What should you expect after birth? When will the bleeding slow down? What should you be looking out for? Read on for all your postnatal bleeding questions answered!
I remember after I had my first daughter (having had a C-section) I was so confused to discover I was bleeding afterwards, I mean a baby didn’t come out of my vagina and that aside surely they just sucked all that icky stuff out with the baby?!
It's amusing now, doing the job that I do quite how unprepared I was for the postnatal recovery period. Nobody had actually told me what to expect after birth they just assumed I knew, so in case you didn't know, you'll still bleed irrelevant of what sort of birth you have and it is just as important to educate yourself on what to expect after birthing your baby as it is to prepare yourself for giving birth!
So what should you expect from postnatal bleeding? Is it really THAT bad?
We put so much effort into preparing for giving birth. We do the antenatal classes, watch the videos, practice labour breathing and make sure we have everything including the kitchen sink packed in the hospital bag, if only we put so much effort into preparing for the postnatal days and transitioning into the fourth trimester, many of us would find early parenthood far more manageable.
After giving birth it is likely you'll be feeling a little delicate irrelevant of what sort of delivery you have had so there are a few bits and bobs you can get together ready to help during the first days of birth recovery.
The Preparation- shopping list 101
You'll go through a few packs of maternity pads over the first couple of weeks postpartum, take 2 full packets into the hospital with you.
I always recommend disposables for the first day or two, placing one pad towards the front of your underwear and a second towards the back as the bleeding is so heavy. Alternatively incontinence knickers work well.
Change your maternity pads every time you go to the toilet and if your have a wound from stitched or an episiotomy it is important to wash your hands before and after changing your maternity pad.
From day 2/3 onwards I much prefer to use reusable cloth pads specifically designed for the postpartum period- they're like a pillow for your fanny :)
It is well worth investing in some perineal compresses too, especially those that can be cooled or warmed to your desire, these can be soothing even after a straight forward birth.
A peri bottle is a useful investment. Alternatively just take a jug of warm water to the bathroom with you. Use these in place or wiping after urinating but also to help to prevent pubic hair matting from the heavy blood loss.
Ok so we have the labour bag packed, now what?
Why is it so important to know what to expect from postpartum blood loss?
Whilst bleeding after birth is a normal and expected postnatal experience. Understanding the progression of postnatal bleeding and being informed as to abnormalities that may occur could prevent delays in treating possible infections.
It is common to pass some clots in the early stages of bleeding. Clots smaller than a 50 pence piece are considered normal and having jelly like consistency. Anything larger than a 50p should be reported to your midwife along with passing excessive amount of blood, around a pint in the first 24 hours, these could be signs of a postpartum haemorrhage or placenta fragment retention.
Some signs to watch out for and seek medical support...
Fever
Foul smelling lochia
Light headed/dizziness or disorientation
Soaking a maternity pad front to back in an hour
Abdominal pain
Difficulty urinating or passing cloudy/bloody urine
What is normal bleeding after giving birth?
The discharge produced after birth is called lochia and it goes through a couple of different stages.
The first stage of postpartum bleeding is known as ‘lochia rubra’, it is dark red in colour and last for the first 3-4 days.
You'll probably want to double up your maternity pads during the first stage of postnatal bleeding, one towards the front of your underwear, one towards the back.
You may notice a ‘gush’ of blood first thing in the morning or when you’ve been sat down for a while, this is due to the shape of the vaginal canal and the blood 'pools' before standing up. You may notice during breast/chest feeding the uterus contracts. If this is your first baby you may not notice these sensations at all, however the sensation can be a lot striger with subsequent births and can be quite uncomfortable. The contractions during nursing sessions are helping the uterus to shrink back to its pre-pregnancy size, this stimulation can cause an increase in lochia expulsion too.
The second stage of postnatal bleeding is known as ‘lochia serosa’ and lasts from day 4 to10 postpartum. You'll experience a change in the discharge. The colour will lighten to a pinkish brown colour. Blood clots may still be passed during the second stage of lochia discharge however these should be less frequent and smaller in size.
The final stage of bleeding after birth is called 'Lochia Alba' and can last from day 10 to 28 days postpartum. Lochia Alba is yellowish in colour, quite similar to what you may have experienced in the days just before or following a menstrual period.
Remember that after you give birth the placenta breaks away from the uterine wall leaving a wound the size of a dinner plate (roughly 9 inches). If this would were on the outside of your body you wouldn't feel guilty about 'not getting much done' in the first few weeks. Your body needs to heal. You need to rest and relax. If your blood loss starts to reduce or move into the Serosa stage but then returns to fresh red or heavier bleeding, you have likely over done it. This is your body's way of telling you to slow down, listen to it.