleeding in the afterbirth and early postpartum period. Most often, the reason for its appearance is ruptures.
Pain in the lower abdomen, fever, dizziness, deterioration in health, etc. Requires immediate diagnosis, because There are many reasons that can cause such symptoms (endometriosis, pelvic inflammatory disease, etc.).
Scanty discharge, heavy bleeding after childbirth, accompanied by an unpleasant odor.
Green, yellow-green, brown or other color that is not typical for uterine discharge.
Prolonged bleeding. Even if a woman’s discharge is scanty and there are no other symptoms indicating pathology, but the lochia does not go away for a long time, she needs to undergo a gynecological examination.
Sudden increase in the amount of uterine discharge.

If bleeding in a young mother, which lasts 4-6 weeks, stops and then resumes after a few days, then it is not lochia. This symptom may indicate the resumption of the menstrual cycle. But there are also pathological reasons that are a deviation from the norm, for example, divergence of postoperative sutures.

What to do

If a woman is diagnosed with postpartum bleeding that does not meet the norm, in order to treat the pathological process it is necessary to determine the cause of its occurrence. The source of the problem can be determined by visual examination of the patient or by ultrasound scanning. A blood test and vaginal smear may be ordered if a bleeding disorder or infection is suspected.

When the 3rd stage of labor is complicated by placenta accreta, in order to prevent bleeding, it is removed manually. The procedure is performed under anesthesia.

When the blood has stopped flowing, but accumulates in the uterine cavity, a woman may be recommended an abdominal massage, an oxytocin injection, or curettage.

If the lochia progressed without pathologies, but bleeding began in the late labor period, it is necessary to call an ambulance. Until the doctors arrive, the woman needs to lie on her back with a cushion under her buttocks.

How to stop

Stopping postpartum hemorrhage caused by pathological causes can only be done in a hospital setting. If the birth canal ruptures, the woman needs stitches. If during the ultrasound scanning remnants of placental tissue were detected, the patient is cleaned, i.e. scraping. If an infection is suspected, antibiotic therapy is prescribed.

If a woman has weak blood vessels, she may be prescribed calcium gluconate. It is not an emergency measure to stop uterine bleeding. It is often used in combination with other drugs.

Major blood loss can be prevented with the following medications:

Dicynone;
Aminocaproic acid;
vitamin K.

To reduce blood loss during uterine atony after the birth of a child, a woman can undergo external, internal or combined massage.

The treatment method is selected individually for each woman based on the totality of medical information about the patient. In critical situations, when all previous attempts to stop the bleeding have not brought positive results, a hysterectomy may be performed. The operation involves removing the uterus. After it, the woman is deprived of her reproductive abilities, but such surgical intervention can save the patient’s life.

Trying to shorten the duration of uterine discharge (lochia) on your own is not recommended if postpartum recovery of the body proceeds without complications.

When to go to the doctor

The appearance of bleeding in the early postpartum period is diagnosed immediately, because at this time the woman is under close medical supervision. If the woman in labor has already been transferred from the maternity ward to the ward, the reason for an unscheduled examination may be an increase in the volume of lochia, a progressive deterioration in health, an increase in temperature and the appearance of pain in the abdominal area.

A woman should go to the doctor if there is any suspicion of a pathological process.

You should undergo a routine examination by a gynecologist after the uterine discharge has stopped, regardless of whether there were any health problems after childbirth.

Bleeding after childbirth is normal, as long as it occurs without pathologies. By and large, these are blood cells and epithelium from the walls of the uterus. Bleeding after childbirth in a woman is explained by the fact that this is a very difficult physiological process, in which ruptures and multiple microtraumas very often occur. After the placenta is expelled, a huge amount of unnecessary epithelium and blood vessels remain in the uterus. They are the ones that leave a woman’s body during the postpartum period.

Some people tolerate this bleeding after pregnancy calmly and painlessly, while others sometimes need qualified help. It is quite natural to have copious bleeding in the first hours after childbirth; up to 500 g of blood can come out. But the woman must be constantly monitored. After a certain time, they subside. In a month this should disappear to almost nothing.

Causes

Many women worry about how long bleeding should last after childbirth. The normal duration of bleeding after childbirth lasts up to 60 days. There are cases that a woman’s bleeding subsides after two weeks after childbirth.

In the first 2 hours after birth, heavy bleeding may be due to:

– it is liquid and literally “flows like a stream” without even trying to curl up;
Rapid labor is also a cause of severe blood loss;
If the placenta is accreta and interferes with involution.

If the blood does not stop coming out after 2 months, then this is a serious reason to consult a doctor for diagnosis and treatment.

The reasons for this bleeding may be the following:

Dysfunction of the uterus, in which it contracts little. Or does not try to get rid of unnecessary organic material at all;
Fibroids and fibroids are also a cause;
The body of the uterus is greatly stretched during multiple pregnancy;
Large baby;
Prolonged labor during which stimulant medications were used;
It could also be the negligence of a midwife or doctor;
Not all of the afterbirth came out and caused an inflammatory process;
Endometritis;
If there was premature separation of the placenta, or tight attachment, etc.

After a woman gives birth to a child, her body must independently cleanse itself of everything unnecessary. That is, particles of the uterine mucosa come out with the blood, and if they come out abundantly at first, this is great - it means the process of self-cleansing is underway.

Over the entire period, which is approximately 6-8 weeks, a woman on average loses from 500 to 1500 g of blood.

Women after childbirth feel aching pain in the lower abdomen - this process occurring in the body of the uterus is called involution - contraction of the uterus.

When a woman in labor puts her baby to her breast, she produces the hormone oxytocin, which causes the uterus to contract. Therefore, in women who breastfeed, involution occurs faster than in women who do not breastfeed. And if involution occurs slowly, it means that the young mother may have hormonal or immune disorders. It is possible that pieces of the placenta remain in the uterus, and this provokes a slowdown in uterine contractions.

Some women in labor claim that in the first days it is difficult to even get out of bed, since after pregnancy they literally “flow like a stream.” This suggests that when getting out of bed, the muscles tense, and as a result, I push out everything unnecessary from the uterus. Because of this, it is not recommended to move a lot and put pressure on the stomach so that the woman’s bleeding does not increase. True, doctors advise sleeping on your stomach for the first time after childbirth, but under no circumstances should you pull it over.

Norm

You can argue for a long time about the norms of blood secretion, but you need to take into account that each woman is individual. Most doctors say that heavy bleeding after childbirth should not last more than five days. If your bleeding continues for a long time and does not decrease in abundance, then you need to consult a doctor.

Some women consider their heavy discharge to be quite normal even after two weeks; one condition is to monitor your red blood cells - by doing a blood test. There are times when the blood discharge turns brown. This means that there are few red blood cells; in general, this is not dangerous for the body.

If your blood comes out bright red for a very long period of time, then this is a sign that something is wrong. It is considered normal for blood discharge after childbirth if the first days your discharge is bright and thick, and later it becomes brown and just “smears”. Then, the discharge may change color to yellowish. This is also normal and does not pose a health hazard. This is explained by the fact that it is becoming less and less, and the “daub” is decreasing.

If bleeding resumes after a certain period, special medications must be used.

Because due to large blood loss, the patient may experience hypotension and pale skin. Bleeding after the baby’s pregnancy can be stopped either with medications, you can do an external muscle massage and put on an ice heating pad, or in a surgical way - by suturing perineal tears and removing the remaining placenta by hand.

If the uterine ruptures are significant, this can even lead to complete removal of the uterus. Whatever the surgical actions, they are always accompanied by the introduction of special drugs that restore blood loss, either infusion or blood.

Sexual relations after childbirth

After giving birth, doctors recommend not to be sexually active for one and a half to two months so that the woman can recover. After all, during sexual intercourse it is easy to introduce an infection into a weakened and exhausted woman’s body, since the uterus at the moment is a continuous non-healing wound, and the infection can lead to inflammatory complications and endometritis, and this is already dangerous for the health of the woman in labor.

The next fact is that early sexual intercourse causes pain to a woman, due to ruptures that heal slowly and physiological vaginal dryness. Nature intended it this way that a woman does not want intimacy for the first time after childbirth. So that a complication does not begin, and the next, unwanted pregnancy does not occur.

If you rush into sexual intercourse, you may cause bleeding to increase or return. Untreated cervical erosion can also contribute to this.

When to contact a gynecologist

You should go to a gynecologist if:

The discharge continues for more than two months;
If in them they intensified;
If pain is present;
If after a short period of time bleeding starts again.

An unpleasant odor from the discharge may be a reason to go to the doctor. In general, there should be no smell during bleeding after childbirth; if it is present, it means that there may be some kind of infection in the uterus. It could have been caused by ruptures during labor, or more specifically by improperly done treatment.

After 30 days have passed after delivery, you must visit a gynecologist for a consultation. Don’t follow fortune tellers and don’t heal yourself, otherwise it can lead to dire consequences.

Prevention

In order to avoid infection, you must follow the rules of prevention and personal hygiene:

Take a shower every day with warm water, using soap or intimate hygiene gel;
For the first time after childbirth, use sterile diapers as pads;
If bleeding is heavy, change pads often (up to 8 times);
And lastly, do not use tampons under any circumstances, even at the end of this period.