I had no idea what to expect when I was pregnant, and the same could be said for the days when my pregnancy ended. I didn't know how rough recovery would be, that my pre-pregnancy pants wouldn't fit, or the postpartum bleeding red flags to look out for. I went home from the hospital bleeding so much that each trip to the bathroom was a scene from Carrie, armed with nothing but mesh panties and a package industrial-sized pads.
After a few frantic calls to my midwife's office, I was assured that my postpartum bleeding was typical and, after a few weeks, it finally tapered off. But I wish I would have known what was typical and what wasn't, if only for my peace of mind. So, to find out more about the ins and outs of postpartum bleeding, what's normal, and when to worry, Romper spoke with OB-GYNs Dianne Haynes, MD of Upper Chesapeake Women’s Care at the University of Maryland, James Greene, MD, Medical Director for Women’s Health, Kaiser Permanente Washington, Nicolle Underwood, MD at Hoag Hospital in Newport Beach, Calif., and Huma Farid, MD, at Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Mass. via email.
It turns out that while postpartum bleeding is something that most new gestating parents have to deal with, heavy bleeding can be a sign of a serious problem, especially when it's accompanied by other symptoms. "If your bleeding continues to get heavier instead of lighter/tapering off, this may be an indication of postpartum hemorrhage," Dr. Haynes tells Romper.
"Signs of a problem could include tapering of the bleeding, then an increase in bleeding, a passage of clots, or heavy bleeding," Dr. Farid adds. "Bleeding should definitely get better, not worse." And Dr. Underwood says, "After leaving the hospital, you should generally expect the bleeding to decrease over the first two weeks and to slowly feel better and stronger." For more on postpartum bleeding red flags, and when to call your doctor, read on:
Heavy Flow
As Dr. Underwood tells Romper, some postpartum bleeding is to be expected. "Postpartum bleeding is normal for several weeks, up to 6 weeks, following a vaginal delivery," she says. "The bleeding may also be inconsistent. Just when you think it's done, you'll have another day of dark red bleeding. Although some days may be heavier than others, soaking through a pad in just one hour is too heavy."
Dr. Haynes agrees. "During the first few days after birth, you will likely have some heavy bleeding — maybe even clotting — and the blood will be bright red," she says. "Don’t be surprised when your nurse provides you with a hospital pad. Once you’re home, though, your flow should be similar to a normal period."
Bleeding That Never Eases Up
Your postpartum bleeding should not last forever. As "Most bleeding is often concluded by four to six weeks, but up to 15 percent of women will bleed as long as eight weeks," Dr. Greene says. "Breastfeeding may help reduce postpartum bleeding as the process releases natural Oxytocin that encourages uterine contraction and the uterus to return to its normal size."
Feeling Weaker Or Dizzy
You should also call if you start feeling dizzy or light-headed, which may be a sign of blood loss. "If you feel like you are sliding backwards, the bleeding improved and is now heavy again or you're feeling weaker than you were, call your provider," Dr. Underwood says.
Symptoms of a hemorrhage may vary, though, and Dr. Haynes says, "Everyone experiences the condition differently, but symptoms include excessive bleeding, increased heart rate, and decreased blood pressure."
You Are Passing Clots
According to Dr. Underwood, passing some clots when you're postpartum is normal, but those clots should be on the small side and only last a few days. "Small clots may occur in the first few days, but clots larger than a golf ball may be concerning," she says.
"If you pass clots bigger than an apricot, or are consistently passing smaller clots with increased bleeding and cramping, you should call your doctor, as that could be a sign that a piece of placenta is still inside of the uterus," Dr. Farid adds.
Bleeding That Stops & Starts Back Up Again
If your bleeding changes in consistency, it may or may not be a sign of a problem. "Overall bleeding can be influenced by activity. You might notice that the discharge will increase in the second and third weeks as you become more active," Dr. Greene tells Romper.
But as Haynes notes, an increase may be problematic. "If your bleeding continues to get heavier instead of lighter/tapering off, this may be an indication of postpartum hemorrhage," she says.
Fever Or Chills
Other symptoms that accompany postpartum bleeding might be cause for concern, too. "If you have a temperature greater than 100.4, you should call your doctor, particularly if you are having heavy bleeding or passing clots, as that could be a sign of an infection inside the uterus," Dr. Farid tells Romper.
Haynes adds, "Other symptoms that should trigger a call to your provider include: blood that remains bright red after days of giving birth, significant blood clots, fever, chills, nausea, rapid heartbeat, or clammy skin."
If you are ever concerned, or have a question, just call your health care provider. "Anytime you have concerns about yourself or your baby, never hesitate to call your provider," Dr. Greene continues. "We are always happy to lend assurance or provide advice at this important and potentially vulnerable time for you and your family."
Editor's Note: A previous version of this post miss-attributed a quote. It has been updated.
