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What Is Postpartum Bleeding? Know About Acute Postpartum Haemorrhage And Its Treatments

Postpartum bleeding or vaginal postpartum bleeding or lochia is a post-delivery symptom characterised by heavy vaginal blood flow and mucus, usually for a few days or week. The symptom is often considered normal after delivery, but if the flow of bleeding remains high and has not stopped for a month, medical attention is needed.

Lochia varies in every woman, no matter caesarean or vaginal birth. There will be bleeding as the body will expel the leftover blood, tissues or mucous present inside the womb. In some cases, the bleeding can even last for a month or more. Continue reading the article to know more about postpartum bleeding and other details.

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What is Normal Postpartum Bleeding?

A woman's body experiences a lot of changes during pregnancy. The changes are not only limited to nine months but also post-delivery as the body requires some time to recover and get back to its normal functioning.

Normal postpartum bleeding is similar to periods, just the duration of the prior is more. For the first few days after delivery, the flow of the blood is heavy, as experienced in the first two days of menstruation. The blood will be bright red and there may be clots.

The bleeding may last for four to six weeks. In many cases, the bleeding may continue for up to one or two weeks followed by spotting for a few weeks more.

Postpartum bleeding contains a mixture of blood, mucus, uterine shedding and white blood cells. As the weeks pass by, the discharge will be more mucus than blood and the colour of the blood will also change from bright red to brownish or pinkish while the clots may get disappear.

The flow of blood may increase even after a small movement or walk. That's why it is suggested to take complete rest after the delivery. Experts suggest using maternity pads during the time and avoid the usage of tampons or menstrual cups as there may be a risk of infection.

In the case of caesarean delivery, the blood flow may be less compared to normal delivery.

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What Is Acute Postpartum Haemorrhage?

Acute postpartum haemorrhage is a serious complication of childbirth. It is defined as blood loss greater than 500 mL in vaginal delivery and greater than 1000 mL in caesarean delivery.

There are two types of acute postpartum haemorrhage; primary postpartum haemorrhage (bleeding that occurs in the first 24 hours post-delivery) and secondary postpartum haemorrhage (bleeding that occurs after 24 hours and within 12 weeks after delivery).

Causes Of Acute Postpartum Haemorrhage

The main causes of primary postpartum haemorrhage include uterine inversion (in which uterus turns inside out), uterine atony (uterus fails to contract to normal size), retained placenta (failed separation of the placenta from the lining of the uterus), genital tract lacerations (cut in genitals), coagulation disorders (blood clotting disorder) and abnormal placentation (placenta grows deeply in the uterus walls). [1]

Causes of secondary postpartum haemorrhage include infection, inherited coagulation deficits and retained product of conception (remained tissues after miscarriage pr pre-term delivery).

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When Do Postpartum Bleeding Gets Serious?

Postpartum bleeding gets serious when acute postpartum haemorrhage occurs. The blood loss exceeds the aforementioned amount causing life-threatening complications such as organ failure, oedema, transfusion complications, shock, sepsis, respiratory problems, anaemia and hospitalisation for many days. [2]

Symptoms that follow during excessive bleeding include extreme fatigue, increased heart rate, high fever, foul vaginal discharge, decreased blood pressure and increased blood clots.

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Treatment And Prevention

  • Active management during the third stage of labour to reduce incidences of heavy blood flow.
  • Use of oxytocin to prevent uterine atony post-delivery.
  • Avoidance of routine episiotomy (a cut made in the vaginal wall at the time to delivery to enlarge the opening for smooth delivery). [3]
  • Facilities for prompt recognition and timely aggressive treatment.
  • Blood transfusion to supply new blood immediately.
  • Immediate surgical options to remove the cause of bleeding. [4]
  • Medicines to stop bleeding
  • Combinational treatments.

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Common FAQs

1. How long do you bleed after having a baby?

Postpartum bleeding or bleeding after the delivery varies from person to person and pregnancy to pregnancy. It can last from 24 hours to a week or to a month or more.

2. Can postpartum bleeding stop and start again?

Postpartum bleeding can start again during secondary postpartum haemorrhage caused by infection, retained products of conception and inherited coagulation deficits.

3. How long do you bleed after giving birth while breastfeeding?

After giving birth, women may bleed for 4-6 weeks. The bleeding increases during any kinds of physical activities or even walking or during breastfeeding.