Bleeding from the uterus after delivery is called as lochia. Uterine bleeding after delivery is a natural phenomenon that occurs in case of both normal delivery and delivery by C-section. Bleeding occurs from the site inside the womb where the placenta was attached and got detached and sloughed off after delivery. The placenta detaches from the uterine wall and the underlying bloods vessels (arteries and veins) open directly into the uterine cavity.
Bleeding after delivery persists for the first few days and appears similar to a heavy menstrual flow, comprising of dark blood with clots. The Lochia after birth smell is musty like during periods. It might gush out unexpectedly while sitting up, lying down, etc.
Bleeding after childbirth lasts for 5 weeks on an average. Lochia after C-section delivery is a heavier flow as compared to normal delivery.
The color of bleeding after delivery undergoes changes as weeks pass by. By the end of 6th week the uterus returns to its non- pregnant shape and size. This process of uterus recovering to its original state post delivery is called involution. The amount of blood loss decreases gradually during involution due to the contraction of smooth muscles of the uterus. This seals the open blood vessels and squeezes tightly all the stretched out uterine and pelvic muscles to pre-pregnancy state.
Stages of lochia after delivery
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Lochia after childbirth undergoes numerous changes over a period of 6 to 8 weeks during the process of involution.
1. Lochia rubra - Bleeding after a delivery for first 3 to 5 days is heavy and dark red in color. Lochia after delivery consists of blood, shreds of membranes that were around the baby before birth, cells of the inner lining of the uterus, etc. This stage is known as lochia rubra.
2. Lochia serosa - Lochia rubra changes into lochia serosa which is a pink or dark brownish colored discharge of watery consistency that lasts for 2 to 3 weeks after delivery.
3. Lochia alba - Bleeding further decreases and turns yellow with passing weeks. Lochia serosa turns to lochia alba which is chiefly made of white blood cells and appears whitish.
Management of bleeding after delivery
1. Use special sanitary pads to absorb the heavy flow. These are usually available in hospitals.
2. Take adequate rest.
3. Pass urine at frequent intervals as a full bladder restricts contractions of uterus leading to heavy bleeding and pain.
4. The hormone oxytocin released by the body for secretion of milk after delivery, also helps in contraction of uterus. This helps in reducing bleeding from uterus.
5. Avoid use of tampons for 6 weeks to prevent infection.
Bleeding after birth when to worry
Lochia or bleeding after childbirth is germ-free initially for first 2 to 3 days. On the 4th day, symbiotic bacteria that are not harmful start growing back in the vagina.
In rare cases, it is necessary to differentiate between normal bleeding after delivery and disproportionate blood loss which might occur due to hypotonic uterus (low contractility of the uterus), injury to the uterus during delivery, disorder in blood clotting, etc.
In some cases a foul smelling lochia after delivery may occur due to infection in the vagina or uterus. This causes changes in lochia after delivery along with fever and increased pain in the lower abdomen. It is essential to inform your doctor about foul smelling lochia, or change in the color of lochia.
Sometimes the flow of lochia increases for a second time after it has regressed initially. This is termed as postpartum hemorrhage and is a serious medical condition that requires immediate medical attention in anticipation of severe blood loss.
Disclaimer: The information in the article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor.
Also Read - Post - Partum Bleeding: What To Expect
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