When does bleeding stop after childbirth? What every woman needs to know about postpartum bleeding

Childbirth is a labor-intensive process, which in many cases occurs with complications. Such a postpartum pathology is postpartum hemorrhage. Of course, with uterine bleeding, the mother’s life is in the hands of medical personnel. After all, qualified monitoring of the health indicators of the postpartum mother, preventive measures, timely provision of suitable health care- all this allows you to save the life and health of the woman who gave birth. Why do they arise? inside uterine bleeding and how to prevent them - these are the main questions to which a woman giving birth should know the answers.

Postpartum hemorrhage: what is it?

One of the scary obstetric complications which a woman may experience after childbirth is bleeding.

Postpartum hemorrhage is the cause of death of a woman during or after childbirth, ranking third after death from anesthesia and infection.

The severity of the condition of a young mother, faced with such a terrible deterioration in her health, is determined by the amount of blood lost. Blood loss during and after childbirth is physiologically natural. But this is only in case of blood loss in an acceptable volume (0.3% of body weight). The female body prepares for this already during pregnancy, increasing the volume of circulating blood. Large blood loss (over 500 ml to several liters), no matter how frightening it sounds, can cause the death of a woman in labor. Such intense bleeding is provoked by the wounded state of the uterus after childbirth. In women prone to hemorrhage, the process of uterine contraction is disrupted or the process of blood clotting and blood clots does not start.

The outcome of postpartum hemorrhage depends on the following factors:

• volume of blood lost;
• bleeding rate;
• the effectiveness of the therapy and the speed of its implementation;
• blood clotting disorder.

Causes of complications

It is considered normal if a woman loses blood in an amount of no more than 0.5% of her body weight. In terms of volume, this is about 300 - 400 ml. Bloody discharge from birth canal explained by physiology. So, at the birth of a child, the placenta is separated from uterine wall. The uterus is injured, which means bloody discharge is inevitable.

If the woman in labor postpartum period loses more than 400 ml of blood, this is a deadly pathology that requires immediate elimination of its cause. What is she like?

Atony and hypotension of the uterus

What is hidden behind the medical terms “atony” and “hypotony of the uterus”?

The uterus - the organ in which pregnancy develops - has in its structure muscle layer, called “myometrium”. He's like anyone muscle, tends to get excited (come into a state of tone). When after childbirth the myometrial tone decreases along with the ability to contract, we speak of uterine hypotension, and when it is completely lost, we speak of atony. Vessels injured by childbirth must undergo the process of thrombus formation (coagulation into clots). If this does not happen, and the uterus has already lost or decreased its tone, the blood clots are washed out through the bloodstream from the mother’s body. Developing heavy bleeding, when a woman can lose several liters of blood. Needless to say, how dangerous this is for the life of a young mother.

What could cause this clinical picture:

• fatigue of muscle fibers due to protracted or, conversely, rapid labor;
• the use of drugs that reduce uterine tone;
• loss of the myometrium's ability to contract normally.

Conditions predisposing to hypotension and atony are:

• young age;
• pathological conditions of the uterus: fibroids and uterine fibroids; developmental defects; postoperative scars on the uterus; inflammatory processes; a large number of births; excessive stretching of the uterus during multiple pregnancy, with polyhydramnios;
• pregnancy complications;
• prolonged labor with a large fetus;
• abnormalities of the placenta (previa or abruption) and some others.

How can an obstetrician-gynecologist help a woman in labor? Conducted medical events determined by the type of bleeding and the woman’s condition:

• Hypotonic bleeding: external massage of the uterus is performed through abdominal wall and administration of contraction drugs.
• Atonic bleeding: with blood loss above 1 thousand ml it is carried out complete removal uterus, removing a woman from the state hemorrhagic shock as a result of heavy blood loss.

Violation of placental separation

The placenta leaves the uterus at the end birth period.
Labor has three stages: cervical dilatation, expulsion of the fetus and the postpartum period.

When the placenta is delivered, the early postpartum period begins (it lasts for the first two hours). The placenta is carefully examined by obstetricians: it should be completely expelled. Otherwise, the placental lobes and membranes remaining in the uterus will not allow the uterus to fully contract, which, in turn, will lead to the launch of inflammatory processes and the occurrence of bleeding.

Unfortunately, such bleeding, which suddenly begins a month or more after childbirth, is not uncommon. Of course, the doctor who delivered the child is to blame. I noticed that there was not enough lobule on the placenta, or maybe it was an additional lobule (separate from the placenta), and did not take appropriate measures (manual control of the uterine cavity). But, as obstetricians say: “There is no placenta that cannot be folded.” That is, the absence of a lobule, especially an additional one, is easy to miss, but the doctor is a person, not an x-ray.

Obstetrician-gynecologist Anna Sozinova

http://zdravotvet.ru/krovotechenie-posle-rodov/

Why do parts of the placenta remain in the uterine cavity? There are a number of reasons:

• partial placenta accreta;
• improper management of the third stage of labor;
• uncoordinated labor activity;
• cervical spasm.

Blood diseases

Blood diseases that often cause bleeding include:

• hemophilia: blood clotting disorders;
• Werlhof's disease: the presence of hemorrhages and bruises on the torso and limbs against the background sharp decline number of platelets in the blood;
• von Willebrand disease: increased permeability and fragility vascular wall- and others.

Bleeding associated with these diseases is relatively rare. However, women with this diagnosis should be carefully monitored by a doctor during pregnancy and comprehensively prepare for childbirth.

Birth canal injuries

Bleeding in a woman in labor (usually early) can be caused by trauma to the birth canal during the birth of the baby.

Tissue damage can be detected in the area:

• vagina;
• cervix;
• uterus.

Tissues are damaged spontaneously, as well as due to improper medical actions. Therefore, typical tissue tears can be classified into groups:

• spontaneous ruptures are possible during expulsion of the fetus (for example, during rapid labor);
• ruptures are associated with medical manipulations when extracting the fetus (imposition obstetric forceps, vacuum escochleator);
• uterine rupture is also provoked by scars on it after previous surgical interventions, curettage and abortion, use intrauterine contraceptives, obstetric manipulations (external fetal rotation or intrauterine rotation), stimulation of labor, narrow pelvis.

Early and late bleeding after childbirth and cesarean section: symptoms, duration, difference from lochia

Bleeding after childbirth is classified as early and late:

• early (primary) - occurred immediately after birth or within the first 24 hours;
• later (secondary) - occurred after 24 hours or more.

Video: postpartum bleeding

A visual examination of the birth canal, examination of the uterine cavity, and ultrasound diagnostics helps the doctor determine the fact of bleeding.

Early bleeding

If the medical indicators of a woman who has given birth are normal during the first two hours (pressure, pulse, skin color, amount of discharge), she is transferred from the delivery room to the postpartum ward. There, being in a separate room, the young mother must control her own well-being and in case of any deviations in postpartum recovery call medical personnel.
Every woman who has given birth should understand the importance of self-monitoring in the first days after childbirth, since bleeding can occur rapidly

Bleeding after childbirth varies in the amount of blood released and the intensity of blood loss. If the uterus does not contract, the bleeding is profuse. Wherein blood pressure falls, the heartbeat slows down, the woman’s skin turns pale. Such massive blood loss is rare, and successful control of bleeding in this case is difficult.

Bleeding may be continuous or start and stop alternately. This situation (blood discharge in portions when the uterus relaxes) is more common. The body resists, resists blood loss, manages to work defense mechanisms. If assistance is provided in a timely and qualified manner, the bleeding can be stopped.

If bleeding does not stop after medications that contract the uterus, massage of the uterus may be necessary. surgery. The doctor must act immediately so that the woman does not fall into a state of hemorrhagic shock and so that irreversible pathological processes in organs.

Late bleeding occurs when the woman is no longer in the hospital. This is the danger of the situation. Intense bleeding from the birth canal may suddenly appear at the end of the first week after birth, as well as in the second and third weeks. It can be triggered by physical activity or heavy lifting.

What signs of illness should a young mother pay close attention to?

Table: pathological conditions that cause anxiety in women

If you observe one of these symptoms, a young mother should consult your doctor. Any delay is a risk to life.

Difference from lochia

Postpartum bleeding cannot be identified with discharge after childbirth (natural or surgical) - with lochia. Lochia leaves the uterine cavity in response to the healing of its wound surface. This is a natural process determined by physiology. When the endometrium lining the uterine cavity is completely restored (by the end of the third week after natural birth, a few weeks later - after caesarean section), the discharge stops. Recovery period postpartum is on average 8 weeks. During this time, the woman loses 0.5 - 1.5 liters of lochia, which change color (from scarlet to dark red, brown, yellowish, transparent white), consistency.

Bleeding is always a heavy loss of blood, possibly sudden, the blood is liquefied and scarlet in color. The woman feels dizzy, blood pressure drops, and her skin turns pale. This is an indication for urgent hospitalization.

Bleeding after cesarean

Let us separately dwell on cases of bleeding after surgical delivery.

Bleeding after a cesarean section occurs 3 to 5 times more often than during vaginal delivery.

http://www.tinlib.ru/medicina/reabilitacija_posle_operacii_kesareva_sechenija_i_oslozhnennyh_rodov/p6.php#metkadoc2

The main causes of bleeding after cesarean section in early postoperative period the same ones that cause bleeding after natural childbirth:

• the contractility of the uterus is impaired;
• Intravascular coagulation syndrome (DIC) develops, which leads to massive bleeding and bleeding from unsutured uterine vessels when sutures are not completely applied to the incision.

Bleeding associated with the loss of the ability of the uterus to contract may result from incorrect actions by the doctor during surgery. Obstetricians and gynecologists try to preserve the uterus to the last minute, and often the bleeding intensifies and becomes irreversible. In most cases, amputation of the uterus is inevitable, and it is not advisable to delay it due to the high risks ( state of shock due to excessive blood loss, death).

If a woman preparing for a cesarean section is diagnosed with DIC (blood clotting pathology), complex therapeutic measures are carried out before and after surgical delivery. Medical actions are aimed at the following:

• normalization of blood clotting;
• treatment of the underlying disease or complications of pregnancy that caused the development of DIC syndrome;
• combating shock, eliminating septic infection, improving microcirculation, restoring circulating blood volume, eliminating influences that may maintain or aggravate DIC syndrome.

Late postoperative bleeding is rare and is caused in most cases by purulent-septic processes.
Incorrectly placed sutures are the main cause of bleeding after cesarean section. For example, not all vessels can be sutured; the sutures on the uterus can come apart. This is the fault of the doctor who performed the operation. According to indications, it is possible to carry out reoperation with hysterectomy

Has anyone experienced postpartum bleeding? If someone knows something, please explain why this happens? I had a caesarean section, the reason was simple - breech presentation. I woke up after the second operation. Thank God that everything is fine with my child. After the caesarean section, I was taken to the ward and the bleeding was not immediately noticed at all. Noticed after 30 - 40 minutes. Then they tried to save him for two hours, and then they took him to the operating room again. They say the uterus did not contract. But they somehow stitched me up after the first operation, which means I was contracting... As a result, I lost 2,200 blood and will never be able to get pregnant again.

Diagnostics

To understand whether a woman is at risk for postpartum hemorrhage, modern medicine conducts examinations of pregnant women. During regular blood tests, the following indicators are established:

• hemoglobin level;
• the number of red blood cells and platelets in the blood serum;
• bleeding and clotting time;
• state of the blood coagulation system.

A qualified doctor diagnoses insufficient contractility of the uterus visually in the third stage of labor.

When a woman has already given birth, the obstetrician-gynecologist examines the placenta, fetal membranes, and birth canal of the mother for ruptures, failed tissue, and blood clots. Under anesthesia, the uterine cavity can be examined for tumors that interfere with contractile processes.

On the 2nd - 3rd day after birth, an ultrasound of the pelvic organs is performed, which makes it possible to accurately determine the presence or absence of unremoved fragments of the placenta and fetal membranes in the uterine cavity.

Treatment

The algorithm of actions of medical personnel in the development of postpartum hemorrhage is as follows:

1. Determining the cause.
2. Taking measures to quickly stop bleeding and prevent large blood loss.
3. Restoring circulating blood volume and stabilizing blood levels blood pressure.

Performing these medical actions involves therapeutic procedures (medication, mechanical manipulation) and surgical intervention.

Table: drug treatment

Drug therapy is not limited to the named medications, but is supplemented by a doctor depending on the specific clinical picture. The patient is given donor blood (erythromass, plasma), and blood substitutes are used.

Elimination of early bleeding

If in the first hours after childbirth the bleeding of a woman who has given birth increases (discharge is over 500 ml), medical personnel carry out the following therapeutic actions:

1. Emptying Bladder, possibly through a catheter.
2. Administration of contractile drugs intravenously (usually methylergometrine with oxytocin).
3. Coldness in the lower abdomen.
4. External massage of the uterine cavity: the doctor places a hand on the bottom of the uterus and squeezes and unclenches it, stimulating contractions.
5. Manual massage of the uterus: under general anesthesia The uterus is compressed with one hand of the doctor until its natural contraction starts, while at the same time with the other hand the doctor performs an external massage of the uterus.
6. A tampon soaked in ether is inserted into the vagina to cause a reflex contraction of the uterus.
7. Infusion-transfusion therapy with blood components and plasma-substituting drugs.

Table: postpartum complications and therapeutic measures

The described medical actions are performed under local anesthesia or general anesthesia after a thorough diagnostic examination women.

I had postpartum bleeding... Then, under anesthesia, they manually cleaned the uterine cavity... They said that the cause could be endometriosis, infections, or just a coincidence... My uterus did not contract... I lay there and said that it was pressing on the rectum, they said that this happens , and they took me to the ward, and there I was alone, and I felt like there was a contraction and an effort, and I went crazy, I could barely stand up, walked to the corridor and called the doctor, but it was pouring from me, I remember that I was dizzy, they took me to the intensive care unit and cleaned the stomach, because I had time to eat, but I can’t take anesthesia with food in my stomach. When I left, everything hurt and I lay with the terminals for another 3 hours.

https://www.u-mama.ru/forum/waiting-baby/pregnancy-and-childbirth/138962/index.html

Elimination of late bleeding

When parts of the placenta or blood clots remain in the uterine cavity, late postpartum bleeding occurs.

What actions are taken by doctors:

• immediate hospitalization of the woman to the gynecology department;
• curettage of the uterine cavity under anesthesia;
• cold on the lower abdomen for 2 hours;
• carrying out infusion therapy, if necessary, transfusion of blood products;
• prescription of antibiotics;
• prescribing reducing medications, iron supplements and vitamins.

I had bleeding 4 - 5 hours after giving birth, the doctors said that this often happens with anemia, the uterus did not contract, my head began to spin (almost fainting), and clots, like beef liver, began to stand out. We cleaned it manually, now everything is fine, the baby is 10 months old.

Julia David'son

https://www.u-mama.ru/forum/waiting-baby/pregnancy-and-childbirth/138962/index.html

Rehabilitation of a woman

After bleeding in the postpartum period, the female body is weak. To recover he needs Extra time and strength. A woman should find time to rest and eat well. It is better to entrust some of the responsibilities for caring for the child to close relatives: their help is now extremely important.

How to strengthen a weakened body? Taking it for several months will help. vitamin complexes(for example, Centrum, Complivit, Oligovit, etc.), the use of which is possible during lactation.

Large blood loss can cause iron deficiency (anemia). Therefore, after consulting a doctor and taking blood tests (including hemoglobin levels), it is possible to use iron supplements.

Drugs will help strengthen blood vessels and prevent their bleeding. active substance in which - calcium (calcium gluconate, calcium chloride).

Facilities traditional medicine They will also act as an assistant to the young mother at the stage of recovery of the body after bleeding.

Photo gallery: fruits and berries that help mothers recover

Juice from viburnum fruits and a decoction from the bark of the bush are used as a hemostatic agent. Preparations from lingonberries are an excellent vitamin remedy for bleeding. Chokeberry contains among many useful microelements vitamins K and P, which help blood clot Pomegranate fights anemia, improves blood counts

Medicinal herbs have long been used as stimulants protective forces body.

Table: medicinal herbs as a general tonic

To restore the body, it is important to drink high-quality mineral water With high content calcium, iron (Essentuki, Borjomi and others).

Bleeding is an irreversible condition that is best prevented preventive measures than to cure.

I had a postpartum hemorrhage! I already gave birth to an afterbirth, and they even stitched me up. And when the baby was put to the breast while still in the birthing chair, I complained about nagging pain lower belly! They pressed on the stomach, and from there two clots! They immediately put in an IV and did a manual examination! As a result, everything is fine with the child, blood loss is 800 ml, I can have children!

Yana Smirnova

https://www.u-mama.ru/forum/waiting-baby/pregnancy-and-childbirth/138962/index.html

A woman can protect herself by following the following recommendations.

Prevention of early bleeding

Even during pregnancy, women at risk (diseases circulatory system, gynecological diseases, taking blood thinning medications) are under the supervision of doctors and, if possible, are sent to specialized perinatal centers. A woman preparing for childbirth should know about existing chronic diseases (diseases of the cardiovascular system, kidneys, liver, respiratory organs), and the doctor leading the pregnancy should carry out diagnostic examination future mother in labor.

The delivery process, especially for women at risk of bleeding, should be carried out with a minimum amount of medical interventions, with a careful attitude towards the woman in labor.

Measures to prevent future bleeding are carried out by medical staff immediately after birth.

Table: preventive measures in the early postpartum period

Of course, the success and effectiveness of many preventive measures depends on the doctor’s competence, his professionalism and attentive attitude towards each patient.

Prevention of late bleeding

Being already outside the hospital walls, every mother must perform simple recommendations, reducing the risk of late bleeding.

Table: preventive measures in the late period

It is difficult to overestimate the danger of a situation when a woman who has given birth suddenly or predictably experiences uterine bleeding. At this moment, the doctors' efforts are focused on stopping the large blood loss, eliminating the cause of the hemorrhage, and subsequent rehabilitation of the patient. In order for qualified medical care to be provided to the postpartum mother in a timely manner, the woman must also be aware of the possibility of such a severe postpartum complication occurring. After all, we are talking about the life or death of a young mother.

After the birth of a child, a young mother must undergo an examination by a gynecologist. The first visit is scheduled two weeks after discharge from the hospital. maternity hospital, then two months later. At the reception…

Blood after childbirth is a completely normal natural process that helps the uterus empty its cavity of placenta particles. By and large, vaginal discharge should not frighten a woman, but heavy bleeding is a cause for concern.

What is considered normal and natural, and what symptoms should alert a young mother - we will talk about all this further.

"Good" type of bleeding

Dark blood clots that are released after the baby is born may be caused by lochia discharge. This is normal bleeding and is not dangerous to a woman's health.

If the postpartum period is stable and there are no complications, this type of bleeding should completely stop after 14-16 days. Moreover, it should be understood that “good” bleeding after childbirth cannot be abundant. Otherwise, this is a real pathological acute bleeding.
In order to reduce the likelihood of severe bleeding after childbirth, immediately after the baby is born, doctors should apply a heating pad with ice to the mother's abdomen. Also, if necessary, enter medicines to stop bleeding.

Important! All women should continue to bleed for several days or even weeks after giving birth. At the same time, if dark blood is released in small quantities and does not cause pain, then this is considered normal. The opposite picture will occur when a woman has red blood, which is accompanied by a high temperature. This condition is a good reason for an urgent visit to a specialist.

It should also be noted that “good” bleeding is late menstruation, which a woman may accidentally confuse with menstruation.

For those new mothers who do not breastfeed certain reasons, normal cycle able to return to normal after 20 days.

“Bad” type of discharge

Bleeding that occurs a month after childbirth is dangerous. , as well as cases when a woman goes to the toilet with blood . In addition, bleeding is regarded as pathological in the following cases:

1. When after labor is underway blood for three or more days and at the same time it has a bright red color (lochia cannot have this shade, which indicates uterine bleeding).
2. If bleeding occurs a month after a strong emotional experience, intimate connection or sports stress on the body.
3. With increasing blood loss, when a woman needs to change hygiene products literally hourly.
4. Acquisition by blood putrid smell and strange consistency.
5. The appearance of secondary impurities in the blood that can be signs of acute purulent focus in the reproductive organs.
6. Bleeding, which is accompanied by disturbances in blood pressure, pallor of the woman and other signs of a pathological focus.

Important! Until the cause of bleeding is determined, the gynecologist after childbirth does not advise women to breastfeed, because if the source of the blood is an infection, then it can harm the baby.

Features of bleeding

How many days a woman will bleed or bleed after giving birth is determined by the following factors:

1. The presence or absence of problems with blood clotting.
2. Method of childbirth. Thus, during the natural birth of a baby, the woman’s uterine cavity is more traumatized, and during a caesarean section, the muscles of the anterior abdominal cavity are affected.
3. Success of childbirth, fetal weight and the presence of postpartum injuries.
4. The general health of the mother in labor and the presence of severe chronic diseases.
5. State immune system women.
6. Practice breastfeeding (if a woman frequently puts her baby to her breast, the uterine cavity clears faster and the volume of lochia decreases).
7. Correct adherence to postpartum measures (application of a cold compress, administration of a number of medications, cleanliness during childbirth, etc.).
8. Physiological characteristics of a woman and her tendency to recover.
9. The presence of postpartum complications, such as infections or inflammatory processes in the reproductive organs.
10. State hormonal levels women, as well as the presence of a number of endocrine disorders.

Causes

The main causes of bleeding in this state are:

1. Rapid childbirth, which became the culprit of severe damage to the woman’s birth canal. In this condition, a woman in labor may experience severe ruptures of organs. At the same time, copious bleeding can be observed for several days after rapid labor.
2. Pathologies of the attachment of the placenta to the uterus, which subsequently provoke severe bleeding.
3. Poor blood clotting in a woman in labor can provoke excessive bleeding. IN similar condition Doctors should urgently administer hemostatic drugs to the woman. Otherwise, death from blood loss cannot be ruled out (which is why it is dangerous to give birth outside a hospital setting without medical supervision).
4. Presence of changes in the uterus.
5. Poor contractility of the uterus, which can be caused by very strong stretching of its walls.
6. Rupture of the uterus, which was provoked by difficult childbirth (usually occurs with a large fetus).
7. Accumulation in the uterus of amniotic mucous tissue that has not yet come out.
8. The appearance of blood that cannot completely leave the organ due to reflexive contraction of the uterus. This condition is often observed during cesarean section.
9. Presence of outbreak acute inflammation, which led to a slowdown in the recovery process.

Diagnostics

At the first suspicious discharge of blood, a woman should contact her observing gynecologist. After the initial examination and history taking, the doctor may also prescribe the patient an ultrasound examination and blood tests.

If blood appears, the woman must be urgently hospitalized and given medicinal treatment.

The doctor must also determine the type of bleeding: primary (occurs immediately after childbirth and in the first three days after it) and secondary (develops after several weeks).

Treatment

Immediately after the baby is born, doctors take a number of steps to prevent postpartum hemorrhage. Therefore, the woman needs to stay in the delivery room for two hours after giving birth. This is necessary to take emergency measures in case of bleeding.

During this period, the condition of the woman in labor is monitored by staff who monitor pulse, blood pressure and the amount of blood released.

For women who are giving birth for the first time or have had a difficult labor, the doctor examines the vagina and uterus to look for damage. If necessary, the affected areas of the ruptures are stitched and treated with antiseptics.

The permissible amount of blood loss during childbirth should not exceed 500 mg. Otherwise, the woman's blood loss will be regarded as bleeding.

If bleeding occurs, the following treatment measures are taken:

1. Administration of drugs to stop bleeding. They are selected by a doctor in each individual case.
2. Applying cold to the lower abdomen.
3. Carrying out external massage of the uterine area. To do this, the doctor places his hand on the fundus of the uterus and gently squeezes it until the organ contracts. For women, such an event is unpleasant, but it can be endured without anesthesia. A hand can also be inserted into the organ to examine its walls. After this, the hand is clenched into a fist.
4. Inserting a tampon into the vagina. The tampon itself must be soaked in a special agent that will cause uterine contractions.
5. If there is severe bleeding, the patient needs an urgent blood transfusion.

If bleeding is advanced, a woman may need surgery. The following operations can be used to stop bleeding:

1. Complete removal of the uterus.
2. Squeezing of affected vessels in the reproductive system.
3. Stitching of uterine injuries.

Important! If bleeding is severe, it is impossible to stop it at home. Moreover, if at the same time the woman tries to recover traditional methods, then she will only waste precious time. The wisest thing to do in such a condition is to call an ambulance.

Why is blood released: normal

According to gynecologists and obstetricians, after the birth of a child, small amounts of blood can be released for up to four weeks in a row. If the woman’s condition is satisfactory, she does not suffer from pain, high temperature and others danger signs, so then this process is regarded as a physiological norm.

Gradually, the uterus will clear itself of postpartum injuries and restore its mucous layer.

Important! After a caesarean section, the woman’s recovery process takes longer, since the muscles and walls of the uterus are injured. surgically. In this condition, the healing period of the organ will be longer.

Preventive measures

In order to reduce the risk of pathological bleeding after the birth of a baby, it is important for young mothers to adhere to the following doctor’s recommendations:

1. Avoid sexual intercourse with a man for several weeks to allow the uterus to fully recover and heal birth wounds.
2. Regularly take clinical blood tests to monitor white blood cells in the blood, as well as hemoglobin and platelets. If any malfunctions are detected, take normalizing medications prescribed by your doctor.
3. Before the birth of a child, it is very important to take blood tests for clotting. This way, the woman herself and the doctors will specifically understand what they need to be prepared for.
4. It is strictly prohibited to smoke or drink alcohol during the postpartum period, especially if the woman is breastfeeding.
5. Carefully observe personal hygiene of the genitals. However, you need to change it regularly sanitary napkin and wash with simple baby soap.
6. For two months after the birth of the child, any physical activity, especially heavy lifting, is strictly contraindicated. During such a period, a woman needs to take maximum care of herself, especially if she had a caesarean section (stress can not only cause bleeding, but also contribute to the divergence of the stitches).
7. To improve lactation, it is useful to enrich the diet with fermented milk products.
8. Carefully monitor your diet. In this state, it is very useful for a woman to eat cereals, soups and vegetable dishes. At the same time, food should be cooked mainly by steaming, baking or boiling. You need to forget about fatty, smoked, salted and fried foods for a long time.
9. On the first day after giving birth, be sure to apply a cold ice compress to your stomach.
10. To cleanse the uterine cavity as quickly as possible, a woman is recommended to lie on her stomach.
11. When you first feel the urge to urinate, you should immediately visit the toilet so that a full bladder does not lead to unnecessary contractions of the uterus.
12. Visit more fresh air. At the same time, it is very useful to practice long hiking with the baby, as these actions will be useful for mother and child.
13. In order to reduce the likelihood of postpartum complications, every week a woman must undergo a follow-up examination with a gynecologist. Only a specialist will be able to identify problems with the uterus in a timely manner and prescribe the necessary treatment.

It should be understood that it is important not only how much there is bleeding, and what character does it have, and what additional symptoms at the same time observed in women. Wherein, copious discharge bleeding can be extremely dangerous to health, so do not delay in contacting a doctor if they appear.

Bleeding after childbirth is normal process, in which the uterine cavity naturally gets rid of lochia and remnants of placental tissue. The very nature of bleeding, its pain, severity and duration (duration) are always different, and can vary greatly in different women. How long does bleeding last after childbirth? This question worries all young mothers, especially those giving birth for the first time.

All women know that without bleeding, childbirth is hardly possible. Everyone is concerned about the question: how long should the blood flow, how long will the blood flow after childbirth?

Blood can flow for several reasons.

1. Poor blood clotting parameters. This parameter is always individual in nature, and it often happens that blood flows out of the woman’s genital organs in small liquid streams, and there are no signs of the beginning of the coagulation process. This situation can be foreseen if the woman undergoes appropriate tests before giving birth.
2. Rapid (quick) birth, which caused serious injuries to the birth canal.
3. Incremental tissue of the placenta and membranes, which prevents normal contractions of the uterus. This also causes bleeding.
4. Inability of the reproductive organs to contract due to excessive tissue stretching caused by the large size of the fetus (either multiple births or polyhydramnios).
5. Some customized gynecological problems– fibroids, fibroids, long recovery of the uterus, problems with myometrial contraction.

How much time there's blood coming out after childbirth? It's always different.

How long can bleeding last?

How long does bleeding last after childbirth? This depends on several factors:

• how the pregnancy progressed;
• when did the discharge start?
• how the birth took place - natural, or had to resort to stimulation;
• How natural are uterine contractions?
• whether there are any complications after childbirth;
• what is the general individual health status of the woman;
• what are the features of lactation (breastfeeding at the request of the child reduces the number of lochia and stimulates the contractile activity of the uterus);
• whether placenta accreta occurs.

Each of these reasons, to one degree or another, influences how long postpartum bleeding will last (continue).

Personal hygiene rules after childbirth

How much blood will bleed after childbirth largely depends on the woman’s compliance with a number of recommendations. To stop bleeding as quickly as possible and avoid possible complications, you need to follow several rules.

1. Go to the toilet regularly to prevent pressure from a full bowel and bladder on the uterus. The uterus should contract normally.
2. Maintain thorough cleanliness and hygiene to prevent infection.
3. Avoid any physical activity and sexual relations for at least one and a half months after birth.
4. When sleeping, try to lie on your stomach.
5. Establish a breastfeeding routine as much as possible.

How long it takes to bleed after childbirth is always an individual matter. Therefore, to the general standard requirements each woman can have an even longer list of recommendations, from correct execution which depends not only on success postpartum treatment the woman’s body, but also the effectiveness of preparation for the next pregnancy.

Prevention and diagnostic procedures

Modern medicine makes it possible to timely assess the risks of postpartum hemorrhage. A woman should be examined during pregnancy for hemoglobin levels, red blood cell counts and platelet counts in the blood serum. It is necessary to determine the bleeding and clotting time. Then it will be possible to guess how many days the bleeding lasts after childbirth, how much blood can come out after childbirth. This procedure is required.

Norm and pathology

Normally, postpartum discharge from the uterus () lasts no more than 1.5 months. The woman does not experience much inconvenience from them. During the first 20 hours, blood may flow most intensely, and there is nothing to worry about. After a few days, the amount and intensity of discharge will begin to gradually decrease. If pregnancy and childbirth went well, and if after childbirth a normal lactation regime quickly established, then the mucous layer of the uterus will heal quickly.

• more than three days go by dark red blood;
• discharge acquired bad smell;
• the postpartum hemorrhage not only continues in the postpartum woman, but blood loss increases, and there is a need to change hygiene products every hour;
• the number of damages (ruptures) after childbirth does not decrease;
• the woman is very weak, her temperature is not normal, and even loss of consciousness is possible;
• bleeding does not stop after 6 weeks.

Normal bleeding

Postpartum hemorrhage is usually divided into several stages. The main differences are the color and intensity of the discharge. On the very first day after birth, blood flows profusely, the discharge is much larger than during menstruation, it has a bright scarlet color. On the first day after birth, bleeding occurs from the vessels that connected the placenta to the wall of the uterus. This is precisely the reason why blood bleeds profusely at first. How long can you bleed for the first time after childbirth? In normal physiological state– no more than 4 days.

Pathology

To avoid complications after childbirth, you must be able to distinguish pathology from the norm.

• bleeds unevenly after childbirth - minor discharge is suddenly replaced by bright scarlet blood;
• 2 weeks after birth, not only bleeding, but also pain persists;
• The bleeding is still bright red a month after birth.

In what cases is medical help required?

When should you seek help from a doctor? Regardless of how much blood flows after childbirth, if the discharge becomes more frequent, heavier and redder, then immediate medical attention is needed. First of all, go to the gynecologist. Moreover, if the bleeding has not gone away and does not go away for more than 4 days.

- This is a normal physiological process that is inherent in nature. In this way, the woman’s body gets rid of the placenta, lochia and the remains of the placenta. It occurs in the early postpartum period and may continue into the later period. Obstetricians determine its severity by the nature of the discharge and the volume of blood loss.

However, postpartum bleeding is not always a normal physiological process. In some cases, it can even pose a threat to a woman’s life. Normally, losses amount to up to 0.5% of the total body weight of the giving birth woman.

Early postpartum bleeding is what occurs within the first two hours, and late postpartum bleeding can last up to 1.5 months.

Bleeding one month after birth

Normally, during the first week after the birth of a child, a woman continues to experience discharge. Gradually they change color, become paler, clots cease to be present in them, and every day there are fewer and fewer of them.

There are cases that women, even after a month, continue to observe discharge from the birth canal. In small quantities they are normal, as this is a natural process of restoration of the uterus. This is especially true for women who did not breastfeed. If there are no clots or unpleasant odor, then there is no need to worry. In the near future, such discharge will no longer bother the woman and will stop.

It is worth consulting a doctor if minor bleeding becomes heavy.

The situation is especially dangerous when the discharge acquires a putrid odor and turns yellow or green. Most often, this is a sign that an inflammatory process is developing in the uterus or vaginal cavity. It may be associated with an accumulation of lochia due to kinking of the fallopian tubes.

A woman may begin to develop postpartum endometritis. He has varying degrees severity, may be accompanied by a significant increase in body temperature. The most difficult case It is considered when a woman experiences pain in the lower abdomen, accompanied by bloody and purulent discharge. If the doctor confirms such a diagnosis, then the woman undergoes mechanical scraping of the remains and is prescribed a course of antibiotics.

Another option for heavy bleeding a month after childbirth is recovery menstrual cycle. If a woman does not breastfeed, then she does not produce a special hormone - prolactin, which inhibits ovulation. Therefore, after a month, the first menstruation can be observed. This indicates normalization of uterine function and restoration of hormonal levels.

Sexual relations started too early can provoke bleeding a month after birth. Doctors recommend abstaining from intimacy for 2 months after the woman has had a child. This is due to the fact that the uterus needs to recover, return to its previous size, and return to its normal state.

Sometimes bleeding 30 days after delivery can be caused by incompletely cured erosive processes in the cervical area. In this case, it is necessary to consult a gynecologist and undergo a course of appropriate therapy. In this case, sexual relations should not begin.

You should consult a doctor if:

A month after birth, heavy blood loss occurs, with a sudden onset and pronounced intensification.

If the bloody discharge changes color or smell.

When there are bloody clots in the discharge.

If general health deteriorates sharply, there are signs of intoxication of the body.

If pain occurs in the lower abdomen, accompanied by heavy blood loss.

How long does bleeding last after childbirth?

The normal period during which spotting is observed after childbirth is considered to be up to 6 weeks. During this time, a woman can lose up to 1.5 liters of blood. However, you should not be afraid of such numbers, since the body has prepared in advance for such expenses. Indeed, during pregnancy in women, the total volume of circulating blood increases significantly.

Another factor influencing the duration of bleeding after childbirth is breastfeeding. If this happens, the uterus contracts and recovers much faster, which contributes to an earlier process of stopping the discharge.

If a woman has had a caesarean section, the bleeding may continue a little longer. This is due to the fact that the uterus was injured and a suture was placed on it. In this case, it recovers somewhat slower compared to natural childbirth.

Women who experience increased physical activity during the postpartum period may also be more long time observe the process of blood release from the birth canal. Therefore, if possible, you should rest as much as possible and avoid anxiety.

The following factors may also affect the timing of bleeding after childbirth:

Multiple pregnancy, due to which the uterus has significantly increased in size.

A large child with a lot of weight.

Parts of the placenta remaining in the birth canal and the resulting inflammatory process.

Weak contractility of the uterus.

Taking certain medications, such as aspirin.

Trauma to the birth canal, internal sutures.

Placental polyp.

Blood clotting disorders.

To reduce bleeding time after childbirth, it is useful to sleep on your stomach or simply lie on it while resting. Also, do not avoid going to the toilet; you should empty your bladder when the first urge appears. It is important to avoid severe physical activity and lift heavy objects. All this will help reduce bleeding time after childbirth and avoid complications.

Education: Diploma in Obstetrics and Gynecology received from the Russian State medical university Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at NIMU named after. N.I. Pirogova.

Giving birth to a baby is a complex physiological process for a woman. Bleeding a month after giving birth is not always normal. The threat to life is determined by the amount and nature of the discharge.

When the birth proceeded normally without tears or cracks, then during the first 7-10 days mothers observe heavy bleeding. This physiological process in the body allows you to get rid of the remnants of the placenta, lochia and parts of the placenta.

If more than a month has passed since the birth of the baby, and the discharge has not stopped and has become abundant, pay attention to its nature and quantity. If there is no unpleasant odor and are not observed blood clots dark color, then this is normal.

What kind of discharge should there be a month after giving birth:

1. lochia is thicker on the first day, and after a week it becomes liquid;
2. during the first days the blood has a bright scarlet color;
3. on days 10-14 the shade changes to brown, the amount decreases;
4. mucous discharge is light pink and odorless;
5. after 4 weeks the lochia becomes transparent.

Normally, vaginal bleeding during the postpartum period continues for 6-8 weeks, depending on the health of the mother. The volume of blood lost during this period is about 1.5 liters. The body is completely renewed and cleansed.

Causes of spotting a month after childbirth:

• a caesarean section was performed;
• parts of the placenta remain in the birth canal;
• presence of fibroids;
• blood clotting is impaired;
• there was a rupture of the uterus or birth canal.

When a woman does not breastfeed, menorrhagia develops. This occurs due to hormonal imbalance. With this deviation, menstruation before and after the birth of the baby is accompanied by large loss of blood.

Heavy menstruation appears feeling unwell, decreased blood pressure, dizziness. The causes are hormonal imbalances, birth injuries, blood clotting disorders and diseases of the genital organs.

If a month has already passed after giving birth, and the bleeding begins to intensify, you need to consult a doctor. Timely diagnosis will allow you to identify the cause and start treatment in time.

Causes

Bloody discharge 4 weeks after childbirth leads to the death of the woman or removal of the genital organ. Mom, if there are signs such as heavy hemorrhage, dark clots and abdominal pain, needs to call an ambulance.

Causes of bleeding a month after the birth of a child:

• atony or hypotension of the uterus;
• the remainder of the placenta;
• postpartum trauma;
• blood disease;
• inflammatory processes;
• placental polyp;
• hereditary characteristics of the body.

Atony and hypotension of the uterus represent a deviation, resulting in an empty space between the vessels through which blood leaks. This condition is dangerous to health, since blood loss is up to two liters.

When to see a doctor if spotting starts a month after giving birth:

1. bloody discharge lasts more than 42 days;
2. the shade changed to dark;
3. the appearance of pus, black spots and an unpleasant odor.

Heavy bleeding is caused by inflammatory processes due to parts of the placenta remaining in the uterus. Postpartum sutures and hematomas lead to blood loss. This is due to suppuration of the suture or late detection of internal ruptures.

The pathology is diagnosed by a gynecologist during an examination. To do this, a woman will need to undergo blood and urine tests, as well as undergo an ultrasound of the genital organs. Frequent and heavy bleeding talk about the presence of pathology.

Complications

During the postpartum period, a woman should carefully monitor her well-being. If any deviations from the norm appear, or if bleeding occurs a month after childbirth, you need to pay attention to the quality of vaginal discharge.

When to see a doctor for complications:

1. the blood acquired a bright scarlet hue and became liquid;
2. the amount of discharge has increased, a postpartum pad lasts no more than one hour;
3. pulling severe pain in the abdomen and uterine area;
4. increased body temperature;
5. the appearance of blood clots with an unpleasant odor.

Any inflammatory processes in the uterus require diagnosis and treatment. If a woman in labor does not pay attention in time to increased bleeding one and a half months after birth, the consequences can be negative.

Complications:

• endometriosis;
• lack of muscle contractions;
• blockage of the uterus;
• inflammatory infections.

Endometriosis develops both in the genitals and in the abdominal region. It is believed that it occurs due to blood entering the the fallopian tubes. The disease manifests itself both after menstruation and in the postpartum period.

The absence of muscle contractions of the uterus will not allow the organ to return to its original form. Signs of atony are blood clots and a decrease in the patient’s blood pressure. The pathology very often leads to death due to large blood loss and hemorrhagic shock.

Inspection

A full diagnosis is carried out for women who have a predisposition to bleeding. Pathologies are associated with genetic and chronic diseases. Doctors pay attention to the size of the uterus, placenta previa, and blood clotting.

How is the inspection carried out? late discharge with blood after childbirth:

1. checking the fundus of the uterus;
2. examination of the genitals;
3. measuring blood pressure, pulse and body temperature;
4. general diagnostics;
5. Prescribing tests and ultrasound.

When a woman has strong, bright red discharge a month after giving birth, the examination begins with checking the fundus of the uterus and bladder. Then the quality and quantity of lochia are assessed. To do this, weigh the pad 15 minutes after filling.

Bleeding is often caused by trauma, due to which the uterus does not contract and does not return to its previous shape. If the organ has been checked and no abnormalities are found, pay attention to painful sensations and vagina.

It's important to keep track general condition patients. Blood pressure, pulse and body temperature are measured. Normally, the skin should be light in color, lips pink, mucous membranes without dryness. At internal bleeding the pain will be severe, radiating to the pelvic area. The vagina swells and the skin tone changes to dark blue. Next, black discharge appears a month after the birth of the child, which indicates the presence of a laceration inside or outside.

Treatment

Uterine bleeding is treated in stages, depending on the condition of the woman in labor. First, a diagnosis and examination is carried out to determine the cause of the pathology. Throughout the entire period, the nurse monitors the woman’s blood pressure and pulse.

The functioning of the uterus is restored with the help of medications. For each patient, the drug and dosage are selected individually based on the characteristics of the body. To relieve cramps and stop bleeding, cold is applied to the lower abdomen.

Drugs to stop bleeding one month after childbirth:

1. Oxytocin – used to contract muscles. It is used in the form of droppers both during childbirth and after the birth of the child;
2. Methylergometrine is prescribed intramuscularly only during the postpartum period. Accelerates contraction of the uterine muscles.

The doctor examines the uterus and inserts a tampon with a substance inside that helps the organ contract. If remains of the placenta are found inside the cavity and in the birth canal, the organ is cleaned under general anesthesia.

If the bleeding cannot be stopped, the problem is solved surgically:

• uterus removal;
• stitching lacerations and damage inside the organ;
• squeezing damaged vessels.

The operation is used only as a last resort, when medications did not fix the problem. All surgical procedures are performed under general anesthesia. In case of severe blood loss, a blood transfusion is prescribed.

Prevention

Preventive measures promote contraction of the uterus and reduce the risk of developing pathology after childbirth. In the first month, the mother should carefully monitor changes in the body. Failure to comply with hygiene rules and doctor’s recommendations negatively affects a woman’s health.

What to do in the first time after childbirth:

1. if blood clotting is reduced, get tested regularly;
2. It is not recommended to smoke or drink alcohol;
3. maintain genital hygiene. If there are stitches, take a shower using baby soap after each visit to the toilet;
4. treat wounds for speedy healing with antibacterial agents;
5. immediately after birth, apply an ice compress to the uterine area for the first two days;
6. in the first 5 days, to contract the uterus, you need to lie down and sleep on your stomach;
7. after discharge from the maternity hospital, visit a gynecologist weekly for examination;
8. monitor your health until they appear transparent discharge from the vagina.

During the first weeks, to prevent bleeding, you should not play sports or lift weights. After a cesarean section, the period increases to 4 weeks, as the stitches may come apart. If during childbirth there were ruptures of the uterus, birth canal, or an episiotomy procedure, refrain from sexual intercourse with a man.

Preventive measures are aimed at restoring the female body after the birth of a newborn. If there is a deviation from the norm, excessive hemorrhage, change in the color of the discharge and the appearance of an unpleasant odor, you should immediately seek help.

The period after childbirth is quite a difficult time for the mother's body. A weakened immune system often leads to inflammatory processes which provoke uterine bleeding. By going to the clinic and diagnosing the cause of the pathology, doctors will be able to save the woman’s life.