Dear Sun Doc Dear Phatsimo,

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I delivered through caesariansection 10 weeks ago. Anytime I try doing some simple recommended exercise, I bleed. What could be the issue?Phatsimo

After giving birth, whether through caesarian-section or vaginal delivery, there is vaginal bleeding/discharge for six to eight weeks. This is called lochia and it changes over time. In the first three to four days, there is lochia rubra, which is red, and the flow is heavy, sometimes with small clots, and may be accompanied by cramping. After that, there is lochia serosa, where the discharge becomes thinner and is pinkish or brownish in colour and lasts for four to 12 days.

The last stage, lochia alba, has a yellowish or white discharge with spotting and lasts for two to six weeks. Physical activity can cause heavier discharge or even cause the bleeding to start again. For this reason, it is advisable to rest and be careful with the engagement in physical activity including regular activities like climbing stairs.

The bleeding may also be due to postpartum hemorrhage, which is abnormal or heavy bleeding within 24 hours to 12 weeks after giving birth.

This is a serious condition that requires urgent medical intervention. It may be due to retained placenta, infection within the uterus, a bleeding disorder, hormonal disorders or due to a urinary tract infection.

It is advisable for you to be reviewed by a gynaecologist urgently for review. If there is postpartum hemorrhage, then the underlying cause will be addressed. If the bleeding is lochia that is prolonged or reactivated by exercise, then you need to rest and be extra careful with physical activity.