WHAT’S NOR­MAL WHEN IT COMES TO BLEED­ING?

Your Pregnancy - - Q & A Month 9 -

Q:

I’d like to know for how long af­ter a nor­mal de­liv­ery do you bleed? Is it nor­mal to still bleed three weeks af­ter the birth?

A:

The amount of dis­charge (lochia) varies from woman to woman, but di­min­ishes from slightly more than the usual men­strual flow, to slight spot­ting on the per­ineal pad to­wards the end of six weeks. The amount of dis­charge will also vary from day to day. Ini­tially when the mother starts to walk around more or when she breast­feeds her baby, the amount of lochia will in­crease for a while. Nor­mal lochia has a dis­tinc­tive strong smell, but is in no way of­fen­sive, un­less there is in­fec­tion. In the first two to four days af­ter de­liv­ery, the lochia con­sists mainly of blood, dis­solved blood clots from the pla­cen­tal site and other uter­ine de­bris. It is bright red in colour. From four to seven days af­ter de­liv­ery, the lochia be­comes red­dish brown in colour as the bleed­ing starts to sub­side. From the end of the first week un­til about day 15 af­ter de­liv­ery, the lochia con­sists mainly of serum, lymph and leu­co­cytes and varies from a pink­ish to a yel­low­ish-brown colour. The lochia that fol­lows from two to six weeks af­ter de­liv­ery con­tains lymph, leu­co­cytes, cer­vi­cal mu­cus, or­gan­isms and other de­bris from the heal­ing process and is creamy-yel­low­ish in colour. If there is per­sis­tent red or heavy bleed­ing be­yond the first 10 days af­ter de­liv­ery, this must be re­ported to the doc­tor as it would in­di­cate a uterus that isn’t heal­ing or shrink­ing to its nor­mal state. There may be re­tained prod­ucts of the birth process, which could lead to more bleed­ing and in­fec­tion.

DR BRON­WYN MOORE

Gy­nae­col­o­gist

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