Postpartum bleeding: 7 things that can explain it
Postpartum bleeding is normal. However, there are a few circumstances in which you might need to consult a doctor Read more to find out why postpartum bleeding occurs and when you should consult a doctor.
Postpartum bleeding, how long is normal?You can expect to have heavy bleeding for 3 to 4 days after delivery and it will become lighter after this. However, bleeding will continue up to 6 weeks and that is quite normal. Some mothers complain that their postpartum bleeding stopped then started again. This is usually because new moms are not getting enough of rest. Here is what is happening inside your body during postpartum bleeding. When you give birth, the placenta separates from the uterus. The placenta is expelled after the baby, during normal vaginal delivery. During a C-section, your doctor will remove the placenta. However, the placenta does not go quietly. When it pulls itself away from the uterine wall, it is going to leave many open blood vessels. This is why the blood being discharged in the first days after birth is bright red with plum-sized blood clots. Your uterus will take time to heal and shed all the lining that it doesn’t need anymore. How your body deals with it will decide on your postpartum bleeding and how long is normal for you. From 4 to 10 days, the blood will be light pink to brown. If you are still noticing blood clots or heavy bleeding, then you should alert your doctor. From 2 to 4 weeks, there will be light spotting and more of yellowish discharge. There should not be any signs of blood clots. Some women notice a foul odour along with the discharge and this is another sign that something is not quite right. Never use tampons or period cups in the recovery phase after delivery as they can lead to infection. Instead, stock up on sanitary napkins.
7 reasons why Severe Postpartum Bleeding OccursHeavy postpartum bleeding causes might slightly vary depending on the type of childbirth you have had. However, both heavy postpartum bleeding after Caesarian or normal childbirth is characterised by excessive loss of blood through the vagina. Women most at risk are those who have had high blood pressure during pregnancy, are obese, given birth to twins, have had a very long labour or delivered a very large baby. The postpartum bleeding causes are:
- Uterine Atony: The leading cause of postpartum bleeding is because the uterus fails to contract after delivery. Heavy postpartum bleeding after a C-section is usually because of uterine atony. This is because the body does not naturally release the hormones that cause contractions.
- Uterine Rupture: Postpartum hemorrhage (PPH) is sometimes because of a rupture in the uterine wall. There are many risk factors that can cause it such as having a vaginal delivery after a previous caesarian birth or previous uterine scars breaking open.
- Laceration: Some women have severe bleeding because of lacerations while giving birth. These deep cuts can occur in the uterus, cervix or vagina.
- Trapped Placenta: Sometimes the placenta only partially detaches from the lining of the uterus. When this happens the blood vessels in the uterus instead of closing off, continue to bleed.
- Placenta Accreta: The placenta can deeply embed itself into the uterine wall and will not detach as it normally should. When the obstetrician tries to remove it forcefully, it can cause a hemorrhage.
- Uterine Inversion: This is a rare occurrence but can happen if the umbilical cord is too short or the uterus is weak. In such a case the uterus can turn inside out.
- Coagulopathy: This is a bleeding disorder when the blood might not clot and the mother will need anticoagulants to stop the bleeding.
When should you call a doctor?Surprisingly, Asian and Hispanic women seem to be more prone to abnormal postpartum bleeding. While no theory has yet convincingly explained this, the point is that we need to take more care. The 24 hour window after birth is when most postpartum hemorrhages occur but it can also happen at a later stage after you go home. Very heavy postpartum bleeding after Caesarian or vaginal delivery can cause a sudden drop in blood pressure. This extended period of low blood pressure will starve your organs and your body can go into shock. Distinguishing secondary hemorrhage from heavy postpartum bleeding is difficult but if you have a doubt, it is best to clear it with your doctor Call your doctor or go to a hospital immediately if you have any of these symptoms
- Very large blood clots
- Bright red bleeding beyond the third day after birth
- Bleeding that soaks a sanitary pad within 15 minutes or need to change the pad every hour.
- Blurred vision and dizziness
- Feeling unusually cold or having clammy skin
- Nausea or weakness
- Rapid Breathing
Postpartum Hemorrhage TreatmentYour doctor will ensure that you are not at risk of postpartum hemorrhage immediately after childbirth. However, secondary postpartum bleeding needs you to be alert and inform your doctor as soon as you notice any symptoms. Treatment options include
- Medication to stimulate the uterus to contract.
- Manual massage to hasten the expulsion of the placenta
- Examination of the uterus and pelvic tissue, if your doctor suspects secondary PPH
- A Bakri balloon or a Foley catheter to reduce the bleeding inside the uterus
- Using uterine sutures to tie of bleeding vessels
- In extreme cases, surgery will be done to find the cause of the bleeding
- In very rare cases, a hysterectomy will be performed as a last resort.