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Postpartum bleeding is a common and normal part of the end of pregnancy. It’s something like having a very long menstrual period, since this bleeding, called lochia, can last for up to six weeks. In the first couple of days after your pregnancy ends, you’ll experience fairly heavy bleeding that is bright red in color. This is typical, and you should not be concerned unless you are passing large blood clots (about the size of a golf ball), or are saturating more than one pad per hour.
Normal postpartum bleeding can increase if you are especially active the first few days after you deliver. Getting rest is important to slow down bleeding, and if you notice that you are bleeding a lot, but still not passing large blood clots or saturating more than one pad an hour, you may want to spend a day mostly in bed or resting on a couch. After about four days, color of postpartum bleeding is lighter or can look somewhat brown. Appearance of bright red blood, especially a lot of it, can indicate a very serious condition if it occurs after the fourth day.
In about 2-10% of pregnancies, postpartum bleeding becomes too heavy and indicates hemorrhaging. Follow your doctor’s guidelines, but in general, you should be concerned if bleeding is soaking more than one pad an hour, or if light colored blood becomes bright red again suddenly. Another sign of hemorrhaging are blood clots that are as large as or bigger than a golf ball. If you note these symptoms, you need immediate care. Hemorrhaging threatens your life and requires emergency care to help the bleeding stop.
There are a few people who appear to be more at risk for abnormal postpartum bleeding. These include people who have had induced labors, had a multiple birth, had placenta previa during the pregnancy, or who had a very large child. Though these conditions do not have to exist for hemorrhaging to occur, they can make occurrence more likely and you should carefully track lochia for signs of potential hemorrhage.
Another thing you need to watch for when observing lochia is potential for infection. If lochia smells bad or if you have chills or fever, you may have developed an infection. It’s important to call your doctor immediately if you suspect infection.
Normal postpartum bleeding and discharge usually ceases by the sixth week, and some women will only notice lochia for about two weeks after pregnancy ends. If you continue to have discharge after the sixth week, talk to your physician. Also be aware you should not use tampons during the first six weeks after pregnancy. Instead, use pads, and in the first few weeks, plan on using overnight or oversized pads to protect against leaks.
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