Postpartum hemorrhage is a physiological process by which the uterus is freed from the remains of the placenta and lochia. Doctors determine its severity by the nature of the discharge and total blood loss.
For most women, bleeding after childbirth does not pose any threat if it is not accompanied by purulent discharge with an unpleasant odor and abdominal pain.
Painful and heavy bleeding that causes discomfort is an occasion for urgent medical attention.
Causes of bleeding
Abundant blood loss in the early postpartum period, which lasts 2 hours after the birth of the baby, can cause:
- poor blood coagulability, while the blood is liquid and flows out streamlessly without signs of thrombosis – clots and lumps, this complication can be prevented if a general blood test is given before delivery;
- rapid childbirth, which caused damage to the birth canal of a woman – the cervix, the walls of the vagina, less often the uterus;
- an increase in the placenta, which interferes with the reverse development of the uterus and causes serious bleeding;
- insufficient contractility of the uterus caused by excessive stretching of its walls due to the large fetus, polyhydramnios and multiple pregnancy;
- fibrous nodular changes in the uterus – fibroids, fibroids.
The causes of late bleeding, which can begin 2 hours after delivery and over the next 6 weeks, include:
- particles of the placenta, delayed in the uterine cavity;
- blood clots that cannot go out as a result of cervical spasm caused by surgical delivery by cesarean section;
- subinvolution of the uterus or a slowdown in its postpartum recovery, which can be caused by an inflammatory process in the pelvic organs and be accompanied by increased body temperature and bleeding.
What is considered the norm, and when it comes to pathology?
Normally, after the birth, the lochia go no more than 6 weeks and do not cause the woman any particular discomfort. In the first day, the blood after childbirth is the most intense and this is completely normal, after a few days the amount of secretions begins to gradually decrease.
If pregnancy and delivery took place without serious complications, and after the birth of the baby the lactation process immediately began, the healing rate of the uterine mucosa increases.
At the same time, prolactin, the hormone responsible for breastfeeding, activates uterine contractions and promotes rapid recovery of the body after pregnancy and childbirth.
Before postpartum hemorrhage is over, a woman should monitor her well-being.
Bleeding should be considered pathological if:
- Lochia is painted in scarlet color for more than 3 days;
- blood loss is increasing, there is a need to change hygiene products every hour;
- Lochia acquired an unpleasant color and smell;
- discharge occurs along with severe weakness, fever and loss of consciousness.
Sometimes a woman mistakenly accepts the first menstruation for late bleeding.
The menstrual cycle in some women in labor can recover within a few weeks after giving birth, especially if prolactin is no longer synthesized by the body. This happens in young mothers who for some reason do not breast-feed a baby.
In order to accelerate recovery after pregnancy and childbirth, a woman must adhere to the regimen and eat properly.
Positive emotions, walks in the fresh air and healthy food can prevent the development of postpartum problems in a young mother.
In which case you need to see a doctor?
Bleeding becomes dangerous if it begins to mean a threat to the health and life of a woman.
Uterine hemorrhage that occurred immediately after childbirth usually develops against a background of rupture of the uterus, walls of the vagina and perineum – this condition requires urgent suturing of damaged tissues, while the genital organ is usually removed completely to prevent massive blood loss.
If the cause of heavy bleeding is the remains of the placenta and the placenta in the uterus, they are removed manually under general anesthesia.
Emergency care after childbirth is always accompanied by the introduction of hemostatic drugs into the mother’s body, and if necessary, transfusion of donor plasma and blood is performed.
Late bleeding requires medical intervention, if it lasts more than 6 weeks, red blood discharge again changes to red blood, a woman’s condition worsens sharply, accompanied by severe pain and signs of intoxication.
Postpartum blood flow may increase after sex, weight lifting, or physical exertion.
If bleeding does not decrease after a few days, you should consult a doctor.
Most likely, blood clots or particles of the placenta remained in the uterus, because of which it can not contract properly.
If after childbirth it bleeds for a long time, the discharge becomes brown or yellow-green with an unpleasant odor and does not go away, the infection must be excluded.
This condition can accompany pain in the lower abdomen and fever. It is necessary to consult a doctor.
Timely treatment helps to get rid of the inflammatory process in a woman’s body in a short time and without health complications.
If heavy bleeding resumes suddenly after cessation, while the woman’s condition worsens, an ambulance should be called.
It is unrealistic to stop such discharge on their own, and inaction and intense blood loss can threaten a woman’s life.
How long does bleeding last after childbirth?
Allocations in the postpartum period normally last up to 6 weeks. In most women, bleeding after childbirth ends in a month.
During this time, the uterine mucosa is restored, and it returns to its prenatal state.
After cesarean section, postpartum hemorrhage lasts longer, since the walls and muscles of the genital organ were injured by surgery, so the uterus returns to normal more slowly.
How much bleeding will go after childbirth depends on the following reasons:
- features of the course of pregnancy and childbirth;
- method of delivery – after surgical delivery, blood lasts longer;
- uterine contractility;
- postpartum complications, for example, inflammatory processes in the genital organs;
- physiology of the woman herself, her state of health;
- breastfeeding a baby: frequent application to the breast reduces the volume of the goofs and cleanses the uterine cavity faster.
To reduce the duration of postpartum hemorrhage and prevent its complications, it is enough to observe the following rules:
- regularly visit the toilet room so that the crowded intestines and bladder do not exert excessive pressure on the uterus and do not interfere with its contraction;
- observe hygiene, preventing the penetration of infection into the uterine cavity;
- avoid physical activity and sexual intercourse within 6 weeks after childbirth;
- to lie and sleep on the stomach, since the uterine cavity in this position is cleansed best;
- on the first day after childbirth, put an ice pack on your stomach;
- establish lactation.
Bleeding after childbirth, although it is a natural process, but it requires attention and control by a woman.
If you have any doubts, you need to see a doctor, since it is impossible to cure an existing infection or stop uterine bleeding.
Intense blood loss is a threat to life. With the development of bleeding, emergency care must be called.