What is Normal Postpartum Bleeding?

All women will experience some amount of bleeding following childbirth; even those who give birth via caesarian section. This bleeding, often called Lochia (a Greek term meaning ‘relating to childbirth), is the shedding of blood, uterine tissue, and bacteria that remain in the uterus after childbirth.

The cause for the blood part of the lochia is simple. When the placenta separates from the uterus, it exposes many blood vessels where it had previously been attached. These vessels will bleed into the uterus and out of the vagina. These blood vessels are eventually sealed off by the continued contraction of the uterus, generally achieved through breastfeeding/pumping, uterine massage, or administration of Pitocin.

The good news is that, as the body increases blood supply by up to 50% during pregnancy, the body is prepared to withstand some blood loss. In most women the bright red, heavy blood shed will last no more than four days, at which point it begins to taper into a pink discharge, then a dark brown color. Small clots are normal and expected during this phase. The final state of lochia is a yellowish white discharge, comprised of remaining white blood cells and uterine cells. The entire process generally takes between four and six weeks.

There may be times when your post-partum lochia may be a cause for concern. The most obvious sign for concern is when bleeding increases in amount or speed of flow after initial bright red bleeding has stopped. If this happens, try slowing down, increasing your fluids and getting additional rest.

If decreased activity does not slow your flow, or if you begin to see clots the size of a golf ball or larger, you should call your OBGYN immediately. Other signs for concern to keep an eye on include:

  • If your initial bright red bleed lasts more than 5 days post delivery
  • A foul smelling discharge
  • You develop a fever or case of the chills
  • You begin feeling faint
  • You experience “gushing” after your initial bright red flow stops

Each of these warning signs should be taken seriously, as they could denote an infection or a postpartum hemorrhage. If you suspect that you may have a cause for immediate help, do not try to drive yourself to the hospital. If you do not have someone who can drive for you, call an ambulance.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 22 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for the last two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society of Reproductive Medicine, the American Fertility Association, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 28 years and their two teenage daughters.