What Is Postpartum Bleeding?
Medically reviewed by Monique Rainford, MD
Postpartum bleeding is normal after you deliver your baby. The bloody discharge you have is called lochia. It will usually turn pinkish within a week of giving birth and become white or yellow after about 10 days. Lochia may last for four to six weeks, but it should be less bloody after two weeks. It can come and go for about two months.
Excessively heavy and uncontrolled bleeding after giving birth is called postpartum hemorrhage. It is more likely with a cesarean delivery (C-section). Other factors can also make someone more likely to have postpartum hemorrhage. If it happens, you need treatment as soon as possible to stop the bleeding.
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Types
There are three stages of typical postpartum bleeding that are natural and expected occurrences after childbirth. These stages include:
Lochia rubra: This is the first stage of postpartum bleeding. It lasts about a week after delivery and is the heaviest, with bright red bleeding and blood clots expected.
Lochia serosa: This second stage of postpartum bleeding can last between two and six weeks. Blood flow slows and becomes thinner, often taking on more of a pink or brown color instead of bright red.
Lochia alba: In this final stage of postpartum bleeding, blood will be replaced with a whitish or yellowish discharge.
Related: Timing of First Period After Baby
Purpose
After your baby is delivered, you will enter the third stage of labor. This is when the placenta detaches from the wall of the uterus and is expelled through the vagina. The placenta isn't the only tissue that's no longer needed after your baby is born, though. Blood cells and excess fluid and tissue will be gradually cleared from your body in the weeks after delivery.
Bleeding is also the result of the uterine wall healing in the area where the placenta detached. As that tissue heals, bleeding slows. Extremely heavy bleeding can signal trouble with the healing process.
Related: Postpartum Care: A Guide to Taking Care of a Body That Just Delivered
Risks
While bleeding is a normal part of the recovery process after delivery, there are some situations that increase the risk of more intense bleeding after delivery. Risk factors for postpartum hemorrhage include:
Tears in the cervix or tissues of the vagina
Tears in blood vessels of the uterus
A hematoma (blood collecting outside of blood tissues) in the vulva or vagina
Blood-clotting disorders
Placental abruption (the placenta separates from the uterus before birth)
Placenta previa (the placenta lies low in the uterus and covers the cervix)
Distended uterus (an enlarged uterus, which can be caused by too much amniotic fluid or a multiple-baby pregnancy)
High blood pressure during pregnancy (preeclampsia)
Having many previous births
Prolonged labor
Infections
Obesity
Delivery that was assisted with forceps or a vacuum device
Cesarean delivery
Complications
It can be normal to experience bleeding for six weeks or so after delivery and for the bleeding to get heavier or lighter with activity. What isn't expected is heavy bleeding that causes you to soak through a pad every hour or two, or when large clots are present with the bleeding.
Other warning signs that the bleeding is more severe than normal include:
Abnormal blood pressure changes (orthostasis)
Low blood pressure
Increased heart rate
Shortness of breath
Low urine output
Chest pain
Most healthy individuals can tolerate about 500–1,000 milliliters of blood loss after delivery, but more than 1,000 milliliters, or 1 liter, of blood right after delivery is classified as postpartum hemorrhage. This is a medical emergency and requires immediate treatment by a healthcare provider.
Takeaway
Approximately 5% of women experience postpartum hemorrhage, and it accounts for about 25% of maternal deaths around the world—12% in the United States alone.
Postpartum hemorrhage that is not addressed quickly can lead to:
Acute respiratory distress syndrome (ARDS, fluid buildup in air sacs in the lungs)
Hypovolemic shock (heart is unable to pump enough blood to the body)
Disseminated intravascular coagulation (DIC, blood-clotting proteins are overactive)
Acute renal failure (kidney failure)
Loss of fertility
Pituitary necrosis (Sheehan's syndrome, lack of oxygen that damages the pituitary gland)
Death
Side Effects
Even normal amounts of postpartum bleeding can cause side effects like:
Anemia (lack of healthy red blood cells)
Fatigue
Low blood pressure
Problems with lactation or breastfeeding
Cramping
Before you leave the hospital, your medical team will watch the progress of your bleeding and monitor the contraction of your uterus. This will include checking the height and tone of your fundus, the top portion of your uterus.
A fundus that feels too soft can be a sign that you are at risk of postpartum hemorrhage. Your medical team will also check your placenta carefully after delivery since pieces of placenta left in the uterus can also lead to hemorrhage.
Coping
If you experience postpartum hemorrhage, your medical team will work quickly to determine the cause of the hemorrhage, stop the bleeding, and replace your blood through transfusions if needed.
Even with normal amounts of bleeding, cramping and discomfort can make the recovery process more difficult. Some strategies to help you cope with postpartum bleeding include:
Placing a heating pad or pack over your abdomen (make sure what you are using is safe to apply to your skin)
Taking a gentle walk
Using a sitz bath
Taking pain medications, as directed by your doctor
You may also experience some constipation or pain when urinating or having a bowel movement. Your doctor may suggest stool softeners to help increase your comfort.
Your doctor will also give you advice on when to call or go to the hospital after delivery. Generally, some things that warrant a call to your healthcare provider include:
A fever over 100.4 degrees Fahrenheit
Severe chills
Foul-smelling vaginal discharge or blood
Pain, burning, or difficulty urinating
Increased tears, swelling, bruising, or separation of incisions in your perineum (area between the genitals and anus)
Use of more than one pad per hour
Severe cramping or abdominal pain
Severe headache
Dizziness or loss of consciousness
Swelling, redness, or pain in one limb
Summary
Postpartum bleeding is common after delivery and usually not a serious problem. You may experience bloody discharge called lochia for up to two months after giving birth. Sometimes heavy bleeding may occur, which needs to treated as soon as possible. Your healthcare team will usually keep a close eye on you in the hours after your delivery and start treatment if it's needed.
A Word From Verywell
Bleeding is a normal part of the recovery process after childbirth. As the uterus shrinks back to its normal size, extra tissue and blood leaves through the vagina. This bloody discharge may last for two months. In some cases, the bleeding can become more severe, leading to postpartum hemorrhage. This requires emergency medical care.
Your healthcare providers will watch your closely in the hours after delivery, and give you specific instructions on when to be concerned about bleeding once you go home.
Frequently Asked Questions
How long does postpartum bleeding last?
Postpartum bleeding is generally heaviest the first week after delivery, but it can continue for up to six weeks and may come and go for up to two months.
How do you stop postpartum bleeding?
Postpartum bleeding will stop in time on its own, but if you begin bleeding more than you should, your healthcare provider can give you medications or perform techniques like massaging the uterus to help control the bleeding.
When should you worry about postpartum bleeding?
Immediately after delivery, your healthcare team will monitor you closely for hemorrhaging. Generally, most mothers can tolerate up to a liter of blood loss. Once you go home, your healthcare provider may suggest you call the office if you begin to soak through a sanitary pad within an hour or two. 911 should be called or you should be taken to a hospital emergency room if you are bleeding more than this and experience symptoms like dizziness or loss of consciousness.
How long after postpartum bleeding will I get my period?
When your period returns after you give birth can vary, and it depends on whether you are breastfeeding. If you are not breastfeeding or only partially breastfeeding, menstruation can resume about six to eight weeks after giving birth.
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