Blood loss after childbirth

Bleeding continues to occur in the first days and weeks after delivery. One woman experiences it as quite intense, the other as if it were a menstruation. However, this blood loss can also cause discomfort. But what exactly should one pay attention to? Childbirth is not only a psychologically traumatic event, you also undergo major physical changes. The pregnancy hormones did not immediately disappear from the body, a cut or tear occurred. The bleeding to cause the uterus to shrink again is also part of this.
The blood loss continues for several days to several weeks and depends from woman to woman and from situation to situation. The blood loss is a result of the rupture of the placenta from the uterine wall. This has left a wound in the uterus that now needs to be healed. Through uterine contractions, this wound will heal little by little.
Another word for the blood loss (and wound fluid) after childbirth is lochia.

Important points to consider for postnatal blood loss

  • the color of the blood loss
  • the smell of blood loss
  • the amount of blood loss


The color of the blood loss

The first days after delivery, the blood loss is red in color, as if it were a very heavy menstruation. After a few days or weeks, this turns into a dark brown color, somewhat comparable to the last days of menstruation. Eventually this disappears and becomes a clear (white) color again.

The smell of blood loss

Normally the lochia has no particular smell. If there is a bad odor, the doctor/gynecologist should be notified.

The amount of blood loss

The first 3 days after delivery are referred to as lochia rubra, or in other words: a lot of blood loss . After a few days one speaks of lochia serosa or in other words: less blood loss . At the end of the 2nd week after delivery, one speaks of lochia alba, or in other words: little blood loss . As mentioned earlier, there are (often large) individual differences in how long the blood loss lasts.

What to do when…

Genital infection:

A genital infection is usually accompanied by a bad odor and color. The doctor will be notified, the woman will receive extra rinses and prescribed medication.

Bad blood loss:

The doctor must also be notified in this case. Additional rinses (with a possible disinfectant) will take place. A bacterial culture can be taken from the vagina to detect which bacteria are causing this unpleasant odor. Antibiotics will also be prescribed for this.

Excessive blood loss:

The gynecologist must be notified immediately as this can become life-threatening. The cause must be traced. In the event of real bleeding, the uterus will be massaged. The newly delivered woman will be asked to urinate if necessary. Medication may also be administered via IV.
Possible causes of excessive blood loss

  • a full bladder which prevents the uterus from contracting properly
  • retained placental remains in the uterus (if possible, these will be removed manually or surgically)

Childbirth is different for every woman. If you have any doubts about blood loss, the smell, the amount, the color, it is best to contact the doctor, midwife, maternity unit, general practitioner… if you want to rule out that it is more than just normal blood loss.

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