WHAT’S NORMAL WHEN IT COMES TO BLEEDING?
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.