What Is Postpartum Bleeding?

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Postpartum bleeding is normal after you deliver your baby. The bloody discharge you have is called lochia. It will turn pinkish within a week of giving birth and become white or yellow after about 10 days. Lochia may last for four to six weeks, but it should be less bloody after two weeks. It can come and go for about two months.

Heavier and uncontrolled bleeding after giving birth is called postpartum hemorrhage. It is more likely with a cesarean delivery (C-section). Other factors can also make someone more likely to have postpartum hemorrhage. If it happens, you need treatment as soon as possible to stop the bleeding.

Postpartum Bleeding

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Types

There are three stages of typical postpartum bleeding that are natural and expected occurrences after childbirth. These stages include:

  • Lochia rubra: This is the first stage of postpartum bleeding. It lasts about a week after delivery and is the heaviest, with bright red bleeding and blood clots expected.
  • Lochia serosa: This second stage of postpartum bleeding can last between two and six weeks. Blood flow slows and becomes thinner, often taking on more of a pink or brown color instead of bright red.
  • Lochia alba: In this final stage of postpartum bleeding, blood will be replaced with a whitish or yellowish discharge.

Purpose

After your baby is delivered, you will enter the third stage of labor. This is when the placenta detaches from the wall of the uterus and is expelled through the vagina. The placenta isn't the only tissue that's no longer needed after your baby is born, though. Blood cells and excess fluid and tissue will be gradually cleared from your body in the weeks after delivery.

Bleeding is also the result of the uterine wall healing in the area where the placenta detached. As that tissue heals, bleeding slows. Extremely heavy bleeding can signal trouble with the healing process.

Risks

While bleeding is a normal part of the recovery process after delivery, there are some situations that increase the risk of more intense bleeding after delivery. Risk factors for postpartum hemorrhage include:

  • Tears in the cervix or tissues of the vagina
  • Tears in blood vessels of the uterus
  • A hematoma (blood collecting outside of blood tissues) in the vulva or vagina
  • Blood-clotting disorders
  • Placental abruption (the placenta separates from the uterus before birth)
  • Placenta previa (the placenta lies low in the uterus and covers the cervix)
  • Distended uterus (weakened muscles of the uterus cause it to drop into the vagina)
  • High blood pressure during pregnancy (preeclampsia)
  • Carrying multiple babies at once
  • Prolonged labor
  • Infections
  • Obesity
  • Delivery that was assisted with forceps or a vacuum device
  • Cesarean delivery

Complications

It's normal to experience bleeding for six weeks or so after delivery and for the bleeding to get heavier or lighter with activity. What isn't expected is heavy bleeding that causes you to soak through a pad every hour or two, or when large clots are present with the bleeding.

Other warning signs that the bleeding is more severe than normal include:

  • Abnormal blood pressure changes (orthostasis)
  • Low blood pressure
  • Increased heart rate
  • Nausea
  • Shortness of breath
  • Low urine output
  • Chest pain

Most healthy individuals can tolerate about 500–1,000 milliliters of blood loss after delivery, but more than 1,000 milliliters, or 1 liter, of blood right after delivery is classified as postpartum hemorrhage. This is a medical emergency and requires immediate treatment by a healthcare provider.

Up to 5% of women experience postpartum hemorrhage, and it accounts for about 25% of maternal deaths around the world—12% in the United States alone.

Postpartum hemorrhage that is not addressed quickly can lead to:

Side Effects

Even normal amounts of postpartum bleeding can cause side effects like:

  • Anemia (lack of healthy red blood cells)
  • Fatigue
  • Low blood pressure
  • Problems with lactation or breastfeeding
  • Cramping

Before you leave the hospital, your medical team will watch the progress of your bleeding and monitor the contraction of your uterus. This will include checking the height and tone of your fundus, the top portion of your uterus.

A fundus that feels too soft can be a sign that you are at risk of postpartum hemorrhage. Your medical team will also check your placenta carefully after delivery since pieces of placenta left in the uterus can also lead to hemorrhage.

Coping

If you experience postpartum hemorrhage, your medical team will work quickly to determine the cause of the hemorrhage, stop the bleeding, and replace your blood through transfusions.

Even with normal amounts of bleeding, cramping and discomfort can make the recovery process more difficult. Some strategies to help you cope with postpartum bleeding include:

  • Placing a heating pad or pack over your abdomen (make sure what you are using is safe to apply to your skin)
  • Taking a gentle walk
  • Using a sitz bath
  • Taking pain medications, as directed by your doctor

You may also experience some constipation or pain when urinating or having a bowel movement. Your doctor may suggest stool softeners to help increase your comfort.

Your doctor will also give you advice on when to call or go to the hospital after delivery. Generally, some things that warrant a call to your healthcare provider include:

  • A fever over 100.4 degrees Fahrenheit
  • Severe chills
  • Foul-smelling vaginal discharge or blood
  • Pain, burning, or difficulty urinating
  • Increased tears, swelling, bruising, or separation of incisions in your perineum (area between the genitals and anus)
  • Use of more than one pad per hour
  • Blurry vision
  • Severe cramping or abdominal pain
  • Severe headache
  • Dizziness or loss of consciousness
  • Swelling, redness, or pain in one limb
  • Shortness of breath

Summary

Postpartum bleeding is common after delivery and usually not a serious problem. You may experience bloody discharge called lochia for up to two months after giving birth. Sometimes heavy bleeding may occur, which needs to treated as soon as possible. Your healthcare team will keep a close eye on you as you recover during the postpartum period and start any treatment if it's needed.

A Word From Verywell

Bleeding is a normal part of the recovery process after childbirth. As the uterus shrinks back to its normal size, extra tissue and blood leaves through the vagina. This bloody discharge may last for two months. In some cases, the bleeding can become more severe, leading to postpartum hemorrhage. This requires emergency medical care.

Your healthcare providers will watch your closely in the hours after delivery, and give you specific instructions on when to be concerned about bleeding once you go home.

Frequently Asked Questions

How long does postpartum bleeding last?

Postpartum bleeding is generally heaviest the first week after delivery, but it can continue for up to six weeks and may come and go for up to two months.

How do you stop postpartum bleeding?

Postpartum bleeding will stop in time on its own, but if you begin bleeding more than you should, your healthcare provider can give you medications or perform techniques like massaging the uterus to help control the bleeding.

When should you worry about postpartum bleeding?

Immediately after delivery, your healthcare team will monitor you closely for hemorrhaging. Generally, most mothers can tolerate up to a liter of blood loss. Once you go home, your healthcare provider may suggest you call the office if you begin to soak through a sanitary pad within an hour or two. Call 911 or head to a hospital emergency room if you are bleeding more than this and experience symptoms like dizziness or loss of consciousness.

How long after postpartum bleeding will I get my period?

When your period returns after your give birth can vary, and it depends on whether you are breastfeeding. If you are not breastfeeding or only partially breastfeeding, menstruation can resume about six to eight weeks after giving birth.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Michigan Medicine. Postpartum bleeding. Updated October 8, 2020.

  2. Fletcher S, Grotegut CA, James AH. Lochia patterns among normal women: a systematic reviewJ Womens Health (Larchmt). 2012;21(12):1290-4. doi:10.1089/jwh.2012.3668

  3. Stanford Children's Health. Postpartum hemorrhage.

  4. American College of Obstetricians and Gynecologists. Postpartum hemorrhage. Updated October 2017.

  5. American Academy of Family Physicians. Postpartum hemorrhage: Prevention and treatment. Updated April 1, 2017.

  6. Cleveland Clinic. Pregnancy: Physical changes after delivery. Updated January 1, 2018.