Bloody discharge after childbirth. Serous discharge after childbirth

All new mothers and, of course, the doctors who observe them, are concerned about the discharge after the birth of a child. How much discharge goes after childbirth is by no means an idle question, but a very relevant one. To answer the question of whether everything is “calm in the Kingdom of Denmark”, allows the assessment of postpartum discharge and their smell.

A little about the postpartum period

It is clear that the postpartum period occurs immediately after the end of childbirth, that is, the birth of the placenta (placenta), and not the child. And how long it lasts, few know. There are 2 stages after childbirth:

• early postpartum, which lasts 2 hours,
• late postpartum period, lasting 6 to 8 weeks.

What happens in the postpartum period? Once the placenta has separated from the wall of the uterus, it is released or born. In its place, a wound surface has formed in the uterine mucosa, where there are gaping uterine blood vessels from which blood flows. The uterus immediately begins to contract, and in the process of these contractions, the walls of the uterus become tense, thereby compressing the ruptured vessels.

During the first two hours, the discharge is bright bloody, moderate. Normal blood loss in the early postpartum period is no more than 0.4 liters or 0.5% of the weight of the puerperal.

In the case of increased bloody discharge after childbirth, it is necessary to exclude first of all hypotonic bleeding, and then an unnoticed and not sutured rupture of the perineum, vaginal walls or cervix.

If immediately after the birth of a child's place, the uterus weighs about 1 kg, then by the end of the postpartum period, it returns to its usual size and weight, 60 - 70 grams. To achieve this, the uterus continues to contract, but not as hard and painful as during contractions. A woman can only feel small cramps in the lower abdomen, which intensify at the moment the baby is applied to the breast (since stimulation of the nipples provokes the release of a hormone that activates uterine contractions - oxytocin).

For the agreed 6 - 8 weeks, the uterus needs to return to normal size, and the wound surface to heal - this whole process is called postpartum involution of the uterus. During the first day after childbirth, the edge of the uterus is palpated at the level of the navel. By the fourth day, its bottom is located in the middle of the distance from the umbilical fossa to the womb. On the 8th - 9th day, the bottom of the uterus protrudes from the womb by about 1 - 2 cm, so the uterus decreases by 1 cm per day.

Postpartum discharge is called "lochia", and depending on their color, smell and quantity, they judge how the postpartum period proceeds. Lochia are the physiological secret of the birth wound, which include the decidua, red and white blood cells, lymph, plasma and mucus. Ultimately, a month later, postpartum discharge is normally absent.

• After the first two hours after childbirth, the discharge becomes dark red or brownish and moderate. Such discharges last from 5 to 7 days.
• For the first 3 days, their total volume is 300 ml, which requires changing the diaper every 2 hours. There may be blood clots in the discharge, and there is nothing to worry about.
• Starting from 6-7 days (one week after birth) the discharge changes color and becomes yellowish or whitish. The color is determined by the content in the secretions of a large number of leukocytes, which are involved in the healing of the postpartum wound.
• From 9 to 10 days, the discharge looks like watery, has a light shade and a large amount of mucus, their volume gradually decreases. At first, these are meager discharges, and then they become almost imperceptible, and disappear by 3-4 weeks.

Subinvolution of the uterus

The physiological course of the postpartum period is judged by how the uterus contracts, the mucous membrane separates and blood clots come out of the uterine cavity.

Regression of the uterus- involution plays an important role in the physiology of the puerperal - the restoration of menstrual and reproductive functions. When the contractility of the uterus is weakened, then there is a threat of postpartum purulent-septic complications.

To assess the process of postpartum involution of the uterus, the puerperal is invited to an appointment 10 days after discharge, where a general and gynecological examination is performed.

Subinvolution of the uterus- slow return to the previous parameters. If during a gynecological examination the doctor palpates a soft, loose uterus, which is of considerable size (about 10-12 weeks), does not contract at hand, they speak of subinvolution.

To confirm the diagnosis of postpartum subinvolution, an ultrasound of the small pelvis is mandatory, which will determine the causes that prevent normal contraction of the uterus (remnants of the placenta or membranes).

Predisposing factors for subinvolution of the uterus can be:

• prolonged or rapid labor

The issue of hospitalization of a woman is decided on an individual basis. If there are no complaints, the general condition is satisfactory, and there are no remains of the placenta or membranes in the uterus, the puerperal is prescribed uterotonic drugs (tincture of water pepper, oxytocin or methylergometrine).

If foreign content is found in the uterus, it is evacuated by vacuum suction, and in some situations, diffuse washing of the uterus with solutions of antiseptics and / or antibiotics. For prophylactic purposes, antibiotics are prescribed in a short cycle (lasting 2-3 days).

Lochiometer

Lochiometer also refers to postpartum complications and is characterized by retention of lochia in the uterus. As a rule, the lochiometer develops on the 7th - 9th day after childbirth. The causes of this complication are different:

• It can be like a mechanical blockage of the cervical canal
• And insufficient uterine contractile activity
• A mechanical obstruction in the cervical canal can be created by blood clots, remnants of the decidua and / or membranes
• Or excessive kink of the uterus anteriorly

With overstretching of the fetus during pregnancy (large fetal size, polyhydramnios or multiple pregnancy) or during childbirth (discoordination of labor, prolonged or rapid labor, caesarean section, cervical spasm), the contractility of the uterus weakens. With a timely diagnosed lochiometer, the general condition of the puerperal remains satisfactory, the temperature and pulse are normal, the only sign is the absence of lochia or their number is negligible.

On palpation of the uterus, there is an increase in its size compared to the previous day and pain. A missed lochiometer leads to the development of endometritis. Medical tactics is to create an outflow of lochia from the uterus. First, conservative therapy is prescribed:

• or parenterally
• then uterotonics (oxytocin) and cold on the lower abdomen

If uterine inflection is diagnosed, bimanual palpation is performed to return it to its original position.

With blockage of the cervical canal the doctor carefully expands it with a finger (in some cases, Hegar dilators may be needed) and releases it.

Curettage - if after the measures taken for 2-3 days the lochiometer is not eliminated, they resort to instrumental emptying of the uterine cavity (curettage) or vacuum aspiration. Antibiotics are prescribed for prophylactic purposes.

Postpartum endometritis

Another, but more dangerous complication of the postpartum period is inflammation of the uterus or endometritis. As is known, immunological protection is weakened in all pregnant women, which is necessary to prevent rejection of the fetal egg as a foreign body. The body's defenses are restored on the 5th - 6th day after childbirth, which ended naturally, and on the 10th day after abdominal delivery. Therefore, all puerperas are threatened by the development of inflammatory diseases of the reproductive system.

But there are a number of factors that predispose to the occurrence of postpartum endometritis:

Symptoms of acute endometritis

Subacute endometritis is more often diagnosed later, after discharge from the hospital.

• A woman can only note that the discharge continues to be bloody until 10-12 days.
• The temperature can rise both slightly and up to febrile numbers.
• The discharge after childbirth becomes purulent and acquires an unpleasant odor when the woman ignores the previous signs only after 3 to 5 days.
• In any case, postpartum endometritis is an indication for hospitalization.

In a hospital, a woman is required to exclude or identify remnants of placental tissue, membranes and blood clots and then remove them from the uterus by vacuum aspiration or curettage. Diffuse washing of the uterine cavity with antiseptic solutions and antibiotics is prescribed (minimum amount 3). Then parenteral administration of antibiotics is indicated.

The child has grown up, but what about mom?

As already mentioned, normally, lochia after the birth of a child stops by the end of 3-4 weeks. If a woman does not breastfeed, then her menstrual cycle is restored, which can be seen by the nature of the discharge. At first there were mucous, moderate, then (about a month or 2 after childbirth) the leucorrhoea became plentiful and similar to the protein of a raw egg for 2 to 3 days, which indicates ovulation.

Therefore, it is important to resolve all questions about postpartum contraception in advance with your doctor. If the mother is nursing, then by the time the child is a month old, her discharge becomes moderately mucous, without an unpleasant odor, and does not change its character throughout the entire stage of breastfeeding.

But in a situation where yellow discharge appeared after childbirth (after the end of lochia), the mother needs to be wary. Especially if such whites have a pronounced yellow color, they have an unpleasant odor, and the woman herself is worried about itching and discomfort in the vulva or vagina. Of course, it is necessary to visit a doctor as soon as possible, and not postpone the visit to him "for later."

Only a doctor will be able to determine the cause of pathological leucorrhoea, take a smear on the microflora of the vagina and recommend the appropriate treatment (see). At best, if yellow discharge turns out to be a sign (the genital tract of a woman who has given birth is very vulnerable to infection, and the body itself is weakened by pregnancy, childbirth and child care). If, in addition to yellow discharge and the signs listed above, a woman is also worried about subfebrile temperature, as well as pain in the lower abdomen, then it is all the more impossible to delay, since it is possible that there is an inflammatory process in the uterus or in the appendages.

Hygiene of the postpartum period

In order for the uterus to contract and return to its normal "pre-pregnant" size, it is necessary to follow simple rules after childbirth:

• it is desirable to sleep on the stomach, which creates pressure on the uterus and contributes to its contraction, and also positions the uterus and cervix along the same axis, as a result of which the outflow of lochia improves
• go to the toilet at the first call of your body, and not postpone this event (a full bladder and rectum prevent uterine contractions)
• regular change of pads (no later than two hours, since lochia is an excellent breeding ground for bacteria, which creates a risk of infection of the genital tract)
• categorical ban on tampons in the postpartum period
• wash at least twice a day with boiled water, you can use a weak solution of potassium permanganate
• adhere to free feeding, when the baby is applied to the breast on demand (stimulation of the nipples promotes the synthesis of oxytocin)

For several weeks after childbirth, while the uterine mucosa (endometrium) is being restored, the young mother retains discharge from the genital tract. What are these secretions and in what case can they become a sign of trouble?

Discharge from the genital tract of a woman after childbirth is called lochia. Their number decreases over time, which is explained by the gradual healing of the wound surface, which is formed on the endometrium after the separation of the placenta.

Lochia consist of blood cells (leukocytes, erythrocytes, platelets), plasma, sweating from the wound surface of the uterus, dying epithelium lining the uterus, and mucus from the cervical canal. Over time, the composition of lochia changes, so their color also changes. The nature of the lochia should correspond to the days of the postpartum period. In the first days after childbirth (4-5 days after vaginal delivery and 7-8 days after caesarean section), the woman is in the maternity hospital in the postpartum department under the supervision of medical personnel. But after a woman is discharged home, she controls her condition herself, and her task is to see a doctor if necessary. The amount and nature of discharge can say a lot, and it is important to notice alarming symptoms in time.

Allocations after childbirth in the rodblok

The first 2 hours after the birth, the woman is in the maternity unit - in the same box where the birth took place, or on a gurney in the corridor.

It is good if the discharge immediately after childbirth is bloody, quite plentiful, constitutes 0.5% of body weight, but not more than 400 ml, does not lead to a violation of the general condition.

To prevent postpartum hemorrhage, immediately after childbirth, the bladder is emptied (urine is removed through the catheter), ice is placed on the lower abdomen. At the same time, drugs are administered intravenously that reduce the muscles of the uterus (Oxytocin or Metilegrometril). By contracting, the uterus closes off the open blood vessels at the site of the placenta, preventing blood loss.

Note! In the first two hours after childbirth, a woman is in the maternity ward under the supervision of medical personnel, because this period is dangerous for the occurrence of so-called hypotonic uterine bleeding, which is caused by a violation of the contractile function of the uterus and relaxation of its muscles. If you feel that the bleeding is too heavy (the diaper is wet, the sheet is wet), you should immediately tell one of the medical staff about this. It is important to know that while the woman does not experience any pain, however, bleeding quickly leads to weakness, dizziness.

Also, in the first 2 hours, bleeding may occur from ruptures in the tissues of the birth canal if they have not been sutured, so it is important that the doctor carefully examine the vagina and cervix after childbirth. If some gap was not completely sutured, a hematoma (limited accumulation of liquid blood in the tissues) of the perineum or vagina may occur. At the same time, a woman may experience a feeling of fullness in the perineum. In this case, it is necessary to open the hematoma and re-suturing the gap. This operation is performed under intravenous anesthesia.

If the first 2 hours after childbirth (early postpartum period) have passed safely, the woman is transferred to the postpartum ward.

Discharge in the postpartum ward

Well, if in the first 2-3 days the lochia are bloody, they are quite plentiful (about 300 ml in the first 3 days): the pad or diaper is completely filled within 1-2 hours, the lochia can be with clots, have a rotten smell like menstrual flow. Then the number of lochia decreases, they become dark red with a brown tint. Increased discharge during movement is normal. In the postpartum department, the doctor makes a daily round, where, among other indicators of the woman's condition, he assesses the nature and amount of discharge - for this, he looks at the discharge on a diaper or pad. In a number of maternity hospitals, they insist on the use of diapers, since it is easier for the doctor to assess the nature of the discharge. Usually, the doctor asks the woman the amount of discharge during the day. In addition, in the first 2-3 days, discharge may appear on palpation by the doctor of the abdomen.

To prevent postpartum hemorrhage, it is important to follow the following recommendations:

• Empty your bladder promptly. On the first day, you must go to the toilet at least every 3 hours, even if you do not feel the urge to urinate. A full bladder prevents the uterus from contracting normally.
• Breastfeed your baby on demand. During feeding, the uterus contracts as irritation of the nipples triggers the release of oxytocin, a hormone produced by the pituitary gland, an endocrine gland located in the brain. Oxytocin has a contracting effect on the uterus. In this case, a woman may feel cramping pains in the lower abdomen (in multiparous they are stronger). Allocations during feeding intensify.
• Lie on your stomach. This is not only the prevention of bleeding, but also prevents the retention of secretions in the uterine cavity. After pregnancy and childbirth, the tone of the abdominal wall is weakened, so the uterus can deviate backward, which disrupts the outflow of secretions, and in the position on the abdomen, the uterus approaches the anterior abdominal wall, the angle between the body of the uterus and the cervix is ​​eliminated, the outflow of secretions improves.
• Put an ice pack on the lower abdomen 3-4 times a day - this measure helps to improve the contraction of the muscles of the uterus, uterine vessels.

Women whose uterus was overstretched during pregnancy (in pregnant women with a large fetus, in multiple pregnancies, in multiparous women), as well as those who had complications (weak labor, manual separation of the placenta, early hypotonic bleeding) in the postpartum period, the drug Oxytocin is prescribed intramuscularly for 2-3 days, so that the uterus contracts well.

If the amount of discharge has increased dramatically, you should definitely consult a doctor.

Note! If the amount of discharge has increased dramatically, you should definitely consult a doctor, as there is a risk of late postpartum hemorrhage (late postpartum hemorrhage includes those bleeding that occurred 2 or more hours after the end of childbirth). Their reasons may be different.

Bleeding may be due to retention of parts of the placenta if it was not diagnosed in time (in the first 2 hours after birth). Such bleeding can occur in the first days or even weeks after childbirth. The share of the placenta in the uterus can be detected by vaginal examination (if it is located close to the internal os and the cervical canal is passable) or by ultrasound. In this case, the share of the placenta from the uterus is removed under intravenous anesthesia. In parallel, infusion therapy (intravenous drip of fluids) is carried out, the volume of which depends on the degree of blood loss, and antibiotic therapy to prevent infectious complications.

In 0.2-0.3% of cases, bleeding is due to disorders in the blood coagulation system. The causes of these disorders can be various blood diseases. Such bleeding is the most difficult to correct, therefore, preventive therapy, begun even before childbirth, is very important. Usually, a woman is aware of the presence of these disorders even before pregnancy.

Most often, hypotonic bleeding occurs due to insufficient contraction of the muscles of the uterus. In this case, the bleeding is quite plentiful, painless. To eliminate hypotonic bleeding, reducing drugs are administered, blood loss is replenished with the help of intravenous fluid, in case of severe bleeding - blood products (plasma, erythrocyte mass). If necessary, surgical intervention is possible.

When you stop the discharge, you should also consult a doctor. A complication of the postpartum period, characterized by the accumulation of lochia in the uterine cavity, is called a lochiometer. This complication occurs due to overstretching of the uterus and its bending backwards. If the lochiometer is not removed in time, endometritis (inflammation of the uterine mucosa) may occur, because postpartum discharge is a breeding ground for pathogens. Treatment consists in prescribing drugs that reduce the uterus (Oxytocin). In this case, it is necessary to eliminate the spasm of the cervix, for which No-shpu is administered 20 minutes before Oxytocin.

postpartum discharge at home

It is good if the postpartum discharge lasts 6-8 weeks (this is how long it takes for the reverse development of the uterus after pregnancy and childbirth). Their total amount during this time is 500-1500 ml.

In the first week after childbirth, the discharge is comparable to normal menstruation, only they are more abundant and may contain clots. Every day the number of discharges decreases. Gradually, they acquire a yellowish-white color due to the large amount of mucus, may be mixed with blood. Approximately by the 4th week, scanty, "smearing" discharges are observed, and by the end of the 6-8th week they are 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 passes faster. At first, there may be cramping pains in the lower abdomen during feeding, but within a few days they pass.

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

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

During the entire period while the discharge continues, you need to use pads or liners. 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 they better show the nature of the discharge. Pads with fragrances are not recommended - their use increases the risk of allergic reactions. While you are lying down, it is better to use diaper pads so as not to interfere with the release of lochia. You can put a diaper on so that the discharge comes out freely, but does not stain the laundry. Tampons should not be used, as they prevent the removal of vaginal discharge, instead absorbing it, which can lead to the growth 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 should be washed from the outside, but not inside, in the direction from front to back. You can not douche, because this way you can bring the infection. For the same reasons, it is not recommended to take a bath.

With heavy physical exertion, the amount of discharge may increase, so do not lift anything heavy.

You should seek medical help in the following cases:

• The discharge acquired an unpleasant, pungent odor, purulent character. All this indicates the development of an infectious process in the uterus - endometritis. Most often, endometritis is also accompanied by pain in the lower abdomen and fever,
• Abundant bleeding appeared after their number had already begun to decrease or bleeding does not stop for a long time. This may be a symptom that parts of the placenta that have not been removed have remained in the uterus, which interfere with its normal contraction,
• The appearance of curdled discharge indicates the development of yeast colpitis (thrush), while it may also appear in the vagina, redness sometimes occurs on the external genitalia. The risk of this complication is increased when taking antibiotics,
• Postpartum discharge abruptly stopped. After a caesarean section, complications are more common than after a natural birth.
• For heavy bleeding(several pads per hour) you need to call an ambulance, and not go to the doctor yourself.

Restoration of the menstrual cycle after childbirth

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

Discharge after childbirth is called lochia. These discharges are dead particles of the endometrium, as a result of detachment of the placenta from it. As a rule, the first 2-5 days after the birth of a child (it does not matter if he was born naturally or as a result of a caesarean section), the discharge is bright red, very abundant (more abundant than during menstruation). It is difficult to manage with ordinary sanitary pads; you need to purchase special postpartum ones. At the time of discharge from the hospital (5-7 days), vaginal discharge becomes less abundant and acquires a brown tint.

And how long does the discharge after childbirth normally last? Everyone is different. It depends on how well the uterus will contract, as well as on the characteristics of the course of pregnancy and childbirth. For more intense uterine contractions in many maternity hospitals, women in labor are injected with Oxytocin for the first three days (although this is not necessary). How well the uterus contracts can be seen both visually and on ultrasound. Someone leaves the maternity hospital with an impressive tummy at 6 months of pregnancy, while someone else's abs begin to appear. Normally, the discharge already stops a month after the birth, the maximum "daub" can last 6 weeks after the birth of the child. If the process drags on, or the bleeding becomes strong again, it is urgent to contact the antenatal clinic and do an ultrasound.

Slow postpartum involution (reduction, recovery) of the uterus may indicate an inflammatory process. Also, slow recovery is often observed if there are fibromatous nodes in the uterus, with infantilism, backward bending of the organ, reduced blood clotting, and other pathologies. If you suddenly start bleeding heavily - this may be a symptom that part of the placenta remains inside, in which case the uterus is “cleansed” in a hospital setting. By the way, it has been noticed that the uterus contracts faster and returns to normal in women who are breastfeeding at the request of their babies (during feeding, the hormone oxytocin starts the process of uterine contractions); with timely emptying of the bladder; when lying on the stomach (this condition is not met by everyone, since after childbirth the abdominal wall hurts quite a lot).

A dangerous symptom, if the discharge after childbirth has an unpleasant smell, plus fever, chills have joined in - this can be a sign of a serious inflammatory process (postpartum discharge is a wonderful breeding ground for pathogens), infection. Sometimes such discharge after childbirth occurs due to the obstetrician or doctor "forgetting" a cotton swab in the woman's vagina. It is not necessary to ignore the yellow discharge after childbirth or white cheesy, the latter may indicate a relapse of candidiasis (thrush).

It is very important for the prevention of the inflammatory process to observe personal hygiene. It is advisable to change the pads more often, and the postpartum pads should not be scented, as for this reason allergic reactions may occur. While there is spotting after childbirth, you should not take a bath, only a shower. You can wash yourself periodically with decoctions of healing, safe herbs, for example, chamomile. But with manganese, you need to be more careful (manganese is recommended to process sutures on the genitals after an episiotomy), since at its high concentration in water, you can get a burn of the mucous membrane.

Every woman looks forward to the birth of her baby. In each case, the process of childbirth is different: the natural passage of the fetus through the birth canal (with or without ruptures) or the child can be born with the help of doctors performing a caesarean section. But regardless of the course and result of the process, the representatives of the weaker sex have discharge after color, smell - the article will tell about everything. You will learn about the signs of pathologies that occur in women after the birth of a child.

What is postpartum discharge?

The final stage of the birth process is the separation of the placenta or baby's place. This happens almost immediately after removing the baby and cutting the umbilical cord. The place from which the placenta separated remains a wound surface, which, accordingly, begins to bleed.

Postpartum discharge is called lochia. They have a slightly different nature of origin than ordinary menstruation. The duration of lochia also differs from menstruation. During the period of stay in the maternity hospital, specialists examine women daily. Attention is drawn to the color and consistency of the discharge, as well as the presence or absence of an unpleasant odor.

Immediately after childbirth

What discharge should be after childbirth in the first hours? Immediately after the removal of the placenta, the woman begins an active contraction of the uterus. To enhance the effect, obstetricians put the baby to the chest. Sucking movements and stimulation of the nipples contribute to the contraction of the organ.

After giving birth, the woman is in the maternity ward for several hours. A heating pad with ice and a press are placed on her stomach. This is necessary to prevent severe bleeding. The volume of outgoing blood should not exceed 500 milliliters. Allocations during this period of time have a pronounced bloody character with an admixture of mucus and clots. This is how the remnants of the placenta and membranes that have not been removed come out.

The smell of secretions in the first hours

What should be the discharge after childbirth by smell? In the first hours, a woman may feel a stench. In many ways, this is facilitated by the influence of the hormonal background, because after the removal of the baby, the active production of oxytocin and prolactin begins. Therefore, the newly-made mommy becomes more sensitive.

You don't have to worry about these sorts of things. Until you are transferred to the postpartum ward, the doctors keep a close watch on you. If something goes wrong, the doctors will definitely take action. But in most cases, the discharge is normal, and the woman is in her room 2-3 hours after natural childbirth without complications.

First few days

Many women ask themselves: after pregnancy, what should they be like? During the first few days after the birth of the child, there is an intensive discharge of lochia. During this period, the birth canal of a woman is open, so regular hygiene procedures must be carried out to avoid infection. If the infection has occurred, then the woman will definitely notice it. What discharge after childbirth is abnormal, you can find out further.

Lochia in the first 5-7 days have a rich red or burgundy hue. They are quite thick and there is an admixture of mucus. Some women find pieces or clots. This is also the norm. During the first week of putting the baby to the breast, the mother may feel a slight pain in the lower abdomen. These sensations are vaguely reminiscent of contractions. Thus, the contraction of the uterus occurs - this is the norm.

After Discharge: First Days at Home

What color should be the discharge after childbirth in a week? Immediately upon arrival home, a woman may notice a change in the nature of the discharge. One week has passed since the birth. The bleeding wound, which was in place of the placenta, gradually heals. The uterus returns to normal size, but still extends beyond the small pelvis.

In the second week, lochia becomes smaller. They gradually lighten, and there is no longer that intense red color. There is also a gradual thinning of the mucus. If in the maternity hospital a newly-made mother had to change the pad every 2 hours, now a disposable hygiene product is enough for 4-5 hours. Subject to personal hygiene, there is no unpleasant odor in the discharge.

By the end of the month

Many are interested: by the end of the fourth week, what should be the discharge? go on for quite some time. It would seem that a whole month has already passed, and the discharge does not end. This is fine. Worse, if the lochia stopped after two weeks or even earlier.

During this period, a woman can use thin sanitary pads. The volume of allocations continues to decrease. They brighten, approaching the sucrose color. The uterus has almost completely returned to normal size. The woman does not feel pronounced contractions and pain. Allocations by the end of the first month have no smell. The birth canal is completely closed, but, as before, regular personal hygiene must be observed.

End of period

And what allocation should be? It is rather difficult to answer this question directly and unambiguously. Much depends on the woman herself: her individual characteristics, the course of childbirth, physical and emotional state.

Lochia usually lasts for 6-8 weeks. But normally, they can be completed within 4-5 weeks after the birth of the child. In the last 7-10 days, the discharge becomes brown or yellowish and has a slimy consistency. They do not have any smell with the timely change of hygiene products. Already after a few days, lochia completely takes on the form of transparent mucus, which turns into normal, natural secretions corresponding to the day of the menstrual cycle.

Caesarean section: features of postpartum discharge

What discharge should be after childbirth, carried out by caesarean section? Doctors say that the way the baby appears does not affect the character of lochia. But after a cesarean section, the volume of blood can be increased, as the vessels of the uterus are injured. That is why after such an operation a woman with a baby is discharged only for 7-10 days.

After a caesarean section, a newly-made mother needs to carefully monitor her well-being and discharge. This group of women is more likely to develop complications and pathologies. If you're worried about the color or texture of lochia, or about how big it is, talk to your doctor during your daily checkup.

Pathological process

What should be the discharge after childbirth, you already know, but it will not be superfluous to find out everything about the pathological processes of this period.

• If there is a premature cessation of lochia, then this indicates the presence of interference. Perhaps there is a large clot in the uterus that blocks the exit of mucus. An inflection of the uterus may also occur, as a result of which blood accumulates in the region of its bottom. In the presence of a septum, adhesions or neoplasms, such cases are more common.
• mucous secretion may indicate uterine perforation or poor blood clotting. This phenomenon can be life-threatening, therefore, it requires timely intervention. Any damage and rupture of the birth canal should be repaired immediately.
• The appearance of curdled clots and a sour smell indicates thrush. This phenomenon is often encountered by women who have recently given birth. Candidiasis is not particularly dangerous, but brings a lot of discomfort. Therefore, it is necessary to carry out appropriate therapy.
• Inflammatory processes often occur in parturient women. What discharge should be after childbirth in such a situation? Mucus becomes cloudy. At the final stages, purulent inclusions can be detected. Also, the woman notes the presence of an unpleasant odor, itching or pain.

All pathological processes should be immediately eliminated. Some require medical treatment, while others require surgery. If you are concerned about unusual discharge: very scanty or, on the contrary, abundant, having an unpleasant odor and color, consult a gynecologist. It is necessary to call a doctor immediately in case of weakness, fainting, fever, pressure drop.

Drawing conclusions

Every woman has discharge after childbirth. How many go, types, norm and pathology are described for you in the article. Doctors recommend using special sterile pads for women in labor in the early days. Throughout the entire period of the presence of lochia, it is forbidden to use tampons, since these hygiene products can cause infection. Observe hygiene conditions after childbirth, monitor your well-being and the amount of discharge.

After the end of the lochia, the discharge becomes habitual. Subsequent menstruation can begin both a month later and after the cessation of lactation. Be sure to check what discharge should be after childbirth with your gynecologist even before the baby appears. Good luck and easy delivery!

As soon as the long-awaited baby was born, the mother tries to surround him with care from all sides, sometimes forgetting that her body also needs increased attention. At this time, the hormonal background, the tone of the uterus, the abdominal wall are restored, and any deviations from the norm can become life-threatening. How to determine if everything is fine in the body of a woman who has given birth to a child?

In the first months, much can be judged by lochia. So called postpartum discharge from the genital tract. How much is the discharge after childbirth? What is considered normal? Is yellow discharge after childbirth harmless? How to understand what problems need to be treated by changing the number or duration of lochia?

Normal lochia

There are certain standards by which to judge whether lochia is normal or if it indicates a need for urgent medical attention. The characteristics of the discharge should correspond to the period that has passed since the birth.

In the early days, when the woman is still in the hospital, the condition of lochia should be monitored by a doctor. But if he didn’t pay attention to something, it’s better to ask again than to leave the problem unnoticed. And after discharge, the entire responsibility for observing how the postpartum discharge changes falls on the woman in labor herself. Therefore, she also needs to be able to distinguish between the norm and pathology, to know how long lochia should go and at what intervals their appearance will change.

Duration and quantity

To understand how much discharge goes after childbirth, you need to figure out why they appear. First, the remnants of the placenta and waste products of the fetus depart, then blood and lymph are released from the damaged inner layer of the uterus. Its recovery lasts approximately 40-50 days. Accordingly, the same amount of time - from 6 to 8 weeks - continues lochia after childbirth.

The intensity of the discharge depends on how much time has passed since the birth:

• The first two hours, when the woman in labor must still be in the maternity ward under the close supervision of a doctor, are especially dangerous. There are many secretions, in relation to body weight they are approximately 0.5%, but not more than 400 ml. Large losses will certainly affect the general condition.
• Another 2 or 3 days of lochia continue to be plentiful - 300 ml in 3 days. At this time, it is better to use lined diapers, rather than pads, so that it is easier for the doctor to assess the volume of lochia.
• The next week, the amount of discharge is approximately the same as during menstruation. Every day their volume is gradually decreasing. For hygiene purposes, it is more convenient to use ordinary pads with a high degree of moisture absorption, rather than diapers. But it is strictly contraindicated to use tampons.
• When the first month after childbirth has passed, lochia should still be observed, but they are already very scarce.
• After 8, in extreme cases, 9 weeks, the allocation of lochia should stop.

How long the discharge lasts after childbirth depends on the severity of the body's ability to recover, the woman's nutrition, and the daily routine. They should not be too long (lasting more than 9 weeks) or too short (less than 5 weeks).

Color, smell and texture

The appearance of the discharge also depends on how long the lochia goes after childbirth and on their composition.

The norm of qualitative characteristics of postpartum discharge:

• The first few days they are liquid, bright red, with the smell of blood. This is due to the fact that they contain a large percentage of pure blood. Small blood clots and mucus may occur. Such lochia is considered normal for only a few days.
• By the middle of the first week, they should change color and become brown. The smell of lochia at this time is similar to normal menstruation.
• When a month has passed after the birth, the lochia becomes slimy, cloudy, grayish in color. Over time, they become smaller, and the color approaches transparent.

Towards the end of the postpartum period, the discharge is very scanty and mucous, the same as that of any healthy woman before pregnancy.

Signs of pathology

Any deviation from the parameters described above may indicate the presence of serious problems. Throughout the postpartum period, there is a risk of bleeding, infection of the genital tract or uterine cavity. In order to prevent the development of severe complications, it is important to know how many lochia are normal and consult a doctor at the first suspicion of pathological changes.

Possible deviations from the norm:

1. Reducing or increasing the duration of the release of lochia.
2. Abrupt cessation or increase in volume.
3. Allocations ended, and after a while they began again.
4. Color change.
5. The appearance of an unpleasant odor.
6. Change in consistency.

A doctor should be consulted in any case, even if only one characteristic has changed, for example, only the color has changed.

quantitative changes

The most common complication of the early postpartum period is the development of bleeding. In this case, it is felt that the diaper gets wet very quickly, you may feel a little dizzy. In this case, there is no pain. This condition can be caused by blood diseases or too weak uterine contractions. In order for stronger contractions to begin, drug therapy (an injection of a dose of Oxytocin) is necessary.

Deviations from the norm in a later period:

• If the remains of the placenta for some reason did not come out completely immediately after childbirth, bleeding may develop in a more distant period. Its sign will be a sharp increase in the volume of secretions.
• The abrupt cessation of lochia, especially if not even a month has passed since the birth, may be a sign that something is preventing them from coming out. It can be a back bend of the uterus, a spasm of the cervix, a neoplasm. In any case, this can lead to infection of the endometrium and the development of endometriosis.
• If lochia has not ended after 8 or 9 weeks after childbirth, you need to undergo an examination to find out why the endometrium is not recovering at the right rate.

Often, women in labor are happy when lochia quickly ends. But in fact, with normal recovery processes, the healing of the uterine mucosa occurs after at least 40 days. If lochia stops earlier, this should be alarming, not encouraging.

Color or odor changes

The color of lochia can suddenly change if some undesirable processes occur in the uterine cavity or in the cervix. Often, at the same time, especially if yellow discharge appears after childbirth, an unpleasant odor is felt. No matter how harmless such deviations may seem, any of them is a bad sign and cannot go away without medical attention.

Possible options for color change:

• Bloody discharge after childbirth is considered normal only in the first few days. If a week has passed after the birth, and they remain bright red, this is already a pathology, a sign of a violation of the healing of the epithelium or problems with hematopoiesis. If the lochia has already changed color, but then turned red again, there is a high probability that bleeding has opened.
• Black color scares women in labor the most. But it is relatively harmless, as it speaks of changes in the composition of the blood caused by the restructuring of the hormonal background.
• Yellow discharge after childbirth occurs when bacteria enter the uterine cavity and the development of endometriosis. A weak yellow tint of discharge after 2 weeks belongs to the varieties of the norm. Yellow discharge after childbirth is often accompanied by an unpleasant putrid odor.
• Green discharge after childbirth, mucous or purulent lochia is a sign that the infectious process is progressing, the inflammation is already running. In such a situation, there is a risk of developing sepsis. This is due to the fact that the infection can very easily enter the bloodstream through the endometrium, which has not yet recovered.
• The white color of the lochia, especially if they have become curdled, indicates an infection with a candida fungus. This discoloration may be accompanied by itching and burning in the genital area.
• Brown discharge after childbirth usually appears 3 or 4 days after childbirth and stops when 3 weeks or a maximum of a month have passed after childbirth. If more than a month has passed, and the brown discharge after childbirth has not become light, this may indicate a delayed regeneration of the endometrium.

Each of the changes listed above is dangerous for the health and even the life of a woman, so you should immediately consult a doctor. Remember, the baby needs a healthy mother who monitors both his condition and her own.

Allocations after 2 months

When 2 months have passed after childbirth, there should be no postpartum discharge. At this time, the risk of bleeding is already very low, especially if the postpartum period was successful and the discharge had stopped a long time ago. But what then does the discharge at this time mean?

After a woman has given birth to a child, her menstrual cycle is quickly restored. If she breastfeeds, ovulation is suppressed. But when the child is bottle-fed from the very beginning, periods can resume after 2-3 months. Therefore, mucous spotting 2 months after the birth of a child can be a normal menstruation.

If a woman is breastfeeding, the discharge that has reappeared does not look like a period, or there are any other reasons to doubt that there are no problems, it is better to consult your doctor. Such cooperation will help to successfully recover after pregnancy and happily raise a baby.