One week after birth, bleeding. What kind of discharge should there be after childbirth? What is discharge after childbirth

How long does lochia last after childbirth?

The mechanism of childbirth is a serious stress for the body. Fetal rejection is accompanied by a large number of unpleasant and sometimes dangerous phenomena for the woman in labor and for the baby. Possible:

• bleeding;
• incomplete expulsion of the placenta;
• numerous breaks.

A natural component of postpartum recovery is lochia (you can see what they look like in the photo). The contents of the uterus are gradually released, it is cleansed.

It’s worth finding out in advance how long the discharge lasts after childbirth, so that you can be prepared for it and be alert in time if something goes wrong. Note that after an artificial birth (caesarean section), lochia may last a little longer. After the second and third births, the uterus will contract faster.

1. What should they be?
2. Discharge after childbirth: normal
3. Yellow lochia
4. Green lochia
5. Brown and bloody lochia
6. Mucus discharge
7. Purulent lochia
8. White discharge
9. Pink discharge
10. Lochia after childbirth: norm and deviations (by day)

How long does bleeding last after childbirth?

Immediately after childbirth, the inner walls of the uterus are a continuous wound surface. It is easy to understand why so much bloody content is released in the first days after birth. The muscle layer of the uterus contracts, and naturally, under the influence of oxytocin, blood vessels contract, triggering blood clotting mechanisms and stopping bleeding. These are natural consequences of having a baby.

At first, the discharge can be called pure blood - at least that's what it looks like. This is fine. Their duration takes from 2 to 3 days. Everything that begins later no longer seems like bleeding - the nature of the lochia (as postpartum discharge is called) changes.

What kind of discharge should there be after childbirth?

To visualize how long the discharge lasts, how many days it takes, which ones should occur and in what period, let's look at the table. Bloody, bloody, dark brown, spotting, abundant, scanty - how long do they last and when do they stop?

Table 1.

Discharge after childbirth: normal

If a month has passed and nothing comes out of the uterus, you need to go to the doctor, even if you feel well. Has the nature of the discharge changed dramatically? Also a reason to visit a doctor. The normal duration of lochia separation is up to 8 weeks. Doctors say that the discharge goes away within 5 to 9 weeks - this also falls within the normal range. Lochia lasting 7 weeks is normal. Normal discharge after childbirth differs from those considered pathological in several ways.

These include:

• duration;
• character;
• the presence or absence of an unpleasant odor.

Discharge after childbirth with an unpleasant odor

The smell of discharge after childbirth is a significant characteristic of it. If we talk about the norm, then immediately after childbirth the discharge smells like blood. This is natural: the main component is blood. After 7 days, when the scarlet and brown discharge ends, the smell becomes musty.

You should be wary if there is discharge with an unpleasant odor; the reasons for this may lie in the disease. Women rate the smell differently: “Smelly”, “Smells bad”, “Smells rotten”, “Smells fishy”. All these are bad symptoms. Discharge, even light, with an unpleasant odor, is a reason to visit a doctor.

Yellow discharge after childbirth

When the bloody and brown lochia ends, they lighten and gradually acquire a yellowish tint. Normally they have almost no odor. Yellow discharge after childbirth 2 months later, not at all abundant, gradually becoming transparent, doctors attribute it to one of the options for normal healing of the uterus. Discharge of a distinct yellow color, which also bothers a woman with an unpleasant odor or some associated sensations - itching, burning - may indicate a disease.

They can be:

• yellow with a smell;
• liquid like water;
• jelly-like;
• smearing, sticky.

All of them require a medical examination. This kind of discharge can no longer be considered lochia - it is a sign of an infection in the body. Most often in this case they talk about the beginning - inflammation of the uterus. It needs to be treated at the earliest stages, when the temperature has not yet risen and the infection has not covered a large area of ​​the inner layer of the uterus.

Green discharge after childbirth

Green discharge after childbirth 2 months or earlier is a sign that something is wrong in the body. Lochia of this color is not normal at any stage. Greenish or yellow-green lochia indicates that there is a bacterial infection in the uterus, vagina, or fallopian tubes. If you do not deal with it in time, endometritis may begin - a disease that causes inflammation of the inner lining of the uterus.

They happen when:

• gardnellese;
• gonorrhea;
• chlamydia.

Trichomoniasis often causes discharge of this shade. Trichomonas settles in the vagina, and it is dangerous because if left untreated, the infection rises higher.

The first signs of trichomoniasis:

• green color;
• foamy character;

In addition, the woman will feel a burning sensation in the vagina and irritation. The mucous membranes may turn red. If you start treatment immediately, without delaying, you can quickly cope with the disease and prevent the infection from spreading further.

Brown and bloody discharge after childbirth

Bloody discharge should not last long. Bloody and dark red should end within a few days at the latest. The most dangerous hours are considered to be the first hours after the birth of the baby, when the uterus is still, in fact, a continuous bleeding wound. At this time, bleeding may occur. Doctors carefully monitor the condition of the woman in labor and send her to the postpartum ward, place an ice pack wrapped in cloth on the lower abdomen, give an injection of oxytocin, and put the baby to the chest. Intensive observation lasts 1.5-2 hours.

After a caesarean section, just like after a natural birth, bloody lochia is observed. Only the process of uterine involution may be slower due to the suture, and therefore they may last a little longer. After cleaning the uterus, if the placenta did not come out on its own, there will also be spotting.

Brown discharge after childbirth 2 months later is possibly a pathological reaction of the body. This is how the clotted blood comes out. There can be many reasons - from hormonal imbalance to menstruation that begins to recover (if the mother does not breastfeed), the nature of which may be unusual at first, since the hormonal background has changed. The reason may be .

If two months have passed after delivery and you notice spotting, even if the baby is breastfed, you need to consult a doctor. Either a new menstrual cycle begins, or a serious inflammatory process occurs. Moreover, it may not even be accompanied by pain.

Possible presence of tumors, polyps, appearance. When the discharge stops and suddenly starts again, this is a reason for examination in any case. If it is confirmed that this is menstrual flow, you need to protect yourself. You need to know that with the restoration of the cycle appear. During menstruation, the amount of milk may decrease. You need to be patient and continue breastfeeding. Use supplementary feeding only in extreme cases.

Mucous discharge after childbirth

It is normal to have a small amount of mucus discharge a week after the baby is born. At this time, the mother’s body, or rather the uterus, continues to cleanse itself, and the work of the mucous membranes of the genital organs, which produce mucus, is restored. Over the next week their volume decreases.

Further, the appearance of mucous discharge, when the lochia has almost disappeared, may indicate ovulation. At the same time, they are thick mucous, similar to egg white. If the mother is breastfeeding, but has already introduced complementary foods, ovulation can most likely occur within 2-3 months. In non-breastfeeding women, the process of egg maturation begins again after the second month or even earlier. Pregnancy during this period is extremely undesirable - after all, the body has not yet returned to normal, so it is necessary to carefully protect yourself. Yellow mucous discharge may indicate an infection. Has the mucus discharge increased or acquired an unpleasant odor? Contact your doctor.

Purulent discharge after childbirth

An extremely dangerous symptom is purulent discharge after childbirth, whenever it occurs: after a month, after 3 months, after 7 weeks. Purulent discharge is one of the leading symptoms of inflammation. Possible endometritis or salpino-oophoritis.

In this case, it is often noted:

• weakness;
• fatigue;
• headache;
• lower abdominal pain;
• hyperthermia – increased body temperature.

White discharge after childbirth

White discharge after childbirth is a sign of thrush, which tends to worsen with any fluctuations in immunity. The main symptom of thrush is the curdled consistency of the discharge. There is no point in delaying its treatment: in itself it is not dangerous, but it can provoke the penetration of inflammation along the ascending path, and then a bacterial infection is likely to occur. Untreated candidiasis causes significant discomfort to the mother.

Thrush is difficult to confuse with other diseases: it manifests itself in addition to the characteristic cheesy discharge with a sour odor, itching and burning, as well as constant irritation in the vaginal area. Why doesn't this discharge go away on its own? The body is weakened, it is difficult for it to cope with the multiplying fungus, the local immunity cannot cope - help is needed. The appearance of discharge with the smell of fish indicates dysbiosis and the appearance of gardnerella. Gardnerella is an opportunistic organism that is constantly present on the vaginal mucosa. But under favorable conditions, its reproduction is not inhibited, and itching and odor appear. Often its reproduction occurs against the background of thrush.

Pink postpartum discharge

Discharge of a pinkish tint may be due to the presence of erosion, minor injuries to the genital tract that occurred during childbirth, or diseases such as the uterus, suture dehiscence. In any case, you should visit a doctor to determine the cause.

Lochia after childbirth: norm and deviations by day

It may be easier for you to understand whether everything is proceeding within normal limits if you refer to the following summary table.

Table 2.

When does the discharge end after childbirth?

A woman must know when the discharge passes after childbirth - then she will be able to detect any problems in time. Normally, this happens after 8, in extreme cases – 9 weeks. Discharge for more than 2 months is rare. Usually by this time doctors lift the ban on sex. At the same time, nothing should be released from the woman’s reproductive tract. Any strange leucorrhoea or blood that appears during or after sexual intercourse is a reason to contact a gynecologist.

In order to reduce the likelihood of infection entering the uterus, a woman should maintain careful hygiene throughout the postpartum period:

• wash yourself daily (you can wash with plain water);
• change pads every 2-3 hours;
• do not use tampons.

Bloody lochia and the duration of its appearance should not be scary; rather, the sudden cessation of discharge and the appearance of an unpleasant odor should be alarming. Be patient a little: it just seems like it’s taking so long. Soon (in a month and a half) your body will recover, you will feel better, and you will be able to calmly enjoy the happiness of motherhood.

Within a few weeks after the birth of the child, the woman’s uterus is restored to normal, the remains of the dying endometrium are removed, and the surface of the wound at the site of the placenta heals. A woman’s successful recovery or the appearance of any complications can be judged by the nature of the discharge from the genitals. It is important to know what they should be normally. In this case, the duration and abundance of discharge, as well as its color, smell and consistency, matter. In case of trouble, you should consult a doctor as soon as possible.

Content:

What should lochia be like?

The discharge that occurs in a woman after giving birth is called lochia. Their appearance is caused by the fact that during childbirth, damage occurs to the mucous membrane and vessels of the uterus, especially at the site of attachment of the placenta. Discharge after childbirth is associated with the cleansing of the uterus from the remnants of the fetal bladder, exfoliated epithelium, and blood clots. They also contain mucus produced in the cervical canal.

Lochia exists until the wound in the uterine cavity heals and it returns to its normal state (the size is restored, the epithelium is renewed). If the process of cleansing the uterine cavity goes without complications, then lochia stops after about 5-8 weeks.

How long the cleansing of the uterus continues and lochia forms depends on the following factors:

• the ability of the uterus to contract (individual for each woman);
• woman’s age, condition of uterine tissue;
• blood clotting, state of the hematopoietic system;
• physical activity of a woman;
• lactation.

In appearance, lochia in the first 3 days resembles menstruation. Their volume gradually decreases from 500 ml to 100 ml per day.

Video: What is discharge like during the postpartum period?

Types of normal postpartum discharge

Bloody lochia. The first postpartum discharge is bright red and smells like fresh blood. Consist of blood clots and particles of dead tissue. The color is due to the high content of red blood cells.

Serous lochia. Lighter brownish-pink discharge appears around day 4. The content of red blood cells decreases, but the number of leukocytes increases. The discharge has a musty smell.

White lochia. The discharge becomes yellowish-white on the 10th day after birth. They have a more liquid consistency. There is no smell. Gradually they become more and more scanty and smearing. After 5-6 weeks, they already contain only mucus from the cervical canal of the cervix.

Contractions of the uterus, causing the removal of lochia from its cavity, lead to the appearance of pain in the lower abdomen in women in the first days after childbirth. The pain resembles contractions. Moreover, the pain is more severe after repeated births.

Sometimes women develop black lochia after the 3rd week. If there are no painful symptoms or unpleasant odor, then such discharge is not considered a pathology. They can appear as a result of hormonal processes occurring in the body and changes in the composition of mucus secreted by the glands of the cervical canal of the cervix.

Postpartum uterine bleeding and its causes

In the first 2 hours after birth, there is a risk of severe uterine bleeding (hypotonic), which can be caused by poor contraction of the uterine muscles after it relaxes during pregnancy. To prevent this from happening, the woman is given a drug to increase uterine contractility (oxytocin). In addition, the bladder is emptied through the catheter and a heating pad with ice is placed on the lower abdomen. During contraction of the uterus, damaged blood vessels are compressed, dangerous blood loss is prevented, the signs of which are increasing weakness, dizziness, and headache.

The cause of continuous bleeding in the first hours after the birth of the child can also be cervical ruptures if they went unnoticed or were poorly sutured. In this case, local hemorrhages occur in the tissues of the vagina and perineum. If there is bleeding, the doctor, after a careful examination, discovers and opens these hematomas, and re-sutures the tears.

The consequence of uterine bleeding is anemia - a lack of hemoglobin, a violation of the oxygen supply to the body tissues. If a woman in this condition breastfeeds her child, then he will also develop anemia.

Prevention of postpartum hemorrhage

The contraction of the uterus and the reduction of blood discharge after childbirth is facilitated by frequent emptying of the bladder.

It is important to breastfeed your baby. When the nipples are irritated, oxytocin is produced, a pituitary hormone that increases uterine contractions. During feeding, this causes the woman to experience pain in the lower abdomen, reminiscent of contractions. Moreover, the pain is stronger in those women who have already given birth before.

If bleeding persists, cool the lower abdomen with ice.

The danger of stagnation of secretions in the uterus

Medical help should be sought urgently not only if a woman is bleeding too heavily, but also if the bleeding suddenly stops completely after a few days.

Stagnation of lochia in the uterus is called lochiometra. If it is not eliminated, inflammation of the endometrium (endometritis) may occur. The absence of lochia is a symptom of a serious postpartum complication. To achieve restoration of bleeding, the woman is injected with oxytocin, which enhances contractions, and no-shpa is administered to relieve cervical spasm.

In order to avoid stagnation of secretions in the uterus, it is useful for a woman to lie on her stomach. Due to weakening of the abdominal muscle tone after pregnancy and childbirth, the uterus tilts back, and the outflow of blood is disrupted. When a woman lies on her stomach, the uterus takes a position in which the outflow improves.

Pathological discharge during postpartum complications

Signs of complications during this period are:

1. Yellow color and strong unpleasant odor of discharge. They indicate either stagnation of lochia in the uterus and their suppuration, or an infectious infection of the woman during childbirth. The inflammatory process in the uterine mucosa (endometritis) is usually accompanied by fever and pain in the lower abdomen. If you postpone a visit to the doctor for a long time, then due to the appearance of pus in the discharge, it turns green.
2. After childbirth, bleeding increases instead of decreasing. Sometimes they reappear. This happens even 2 months after the birth of the child. It is possible that this is the first menstruation (the likelihood of early menstruation is high in women who do not breastfeed). However, often such discharge indicates incomplete removal of the placenta from the uterus, due to which its contractions are difficult.
3. White, cheesy discharge may appear if a woman takes antibiotics for health reasons, which provoke a deficiency of lactobacilli in the vagina and the appearance of thrush. A woman is bothered by itching and burning in the external genitalia and vagina.

Video: Thrush, treatment methods

Factors contributing to the occurrence of endometritis

During pregnancy and childbirth, a woman's immunity sharply decreases. This provokes the occurrence of an inflammatory process in the endometrium of the uterus after childbirth. The body's resistance to infections begins to increase by the end of the first week in women who gave birth naturally and on the 10th day after cesarean section.

The likelihood of endometritis increases if a woman has other serious diseases (endocrine glands, kidneys, respiratory tract). The occurrence of endometritis is promoted by obesity, anemia, vitamin deficiency, and smoking. In addition, inflammation often occurs in women who have had many abortions or had curettage for medical reasons.

Sometimes the cause of stagnation of lochia and the occurrence of an inflammatory process is the low location of the placenta in the uterus, when the exit to the cervical canal is blocked. If labor continues too long after your water has broken, there is also an increased risk of endometritis.

Treatment of this disease is carried out only in a hospital. Antibiotics and uterine contraction enhancers are used. Disinfecting solutions are injected into the cavity. In some cases, vacuum aspiration or curettage of the uterus is performed to completely remove the endometrium.

Discharge after caesarean section

Bleeding lasts longer and complications occur more often if a woman gives birth by Caesarean section. Contractility of the uterus is hampered due to the suture and swelling of the surrounding tissues. The risk of infection during childbirth and inflammation of the mucous membrane of the uterine cavity increases.

However, despite the peculiarities of this method of delivery, spotting after childbirth should appear within 2 weeks, but no more. Just like during normal childbirth, the color of the discharge gradually changes from bright red to pale brown, and then turns white.

Normal menstruation after a cesarean section occurs at about the same time as after the birth of a child naturally. They occur later if the woman has had postpartum complications (uterine bleeding, endometritis, blood poisoning) or has diseases of the thyroid gland or liver.

Video: Features of discharge after cesarean section

Prevention of complications

In order to reduce the risk of complications after childbirth, a woman’s condition should be monitored by a doctor from the very beginning of pregnancy. Regular examination allows you to monitor your blood composition, detect and treat gynecological and other diseases, and strengthen your immune system.

If after the onset of labor it turns out that uterine contractility is insufficient, then drugs that enhance labor are used. They also help speed up the cleansing of the uterine cavity after the birth of a child.

In order to avoid stagnation of secretions in the uterus, a woman is recommended to begin getting out of bed and walking within 4-5 hours after a normal birth. After a caesarean section, this can be done after 10 hours.

Before discharge from the hospital, an ultrasound is performed to study the condition of the uterine cavity and assess its size in order to monitor the recovery process. For several weeks, the woman is recommended to rest more and avoid activities related to abdominal tension and heavy lifting.

Compliance with the rules of hygienic care of the body and genitals (frequent washing with warm water, daily bathing in the shower) is of great importance.

Warning: The woman should not take a bath for several weeks. Warming up the body, firstly, increases blood flow, and secondly, with such bathing, the likelihood of infection in the internal genital organs increases.

Douching during this period can cause great harm. It also contributes to the rapid spread of infection and the occurrence of endometritis.

On the first day, it is recommended to use diapers instead of sanitary pads to avoid leakage. In addition, it is easier to monitor the nature and volume of discharge. In the future, the gaskets must be changed at least every 2 hours.

The use of tampons is strictly prohibited during the entire period of lochia's existence. By blocking the exit from the uterus, they delay the outflow of secretions and the recovery process, creating a greater threat of an inflammatory process.

If there is a sudden change in the nature of the discharge, increased pain in the lower abdomen, increased body temperature, or dizziness, the woman requires urgent medical attention.

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

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

Lochia consists 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 the lochia changes, and therefore their color also changes. The nature of 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 cesarean 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 consult a doctor if necessary. The amount and nature of discharge can speak volumes, and it is important to notice alarming symptoms in time.

Discharge after childbirth in the maternity unit

For the first 2 hours after birth, the woman is in the maternity ward - 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 abundant, amounts to 0.5% of body weight, but not more than 400 ml, and does not lead to a violation of the general condition.

To prevent postpartum hemorrhage, immediately after childbirth, empty the bladder (discharge urine through a catheter) and put ice on the lower abdomen. At the same time, drugs that contract the muscles of the uterus (Oxytocin or Methylegrometril) are administered intravenously. By contracting, the uterus closes open blood vessels at the placenta attachment site, preventing blood loss.

Note! In the first two hours after birth, a woman is in the maternity ward under the supervision of medical personnel, because this period is dangerous due to 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 someone from the medical staff about it. It is important to know that the woman does not experience any pain, but bleeding quickly leads to weakness and dizziness.

Also, in the first 2 hours, bleeding may occur from tears in the tissue 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 any rupture was not completely sutured, a hematoma (a limited accumulation of liquid blood in the tissues) of the perineum or vagina may occur. In this case, 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 rupture. This operation is performed under intravenous anesthesia.

If the first 2 hours after birth (early postpartum period) went well, the woman is transferred to the postpartum ward.

Discharge in the postpartum ward

It’s good if in the first 2-3 days the lochia is bloody, it is quite abundant (about 300 ml in the first 3 days): the pad or diaper is completely filled within 1-2 hours, the lochia may be clotted and have a musty smell like menstrual flow. Then the number of lochia decreases, they acquire a dark red color with a brown tint. Increased discharge when moving is normal. In the postpartum department, the doctor makes a daily round, during which, among other indicators of the woman’s condition, he evaluates the nature and amount of discharge - for this he looks at the discharge on the pad or pad. A number of maternity hospitals insist on using diapers, because this makes it easier for the doctor to assess the nature of the discharge. Usually the doctor checks with the woman the amount of discharge during the day. In addition, in the first 2-3 days, discharge may appear when the doctor palpates the abdomen.

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

• Empty your bladder in a timely manner. During the first day, you need to go to the toilet at least every 3 hours, even if you don’t feel the urge to urinate. A full bladder prevents normal contractions of the uterus.
• Breastfeed your baby on demand. During feeding, the uterus contracts, as irritation of the nipples causes the release of a hormone that is produced in the pituitary gland, an endocrine gland located in the brain. Oxytocin has a contractile effect on the uterus. In this case, the woman may feel cramping pain in the lower abdomen (in multiparous women they are stronger). Discharge increases during feeding.
• Lie on your stomach. This not only prevents bleeding, but also prevents the retention of discharge in the uterine cavity. After pregnancy and childbirth, the tone of the abdominal wall is weakened, so the uterus can deviate posteriorly, which disrupts the outflow of secretions, and in the position on the stomach, the uterus approaches the anterior abdominal wall, the angle between the body of the uterus and the cervix is ​​eliminated, and the outflow of secretions improves.
• Place an ice pack on the lower abdomen 3-4 times a day - this measure helps improve the contraction of the muscles of the uterus and 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 whose childbirth occurred with complications (weakness of 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 increases sharply, you should definitely consult a doctor.

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

Bleeding may be a consequence of retained parts of the placenta if it was not diagnosed in time (in the first 2 hours after birth). This bleeding may occur in the first days or even weeks after birth. 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 patent) or by ultrasound. In this case, a portion of the placenta is removed from the uterus under intravenous anesthesia. In parallel, infusion therapy (intravenous drip administration of liquids) is carried out, the volume of which depends on the degree of blood loss, and antibacterial therapy to prevent infectious complications.

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

Most often, hypotonic bleeding occurs due to insufficient contraction of the uterine muscles. In this case, the bleeding is quite profuse and painless. To eliminate hypotonic bleeding, reducing drugs are administered, blood loss is compensated by intravenous fluid administration, and in case of severe bleeding, blood products (plasma, red blood cells). If necessary, surgical intervention is possible.

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

Postpartum discharge at home

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

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

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

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

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

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

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

During intense physical activity, the volume of discharge may increase, so do not lift anything heavy.

You should seek medical help in the following cases:

• The discharge acquired an unpleasant, pungent odor and 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,
• Heavy bleeding appeared after its amount had already begun to decrease or bleeding does not stop for a long time. This may be a symptom that there are parts of the placenta that have not been removed in the uterus, which interfere with its normal contraction,
• The appearance of curdled discharge indicates the development of yeast colpitis (). In this case, itching in the vagina may also appear, and redness sometimes occurs on the external genitalia. The risk of this complication increases when taking antibiotics,
• Postpartum discharge suddenly stopped. Complications are more common after a cesarean section than after a natural birth.
• For heavy bleeding(several pads within an hour) you need to call an ambulance, and not go to the doctor yourself.

Restoring the menstrual cycle after childbirth

If the child is breastfed, then his mother’s regular menstrual cycle will be restored 5-6 months after birth, and may resume even after. Before this, menstruation may not occur at all, or it may come from time to time. With artificial feeding (the baby receives only formula), menstruation is restored, as a rule, by the 2-3rd month after birth.

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

Elena Kudryavtseva
Obstetrician-gynecologist, Ekaterinburg

Postpartum recovery is a special state of a woman, when organs and systems return to their normal, “non-pregnant” state. Normally, it should take place without medical assistance, but under the scrupulous supervision of the woman. The main indicator of health is postpartum discharge, which varies depending on the condition of the uterus. It is important to know what their duration, appearance, color, intensity, smell should be at each moment of time.

Discharge after childbirth (lochia) is caused by healing and cleansing of the uterus. The process goes through several stages and is natural. It is popularly believed that a woman “cleanses” for 40 days. Official medicine tends to agree, and calls the average period 42 days. More “blurred” boundaries from 5 to 9 weeks. Anything that lasts less or longer than the specified periods is pathology.

The woman’s task is to carefully monitor the lochia. Any deviation from the norm is a signal of trouble and is a reason for an immediate visit to the gynecologist.

You should sound the alarm if discharge after childbirth:

• Finished in less than a month
• Lasts longer than 2 months
• Let's go green
• Became cheesy white
• Have purulent inclusions
• Acquired an unpleasant odor (putrid, sour)
• Sharply increased in volume
• Blood appeared again

An indicator of a woman’s health in the postpartum period is normal (up to 37) body temperature. If it is elevated or you think that there is “something wrong” with your discharge, go to the gynecologist. It’s better to worry unnecessarily than to miss the problem.

Uterine healing process

The healing process of the wound cavity of the uterus is conventionally divided into 3 stages:

1. from 1 to 7 days after birth - red discharge
2. 2-3 weeks after birth – brown discharge
3. Final stage – white lochia

The established dates are approximate, since they depend on the body, the complexity of childbirth, the method of delivery, and breastfeeding. Only your gynecologist can give an individual consultation when studying your medical history.

The first lochia

Cleansing the uterus begins immediately after the birth of the child - this is the expulsion of the placenta on the birth table. The obstetrician carefully examines its integrity. If breaks are found, then suspicion arises of incomplete separation of the placenta. The uterine cavity is cleaned to remove the remaining placenta.

For the first two hours after giving birth, the woman is monitored in the delivery room. Its purpose is to prevent bleeding. To do this, uterine contractions are stimulated by injection, and ice is placed on the abdomen. The discharge is copious, mostly blood.

How long does bleeding last after childbirth? Intense lochia of a bright red color ends in 3-4 days. At this time, the blood still does not clot well, and the wound surface remains extensive. By day 4, the lochia darken, acquiring a brownish color.

Clots in the first week (especially after sleep) are considered normal, as is the pungent smell of blood. Large clots larger than a chicken egg in volume should cause caution. Lochia comes after childbirth so abundantly that the pad is changed once an hour.

Second phase

The second stage of uterine cleansing lasts up to 3 weeks. The discharge consists of ichor, mucus, remains of dead cells with a small admixture of blood. The volume is comparable to normal menstruation or less. Color – brown. The smell is similar to musty, but not putrid or sour.

End of the recovery period

After the third week, before stopping, the lochia lightens to a white-transparent or yellowish color. Consist of mucus. In terms of quantity they are characterized as spotting. During this period, a woman can switch to panty liners.

Lochia after cesarean

Recovery after a cesarean section goes through the same stages, but more slowly. With this type of delivery, a scar is added to the wound in the uterine cavity on its wall, which delays healing. Discharge lasts longer after childbirth.

Pathological conditions

Discharge after childbirth ended early

Discharge after childbirth stops earlier if the woman was cleansed in the maternity hospital. With this intervention, the uterine cavity is artificially cleansed of the remains of the placenta, dead endometrium, and waste products of the child. This may speed up healing somewhat.

In other cases, the disappearance of lochia before the 35th day does not indicate a strong, quickly recovered body, but an early closure of the cervical canal. With this pathology, the discharge is deprived of its natural outlet and accumulates in the uterine cavity.

It should be understood that lochia consists of dead tissue. If gynecological cleansing is not carried out, the contents of the uterus will begin to decompose. This leads to infection or even sepsis.

Inflammatory diseases and fungus

The inflammatory process in a woman who has given birth can develop for various reasons: chronic infections, colds, insufficient hygiene, decreased immunity. The discharge acquires a characteristic “fishy” smell, greenish color, and changes consistency. After a while, high fever and pain in the lower abdomen are added. Without proper treatment, inflammatory processes in the uterus can lead to infertility.

The appearance of thrush is indicated by itching, a sour smell from the discharge, and a change in the consistency of the lochia to a curd-white consistency.

Bleeding

The appearance of blood in the lochia after the first week always indicates pathology. If you are in a maternity hospital, inform the doctors about this. If you notice blood at home, call an ambulance immediately.

Prevention of complications

Preventive measures in the postpartum period are reduced to:

• Compliance with medical orders
• Following hygiene requirements
• Sufficient physical activity
• Abstinence from sexual intercourse

A natural “reducer” is breastfeeding. With frequent latching of a baby, a woman's uterus receives powerful oxytocin stimulation.

And remember! A woman’s attentive and responsible attitude to her health is the key to a happy life for her children.

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 whether he was born naturally or as a result of a cesarean section), the discharge is bright red and very profuse (more abundant than during menstruation). It is difficult to get by with regular sanitary pads; you need to purchase special postpartum ones. At the time of discharge from the maternity hospital (5-7 days), vaginal discharge becomes less abundant and acquires a brown tint.

How long does discharge last after childbirth normally? It's different for everyone. It depends on how well the uterus contracts, as well as on the characteristics 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 is visible both visually and on ultrasound. Some people leave the maternity hospital with an impressive belly at 6 months of pregnancy, while others are already beginning to develop abs. Normally, the discharge stops a month after birth; the maximum “smear” can last 6 weeks after the birth of the child. If the process is delayed, or the bleeding becomes severe again, you must urgently contact the antenatal clinic and have an ultrasound done.

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

A dangerous symptom is if the discharge after childbirth has an unpleasant odor, plus fever and chills - this may 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 a woman’s vagina. There is no need to ignore yellow discharge after childbirth or white cheesy discharge, the latter may indicate a relapse of candidiasis (thrush).

It is very important to maintain personal hygiene to prevent the inflammatory process. It is advisable to change pads more often, and postpartum pads should not be with fragrances, 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 medicinal, safe herbs, for example, chamomile. But you need to be more careful with manganese (it is recommended to treat sutures on the genitals after an episiotomy with manganese), since if its concentration in water is high, you can get a burn to the mucous membrane.

It is also better to hold off on sex, even if you already have brown discharge after childbirth, and not bloody. Sex can cause heavy bleeding. Intimate relationships, in principle, like any strong physical activity, should be postponed until the lochia disappears completely and a gynecological examination is performed. Be sure to go to the doctor, don’t be lazy, he will also advise you on the most suitable method of contraception.

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