How to determine uterine bleeding after childbirth. How long does it take to bleed after childbirth?

Regardless of the method of delivery and the well-being of the birth process, a woman always experiences bloody issues. The placenta or, as it is also called differently, the baby's place is attached to the uterus with the help of villi and is connected to the fetus by the umbilical cord. Rejection of the fetus and placenta during childbirth is naturally accompanied by rupture of capillaries and blood vessels. But in some cases postpartum period Bleeding caused by pathological causes may occur.

Causes of bleeding after childbirth

In the last stage of labor, the placenta is torn away from the uterus, and a wound forms on the surface. It bleeds until it heals completely, and doctors call this bloody discharge lochia. Women often mistake lochia for their first period after childbirth, but this discharge has a different cause and nature.

Lochia does not require any treatment, but during this period you should pay attention Special attention intimate hygiene. But pathological bleeding should be a reason to immediately consult a doctor.

“Good” bleeding after childbirth

Lochia is a physiological, normal bleeding that accompanies the postpartum period. However, pathological conditions that are dangerous to the health and even life of a woman can also arise when blood loss exceeds acceptable standards. To prevent them, doctors who delivered children should apply abdominal cavity mothers giving birth to an ice heating pad immediately after birth, and also take other measures if necessary (perform external massage of the uterus, administer hemostatic medications).

Until the wound surface of the uterus at the site of the previous attachment heals completely, they will continue. In the first days after birth, they can be very abundant, but gradually their quantity, character and color will change. Soon they will turn blood-colored, then yellow, and eventually your normal prenatal discharge will return.

“Bad” bleeding after childbirth

However, in some cases it is necessary to consult a doctor immediately. You should be wary following signs:

* lochia does not change bright scarlet color for more than 4 days after birth;
* you have to change sanitary pads every hour;
* bloody discharge occurs bad smell;
* against the background of bleeding, you develop fever or chills.

In such cases we're talking about, most likely, about some pathology that requires medical intervention.

Real “bad” bleeding after childbirth can occur for several reasons:

Weak contractile activity of the uterus - atony or hypotension associated with its weakening, excessive stretching and flabbiness. In this case, blood can flow out in separate portions or in a continuous stream. The situation is critical and requires immediate medical attention. The woman’s condition is rapidly deteriorating and, without taking appropriate measures, threatens to fatal.
Remains of the placenta and membranes. When the placenta separates, the capillaries connecting it to the uterus break and, tightening muscle layer the uterus is scarred. But if fragments of the placenta and fetal membranes remain here, the healing process is suspended, and severe sudden bleeding without pain begins. To warn possible problems, it is necessary to undergo an ultrasound scan of the uterus the day after birth.
Poor blood clotting - hypofibrinogenemia or afibrinogenemia. Liquid, clot-free blood is released from the vagina in large volumes. It is urgent to donate blood from a vein for analysis.

Pathological bleeding after childbirth is most often observed in the early postpartum period, but they can also occur more than one month later.

If your spotting after childbirth seems abnormal, consult your doctor to determine the cause of the bleeding and treat it. Treatment of bleeding after childbirth is carried out only in a hospital setting.

How long does bleeding last after childbirth?

Lochia can normally continue for up to 6 weeks after birth. And during this entire period, approximately 1.5 liters of blood are released. It should be said that a woman’s body is ready for such losses, because during pregnancy the blood volume has increased significantly. Therefore, you should not worry.

The duration of lochia largely depends on whether the woman is breastfeeding, since under the influence of the “milk” hormone prolactin, the uterus contracts better - and the process proceeds more quickly. After caesarean section The uterus contracts less well (due to the suture placed on it), and in this case the lochia can usually last longer.

As we said, lochia should gradually disappear. If, after their reduction, the amount of bleeding increases again, then the woman should rest and recover more.

Especially for- Elena Kichak

Most often, bleeding after childbirth is not a spontaneous phenomenon.

Uterine bleeding after childbirth is a pathological process that is provoked by a number of reasons. Among the factors causing bleeding directly from the placental site (the place where the placenta is attached to the uterine cavity), the most significant and common are the following:

too much expansion of the uterine cavity;
pathological labor activity;
rapid labor;
protracted labor process;
however, the main etiological factors Such a pathological phenomenon as bleeding after childbirth is hypotension and/or uterine atony.

Uterine hypotension is a pathological phenomenon that represents insufficient postpartum contractility of the uterine muscles and its imperfect tone.

Hypotony of the uterus may be a consequence of weakness ancestral forces, rapid labor And labor activity with excessive force, functional impairment the ability of the myometrium to contract, overstretching of the myometrium during polyhydramnios or a large fetus, as well as dystrophic phenomena of the myometrium after previous curettage of the mucous membrane of the uterine cavity, the presence of scar changes (after undergoing surgical intervention, for example, after enucleation of a myomatous node or cesarean section) and/or inflammatory processes in the uterus (chorioamnionitis), uteroplacental apoplexy, premature abruption of a normally located placenta, abnormalities of placenta attachment (its accretion or tight attachment), tumors of the uterus (fibroids).

This condition can be stopped by using specialized medicines. However, in some cases, hypotension can transform into atony (characterized by a complete loss of muscle tone of the uterus and its contractility) of the uterus and aggravate the current situation. It is extremely rare that atony can occur without a previous hypotonic state.

Signs characterizing bleeding

Like many other types of bleeding, bleeding after childbirth has a number of characteristic distinctive features.

For example, hypotonic bleeding can have 2 variants of its clinical picture:

Option 1 – initially the bleeding can be very profuse with massive blood loss. In this case, the palpable uterus becomes flabby, atonic and poorly responsive to the administration of uterotonic drugs. There is rapidly progressing hypovolemia, possible rapid development hemorrhagic shock and possibly DIC syndrome. Vital important organs may also undergo pathological changes, which are irreversible.
Option 2 – there is a small amount of initial blood loss. The hypotonic state alternates with temporary restoration of myometrial tone. The uterus is capable of short-term response to conservative measures, the purpose of which is to stop the resulting bleeding (administration of uterotonics). Blood is mainly released from the vagina in portions of 150 to 250 ml. Due to the fact that a woman does not lose blood suddenly, the body is able to adapt to gradually developing hypovolemia: blood pressure numbers remain within normal limits, and slight tachycardia is observed. However, then it is possible that the uterus may stop responding to the administration of drugs and further development hemorrhagic shock, as well as disseminated intravascular coagulation syndrome.

Atonic bleeding is characterized by its massiveness and consistency. Atonic bleeding after childbirth cannot be stopped by the administration of pharmaceutical drugs.

Duration of postpartum bleeding

Question: “How long does bleeding last after childbirth?” concerns all women who have given birth. Normal duration postpartum hemorrhage may vary from 6 to 8 weeks. However, this bleeding is a normal physiological phenomenon - the uterus is cleared of accumulated blood clots, such discharge is called lochia. Total this kind of discharge does not exceed 1500 ml. If a woman notices bleeding a month after giving birth, she should not worry. There are 2 reasons that can cause this phenomenon.

Firstly, this may be the onset of menstruation, and secondly, the release of remaining blood clots may be slightly delayed. However, if bleeding began after 2-3 or more months, it is worth thinking about the presence of any pathological process localized in the uterine cavity, and urgently contact a qualified specialist.

To the question: “How long does bleeding last after childbirth?” the doctor will not be able to give you an answer in a specific figure, because the duration this phenomenon is strictly individual and depends on physiological characteristics the body of every woman.

Treatment

The treatment of postpartum hemorrhage is based on the following set of measures:

diagnosis and elimination of the cause of hypotension or uterine atony;
recovery functional ability myometrium is carried out by using measures such as: catheterization Bladder, external massage of the uterus, intravenous administration of medications that promote uterine contraction (Methylergometrine, Oxytocin), applying an ice-filled bladder to the lower abdomen;
sometimes techniques are used to help reduce blood flow to the uterine cavity: finger pressing of part of the aorta, as well as the application of specialized clamps to the parametrium;
if the above therapeutic measures did not bring the expected effect (the bleeding does not stop and blood loss continues to increase), removal of the uterus is indicated;
An obligatory aspect of treatment is the restoration of circulating blood volume.

After the birth of a child, lochia is secreted from the woman's genital tract for several weeks. Their number gradually decreases, which indicates wound healing after separation of the placenta. Many women are interested in the question: how long does bleeding last after a normal birth?

This one is very important factor, since it can be used to determine the degree of recovery of the body and deviations from the norm. Over time, lochia changes its composition and color. At first the woman is in the maternity hospital, but then discharged home.

If at first her condition is monitored medical staff, then in the future she must do it herself. The amount and nature of discharge indicates the state of health, so you need to notice deviations from the norm in time.

How long does it take to bleed after childbirth?

For 2 hours the woman and the newborn are in maternity ward. At that time normal discharge quite abundant and bloody, but their total amount should not exceed 400 ml. To prevent complications such as bleeding, they can drain urine through a catheter, put ice on the stomach, and administer drugs intravenously to speed up uterine contractions.

These few hours are the most dangerous, because the muscles of the uterus are relaxed and contractions may not occur, and the onset of blood loss may not manifest itself in anything other than dizziness and weakness. So if these symptoms appear and the sheet/diaper gets wet quickly, you should urgently call a nurse.

Complications can also arise from ruptures in the tissues of the birth canal, so the obstetrician carefully examines the vagina and cervix, and if their integrity is violated, take necessary measures, that is, suturing the wounds. If the tear is not sutured completely, a hematoma may form, which is subsequently opened and re-sutured.

How long does bleeding last after childbirth?

The recovery process is successful if in the first 2-3 days the lochia is bloody in nature and quite abundant (up to 300 ml in 3 days). At this time, the gasket should fill completely in just 1-2 hours.

Lochia may have blood clots after childbirth, a musty odor similar to menstrual odor. Gradually their number decreases, and they acquire a brownish-red hue, intensifying with movement. They also appear on palpation of the abdomen.

To prevent bleeding, you must follow certain rules:

Go to the toilet immediately when you have the urge to urinate. During the first 24 hours, you need to visit the restroom at least every 3 hours. An overfilled bladder interferes with the contraction process;
Attach the baby to the breast at his first request. The fact is that when the nipples are irritated, oxytocin is released, the hormone responsible for contractions. Blood leaving after childbirth, during breastfeeding may intensify and be accompanied by cramping pain in the lower abdomen;
Sleep and rest lying on your stomach. This position promotes the release of blood clots. The uterus may deviate posteriorly, but lying on the stomach will bring it closer to abdominal wall. This way the outflow will improve;
Place ice on your stomach several times a day, which will improve the condition of blood vessels and speed up contractions.

When the uterus is overstretched and labor is complicated, oxytocin injections are prescribed to stimulate contractions.

It is worth noting that an increase in the amount of discharge should be a reason to consult a doctor, because it may indicate late bleeding. This phenomenon can occur not only in the first days, but also several weeks after birth. So even at home you need to pay attention to how much fluid is released.

Late bleeding is usually caused by a stuck piece of placenta. Sometimes it is not diagnosed immediately after birth, then it leads to complications that can be detected when vaginal examination or ultrasound. If the diagnosis is confirmed, the remains are removed under general anesthesia. At the same time, infusion and antibacterial therapy are carried out.

Sometimes this phenomenon occurs due to a blood clotting disorder, which can be caused by various diseases. Stopping such blood loss is the most difficult thing.

Most often, complications arise due to insufficient contraction of the uterine muscles. Bleeding after childbirth in this case is also painless, but very profuse. To stop it, contracting agents are administered and blood loss is also replenished. intravenous administration fluids or blood products. If necessary, resort to surgical intervention.

Early cessation of lochia is also a reason to visit a doctor. Perhaps there is lochiometra - an accumulation of secretions in the uterine cavity. This pathology occurs when the organ is overstretched or bent backwards.

If this condition is not eliminated in time, endometritis will appear - inflammation of the uterine mucosa, because lochia is a good breeding ground for microbes. Treatment mainly consists of taking Oxytocin and No-shpa.

blood after childbirth at home

So how much does one bleed after childbirth? The average time is 6-8 weeks. This is exactly the period required for the uterus to develop back after pregnancy and childbirth. The total amount of lochia ranges from 500 to 1500 ml.

In the first week, they can be compared to normal menstruation, only more abundant and with clots. With each subsequent day, their volume will decrease and their color will approach yellowish-white. By the end of 4 weeks they are very scanty, one might say spotty, and after another 14 days they should become the same as before pregnancy.

For those who breastfeed, they end earlier, since the uterus contracts much faster. But for women who have had a caesarean section, recovery is slower because the suture interferes with normal reverse process, and the bleeding takes longer than usual.

remedies for bleeding after childbirth

It is important to comply special rules personal hygiene still lasts postpartum period. Lochia contains microbial flora, which when favorable conditions may contribute to the development of the inflammatory process. That is why it is necessary that the discharge does not linger in the uterus and comes out of it.

For your own comfort, use pads or special disposable panties. Change them every 3 hours. It is recommended to give preference to the soft surface of these products, because this way you can better determine the nature of the discharge. You should not take flavored ones, as they often cause allergic reactions. You should also not use tampons.

You need to wash yourself after every trip to the toilet. You can't take a bath, only shower. The genitals are washed only from the outside, from front to back. At this time, douching is not used to avoid infection.

It bleeds more during significant physical exertion, so it is not recommended to lift things that are too heavy.

It is necessary to apply for medical care in such situations:

Lochia has acquired a purulent character and a sharp and unpleasant odor. These phenomena indicate endometritis. It is usually accompanied by fever and pain in the lower abdomen;
Blood discharge has increased after it began to decrease or its volume is constantly large. These conditions may indicate that there is still an afterbirth in the uterus, which prevents the contraction of the organ and its restoration;
Curdled vaginal discharge is a sign of yeast colpitis, which is popularly called thrush. Typically this disease is characterized by itching in the vaginal and labia areas. Sometimes there is redness skin in the groin. The risk of developing thrush increases significantly when taking antibiotics;
The blood stopped abruptly. This happens when the cervix is blocked by a blood clot. This condition requires medical intervention. It is worth noting that the risk increases after a cesarean section;
If you have to change several pads in an hour, this indicates severe bleeding. In this situation, you need to call emergency help.

The above complications do not go away on their own. Sometimes hospital treatment is required. Therefore, it is very important to seek help from specialists in a timely manner.

It’s good if postpartum discharge lasts 6-8 weeks (that’s how long it takes for the uterus to develop back after pregnancy and childbirth). Their total quantity during this time is 500-1500 ml.

In the first week after childbirth, the discharge is comparable to normal menstruation, only it is more abundant and may contain clots. Every day the amount of discharge decreases. Gradually they acquire a yellowish-white color due to large quantity mucus, may be mixed with blood. Approximately by the 4th week, scanty, “spotting” discharge is observed, and by the end of the 6-8th week it is already the same as before pregnancy.

In women who are breastfeeding, postpartum discharge stops faster, as the entire process of reverse development of the uterus occurs faster. At first there may be cramping pain in the lower abdomen when feeding, but within a few days it goes away.

In women who have undergone a cesarean section, everything happens more slowly, since, due to the presence of a suture on the uterus, it contracts less well.

Hygiene rules during the postpartum period. Compliance simple rules hygiene will help avoid infectious complications. From the very first days of the postpartum period, a variety of microbial flora is found in the lochia, which, when multiplying, can cause inflammatory process. Therefore, it is important that lochia does not linger in the uterine cavity and vagina.

During the entire period while the discharge continues, you need to use pads or diapers. Gaskets must be changed at least every 3 hours. It is better to use pads with a soft surface than with a mesh surface, because the nature of the discharge is better visible on them. Pads with fragrances are not recommended - using them increases the risk of developing allergic reactions. While you are lying down, it is better to use padding diapers so as not to interfere with the release of lochia. You can put a diaper on it so that the discharge comes out freely, but does not stain the laundry. Tampons cannot be used, as they prevent the removal of vaginal discharge, instead absorbing it, which can cause the proliferation of microorganisms and provoke the development of an inflammatory process.

You need to wash yourself several times a day (after each visit to the toilet), you need to take a shower every day. The genitals need to be washed from the outside, but not from the inside, from front to back. You cannot douche, because this way you can get an infection. For the same reasons, it is not recommended to take a bath.

During intense physical activity, the volume of discharge may increase, so do not lift anything heavy.
You should seek medical help in the following cases:
The discharge has become unpleasant, Strong smell, purulent character. All this indicates the development infectious process in the uterus - endometritis. Most often, endometritis is also accompanied by pain in the lower abdomen and fever,
Abundant bleeding after their number has already begun to decrease or the bleeding does not stop for a long time. This may be a symptom that there are parts of the placenta that have not been removed in the uterus, which interfere with its normal contraction,
Appearance cheesy discharge indicates the development of yeast colpitis (thrush). In this case, itching in the vagina may also appear, and redness sometimes occurs on the external genitalia. The risk of this complication increases when taking antibiotics,
Postpartum discharge suddenly stopped. Complications are more common after a cesarean section than after a natural birth.
At heavy bleeding(several pads within an hour) you need to call " ambulance", rather than going to the doctor on your own.
The above complications do not go away on their own. Required adequate therapy, which needs to start as early as possible. In some cases, hospital treatment is required.
If complications arise after childbirth, a woman can contact not only antenatal clinic, but also (in any case, at any time of the day) in maternity hospital where the birth took place. This rule is valid for 40 days after birth. Restoration of the menstrual cycle.

The timing of the restoration of the menstrual cycle is individual for each woman. After childbirth, a woman’s body produces the hormone prolactin, which stimulates milk production in the female body. It suppresses the formation of hormones in the ovaries, and therefore prevents ovulation.

If the child is on natural feeding, then regular menstrual cycle his mother will recover 5-6 months after birth, and may recover after cessation of lactation. Before this, menstruation may not occur at all, or it may come from time to time. At artificial feeding(the baby receives only formula milk) menstruation is restored, as a rule, by the 2-3rd month after birth.

Attention to character postpartum discharge and other indicators of a successful postpartum period will help a woman avoid many complications. It is important to follow all hygiene rules and doctor’s recommendations.

Bloody discharge after childbirth is a completely natural phenomenon. On average, they last up to 1.5 months, but the specified period may change in one direction or another. Some women worry when they are still bleeding a month after giving birth. What could this be connected with, is this considered normal and what symptoms should alert a young mother? Let's look at these questions in our article.

The nature of postpartum discharge

During pregnancy, women experience a significant increase in the volume of blood circulating in the body. According to statistics, the amount of blood can increase by 30–50%. In this way, nature provides sufficient nutrition and oxygen supply to the baby developing in the womb, and also creates a kind of blood reserve to alleviate the consequences of childbirth and the postpartum period. The vessels of the uterus dilate and by the time of birth its blood supply reaches a maximum.

During and after childbirth, quite active discharge is observed for 2–3 days, which is designated by the medical term “lochia.” This is a natural process and should not be frightened. With such secretions, the female body can lose up to 1.5 liters of blood and this is also the norm. Moreover, a small amount of lochia excreted may indicate their accumulation in the uterus, which can cause an inflammatory process. However, it is extremely important to distinguish lochia from uterine bleeding, which has approximately the same appearance. After all, such bleeding is fraught with death, and therefore requires urgent medical intervention.

Late postpartum discharge

Bleeding that occurs in women a month after childbirth may have various reasons. If a woman in labor is tormented by any doubts, then it is better for her to consult a doctor.

Long-lasting lochia. Spasmodic contractions of the uterus, which begin after childbirth and continue for some time, intensify when the baby is attached to the breast and help the uterus to cleanse itself of blood particles and clots in it. Lochia are remnants of the birth canal, placenta, and endometrium, which are excreted for several days after birth. By the end of the first week after birth, their color changes, they acquire a brown tint, become paler, more and more scanty, and by the end of the first month, the release of lochia stops. In some women, the discharge of lochia continues for 1.5 months after childbirth or even more. This is within the normal range and can usually be caused by the following reasons:

The woman is not breastfeeding. At the same time, the hormone prolactin, which stimulates uterine contractions, is not produced, so its cleansing occurs more slowly. If there are no blood clots or an unpleasant odor in the discharge, then there is no reason to worry, they will gradually disappear.
The birth was carried out by caesarean section. The suture on the uterus prevents it from contracting properly, causing its recovery process to be delayed. Injuries and ruptures received during childbirth and the application of internal sutures have a similar effect on the duration of bleeding.
The uterus was greatly distended during pregnancy due to the large size of the fetus or the presence of several fetuses, which increases the time it takes to restore its previous shape.
The presence of fibroids, fibroids, and polyps prevents normal uterine contractions, which increases the duration of discharge.
Blood clotting is impaired. The doctor should be warned about the existence of this problem at the stage of planning the child. And, of course, a woman should be prepared for the fact that natural bleeding after childbirth will last much longer than usual.
Excessive physical exercise can lead to muscle tears and even bleeding, which will slow down the process postpartum recovery and will prolong the duration of discharge.

Why might it appear? Iron-deficiency anemia in a woman after childbirth

The appearance of menstruation. Typically, women do not have periods for two months after giving birth. But this is true for those mothers who are breastfeeding their baby. In this case, the released prolactin inhibits the production of estrogen, which is responsible for the maturation of follicles and the restoration of the menstrual cycle.

For those women who, for one reason or another, do not put their baby to the breast, menstruation can resume within a month or a month and a half after giving birth.

This is good sign and testifies to quick recovery uterus and hormonal levels female body. Since during menstruation the discharge becomes abundant and has a bright red color, a woman needs to correctly determine whether we are really talking about menstruation, or whether she has started uterine bleeding, which is extremely dangerous to health and requires emergency medical attention.

Inflammatory process in the internal genital organs. May be caused by those remaining in birth canal particles of the placenta, endometrium or infection attached during surgery.
Early sexual relations. Doctors usually recommend abstaining from intimate relationships for two months after the birth of the baby. During this period, the pelvic organs should recover. If partners begin sexual relations earlier than the recommended period, this can lead to bleeding.

The presence of cervical erosion can provoke brown or bloody discharge in the late postpartum period. A gynecologist can confirm the diagnosis. He will prescribe appropriate treatment, during which sexual relations are not recommended.

What should cause concern

If, instead of decreasing, the volume of discharge suddenly increases sharply, the woman should consult a doctor, since in this case it may be a symptom of uterine bleeding. If for several hours in a row a standard pad becomes saturated with blood within 40–60 minutes, we are talking about internal bleeding.

Development of thrush in women after childbirth and treatment

If the discharge becomes unpleasant putrid smell or a yellowish-green tint, then most likely an inflammatory process is developing in the internal genital organs. It may be caused by kinking of the uterine tubes and, as a result, the accumulation of lochia there.

An inflammatory process in the uterus can lead to the development of endometritis. It may be accompanied severe pain in the lower abdomen, increased body temperature and purulent discharge. Once the diagnosis is confirmed, the doctor will definitely prescribe a course antibacterial drugs and curettage of the uterus.

In addition to the factors listed above, reasons for urgently seeking medical attention are also:

the appearance of clots and mucus;
pain in the lower abdomen;
increased body temperature, weakness, deterioration of health;
The duration of discharge is more than 6–7 days.

In order for the uterus to recover quickly after the birth of the baby, doctors advise sleeping on your stomach more often, or at least resting in this position. Also, you should not walk with overcrowded bladder, it is better to go to the toilet when the first urge occurs.