Blood loss after delivery. It is normal for a woman to lose blood from the vagina for several weeks. This blood loss may continue for up to six weeks after delivery. Another name for this blood loss is ‘lochia’.
The amount of blood loss can vary per woman and per birth. It is therefore difficult to indicate when there is excessive blood loss. We speak of abnormal blood loss after delivery as the blood loss:
- is too violent
- too long
- increases after there has already been a decrease in blood loss
Symptoms of blood loss after delivery
It is normal for you to have blood loss for the first few days after birth. In the beginning, it is bright red. The amount can be compared with a substantial period. Often clots are also released, some the size of a tennis ball. After a few days, the blood loss decreases and the color changes from bright red to reddish-brown. The amount of clots then also decreases.
It is quite normal for the blood loss to increase temporarily when you get out of bed and move more often. It is difficult to indicate when there is excessive blood loss because the amount of blood loss can vary per woman. We speak of abnormal blood loss as:
- the blood loss is high (more than 450 milliliters)
- the blood stays bright red
- the blood loss does not decrease after a few days
- there is an exacerbation of blood loss at the end of the first or at the start of the second week
- the blood loss lasts six weeks longer
The maternity nurse or hospital nurse monitors the amount of blood that you lose. When in doubt about a too large amount of blood loss, consult with the obstetrician or gynecologist.
How does blood loss occur after delivery?
After delivery, the womb lining is shed, just like with a menstrual period. This releases bloody tissue, called lochia.
There are various causes for excessive blood loss, such as:
- part of the mother cake is left behind
- the uterus does not contract well
- blood loss from an insufficiently attached cut or tear of the vagina
In addition, there are rare cases such as:
- fibroids in the womb
- a non-optimal blood clotting
- blood loss from a tear in the cervix (cervix)
Sometimes the discharge of lochia is temporarily obstructed by, for example, a clot. If this obstruction is removed, all accumulated lochia is released in one go. This can wrongly give the idea of excessive bleeding. This can be accompanied by after-effects.
Is it serious and what can you expect?
There are various causes of abnormal blood loss after delivery. It is important to trace the cause and treat it.
Examination If the maternity nurse or nurse suspects abnormal bleeding, she will discuss this with the obstetrician, general practitioner or gynecologist who supervised the delivery. This will examine how high the uterus is in the abdomen and how the muscular tension of the uterus feels. It is also sometimes felt through the vagina whether the cervix is open. Sometimes it is necessary to view the cervix with a duckbill. If other examinations are required, the midwife will refer you to the gynecologist at the hospital. This can make an echo of the uterus to see what is going on or have the blood checked.
Treatment Treatment depends on the cause.
- Remaining part of the mother cake When part of the mother cake or the membranes remains in the womb, it is very important that this is removed. This is done by the gynecologist at the hospital. You will receive general anesthesia or an epidural for this procedure. The remaining remains are removed by hand. Sometimes it is necessary to do a curettage afterward.
- Insufficiently adhered cut or tear Blood loss due to an insufficiently adhered cut or tear of the vaginal wall can be remedied by removing the old stitches and re-stitching the wound.
- Insufficient contraction of the uterus In order to stimulate the uterus to contract properly and become smaller, medication can be given for two to three days.
When to the doctor?
With normal blood loss, you do not need to contact your doctor or midwife. If you suspect that you are suffering from abnormal blood loss after the delivery, you can contact the obstetrician, doctor or gynecologist who supervised your delivery. You can examine this and the doctor or midwife can refer you to the gynecologist in the hospital for additional examination or treatment if necessary.
What can you do about it yourself?
You cannot do much yourself to prevent excessive bleeding. You can, however, be alert with the maternity nurse. Breastfeeding stimulates the contraction and thereby the womb becoming smaller. This can promote good drainage of the lochia and thus help prevent excessive blood loss.
General advice and precautions for blood loss after delivery
You have an increased risk of heavy blood loss after delivery:
- if there are problems with blood clotting in your family so that the blood clots less easily
- if you use blood-thinning medicines
Report clotting abnormalities in the family Report this to the obstetrician or gynecologist who supervises your delivery. This will then pay extra attention to the amount of blood loss during the maternity period.
Use maternity dressage It is pleasant to use maternity dressings during the first few days after giving birth because these are larger than sanitary napkins. If the blood loss decreases, you can switch to a sanitary napkin. The use of tampons is not recommended because they promote the risk of infection. Make sure you have a maternity bandage in your home to compensate for blood loss, which is most severe in the first days after the birth.
Protecting the mattress It is advisable to protect your mattress against bleeding during the first days after the birth. You can do this by placing a paper mat in your bed or by, for example, placing a plastic cover or sheet over your mattress.