Tips To Deal With Postpartum Bleeding, Causes, Conditions & Treatments

Medically reviewed by Maria Sarino, MD FACT CHECKED

In case of vaginal delivery or even a cesarean section, you could experience vaginal bleeding and discharge after birth. This bleeding or discharge is known as lochia.

The major purpose of your body to discharge off the lochia is because it needs to get rid of the extra tissues and blood that were initially helping your baby to grow in the uterus.

Hence, you may experience heavy bleeding in the initial few days after your delivery. But in case heavy bleeding continues even after a few days, then it may be referred to as Postpartum Hemorrhaging.

As a result, let’s understand in detail the reason behind bleeding after delivery and the meaning of postpartum hemorrhaging which is one of the most under-talked and common postpartum issues.

Being a similar discharge to your menstrual period, Lochia might last for four to six weeks after delivery. It consists of white blood cells, blood pieces of the uterine lining, and mucus.

Just like during menstruation, postpartum bleeding is even caused by the shedding of the uterus lining. So in the initial few days, the major component of Lochia might be blood.

However, as days and weeks pass by, you could see how the composition of lochia changes from less blood and more mucus.

Other pointers are discussed here, it’s all about acute Postpartum Hemorrhage.

What Is Postpartum Hemorrhaging?

The term postpartum hemorrhage could be defined as the loss of more than 500 milliliters of blood during your postpartum phase.

On average you may lose approximately 500 milliliters of blood during vagina birth and 1000ML during Caesarean birth.

Generally, you may not face any problem related to heavy bleeding. However, approximately 3 to 5% of the patients might face postpartum hemorrhage.

There are two types of postpartum hemorrhage based on the period when they occur. The primary postpartum hemorrhage is the risk of hemorrhage during the initial 24 hours after delivery.

On the other hand, secondary postpartum hemorrhage occurs after the initial 24 hours of delivery. Now let’s try to understand the bleeding after Caesarean and vaginal delivery.

Bleeding After A Vaginal Delivery

In normal circumstances, after a vaginal delivery, you could observe bright or dark red blood in your bleeding for the first one to three days.

The smell of this blood might be similar to your menstrual blood. You may even find a few clots of blood from time to time in your bleeding.

Later on, as the days pass by, your blood might turn to a brownish or pinkish color on days from 4 to 7. At the same time, the size of the clots might get smaller, or they may even disappear.

Then as the first week passes, you could see how your discharge may fade to white or yellow color. In approximately three to six weeks, the bleeding might even stop.

More on it here.

Bleeding After A Caesarean Section

In the case of a C-section, you could experience a lesser lochia as compared to word vaginal delivery. However, you might still see some amount of bleeding.

Just like in the vaginal delivery, the color of your blood after a cesarean section might even change from red to brown and then to yellow or white.

A governmental analysis is presented here.

Dealing With Postpartum Hemorrhage

In case you are suffering from postpartum hemorrhage, then you should know about its different aspects. Knowing the different elements of postpartum hemorrhage may help you to deal with it. So let’s have a glance at the different aspects of postpartum hemorrhage and learn how to deal with them.

More on managing the Postpartum Hemorrhage here.

Risks For Postpartum Hemorrhage

Some of the women might be at augmented risk for postpartum hemorrhage as compared to others. This is because of several conditions like.

  • Multiple baby pregnancy.
  • Infection or obesity
  • Vacuum-assisted delivery or the usage of forceps
  • A condition when the placenta is near the opening of the cervix.
  • Placental abruption, when the placenta detaches early from the uterus.
  • Prolonged Labour or high blood pressure disorders.
  • A condition is known as the overdistended uterus when the uterus is larger than the normal size because of a large baby or an excess of amniotic fluid in it.
  • Many previous births
  • Asian ethnic background of the women.

A detailed analysis is presented here.

Knowing When To Call Your Doctor

In case you experience a postpartum hemorrhage that lets you soak through one hospital pad in even less than an hour, then it might be time to call your doctor.

As a result, you should know when to call your doctor. You may call the doctor in the following circumstances-

  • If you see any signs of infection or your discharge smells foul.
  • In case you experience chills or have a fever higher than 38 degrees Celsius.
  • In case you experience signs of shock and low blood pressure due to heavy bleeding or even a very fast heartbeat.
  • When you observe bright red and heavy flow, even during the second week.
  • If you experience irregular heartbeat along with dizziness.
  • A tender feeling on one or even both sides of your stomach.
  • If you experience swelling and pain around your perineum or vagina.

The only method to deal with postpartum bleeding in all such cases is to tell your doctor about your large clots or heavy bleeding.

This is because the primary reason behind postpartum hemorrhage could be that your uterus is having trouble going back to its normal size.

Other factors are discussed here along with factors associated with severity.

Causes Of Postpartum Hemorrhage

To deal with your postpartum bleeding or postpartum hemorrhage, you should know the cause behind it. There are a plethora of reasons that might be responsible for your Postpartum hemorrhage.

Once you know the real cause behind your postpartum hemorrhage, it will be easy to deal with it and find its treatment. Let’s have a look at them.

Conditions Affecting The Uterus

  1. Uterine Rupture

    Though it happens rarely, sometimes your uterus may tear during Labor. The primary reason behind this could be if you had a C- section or any other surgeries in your uterus in the past.

    More info here.

  2. Uterine Atony

    Being one of the most common reasons behind postpartum hemorrhage, Uterine atony refers to the condition when the muscles in your uterus do not contract properly after birth.

    This is because it is the uterine contractions that could help to evade the bleeding from the place where the Placenta breaks away after birth.

    You may have Uterine atony due to giving birth to several children in the past, or if your uterus is enlarged, because of a large baby or twins.

  3. Uterine Inversion

    Uterine inversion is also a rare case that might lead to postpartum hemorrhage. Under this condition, your uterus may turn inside out after giving birth.

Postpartum causes and management are discussed here.

Conditions Affecting The Placenta

  1. Placenta Previa

    Under this condition, your placenta might lie low in the uterus and cover the opening to the uterus known as the cervix.

  2. Placental Abruption

    Placental abruption might lead to postpartum hemorrhage because under this condition your placenta might separate from the lining of the uterus early before birth.

  3. Retained Placenta

    As the name suggests, under this condition, your Placenta may not pass within half an hour to one hour after birth.

    Moreover, your healthcare provider might even check if any of the tissue of the placenta remains inside the uterus that could lead to heavy bleeding.

  4. Placenta accreta, percreta Or Accreta

    Under all these conditions, the placenta might grow so deeply in the lining of the uterus that it may not be separated from it.

Treatment For Postpartum Hemorrhage Or Heavy Bleeding

Once you know the cause of your bleeding, your doctor may decide its treatment. The different treatments for postpartum hemorrhage or heavy bleeding are as follows.

  • Consuming medicines to help your uterus to contract.
  • Making up for the lost blood through blood transfusion. Under this method, you might be given blood through a tube directly to the veins that could help you to replace the blood you had earlier lost.
  • Another method is to undergo a hysterectomy under which the uterus is removed surgically.
  • The doctor might even help you to stop the bleeding by giving you a shot of special medicine.
  • Removing the left tissues of the placenta from the uterus or massaging your uterus could even be helpful to treat heavy bleeding.
  • The doctors might even perform a laparotomy, which is a surgery that includes opening your abdomen to find out the root cause of bleeding and then, treating it.
  • Sometimes the healthcare providers might even use an inflated Bakri balloon inside your uterus. This balloon could help to add the pressure and thus, slow the bleeding.
  • You may even take the help of a radiologist who could perform a uterine artery embolization. The major purpose of this is to limit the blood flow to the uterus and hence, evade excessive bleeding.

Let Us Sum It Up!

Thus you may experience excessive bleeding or postpartum hemorrhage due to a plethora of reasons. It might be because of the conditions affecting your uterus, placenta, or even other issues. Sometimes it could be because of obesity, Preeclampsia or gestational hypertension, different infections like chorioamnionitis or the blood conditions like Disseminated Intravascular Coagulation or von Willebrand disease.

Figuring out the reason behind your excessive bleeding might help the doctors to provide you with the required treatment. At the same time, if you face any issues with the color of your bleeding or different symptoms like dizziness, irregular heartbeats, and a tingling sensation at the side of your stomach, then you may call your doctor immediately.

Though less than 5% of birthing mothers might face postpartum hemorrhage, it has accounted for approximately one-quarter of female deaths globally. So during your prenatal checkups, you could talk to your obstetrician about the different risk factors and concoct a prevention strategy for postpartum hemorrhage. This could help you to understand the protocols of excessive bleeding and figure out ways to keep yourself safe.

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