Postpartum bleeding: What’s normal and what’s not

Bringing a baby into the world is an incredible experience, but the postpartum period comes with changes and challenges that can sometimes feel overwhelming. One of the most common concerns new mothers have is regarding postpartum bleeding—how much is normal, how long it lasts and when to seek help.

Understanding what to expect before welcoming your new arrival can help ease worries and ensure a smoother recovery.

If you’re an expectant or new mother, here’s what to know about postpartum bleeding.

What causes postpartum bleeding?

Postpartum bleeding, also known as lochia, is the body’s way of shedding the extra blood, tissue and mucus that supported your baby during pregnancy. After giving birth, the uterus contracts to expel this material and begin the healing process.

The bleeding is typically heavier in the first few days after delivery and gradually decreases over time. However, in some cases, excessive or prolonged bleeding may indicate a problem, such as a postpartum hemorrhage, which requires immediate medical attention.

What are the stages of postpartum bleeding?

Postpartum bleeding happens in three distinct stages, each with different characteristics:

1. Lochia Rubra (Days 1-4): This stage consists of bright red blood with small clots. It’s the heaviest stage, similar to a heavy period.
2. Lochia Serosa (Days 4-10): The bleeding lightens, changing from dark red to pink or brown. It contains more fluid and less blood.
3. Lochia Alba (Days 10-6 Weeks): By this stage, the discharge is light yellow or white and consists mostly of white blood cells and mucus. Bleeding should be light to minimal and may start and stop every few days.

How long does postpartum bleeding last?

Most women experience postpartum bleeding for about four to six weeks, though it may last up to eight weeks. This can vary based on factors like your delivery method and individual healing. Vaginal deliveries often result in longer bleeding compared to C-sections, although women who have C-sections may still experience postpartum bleeding.

Certain activities, like breastfeeding or physical exertion, can temporarily increase bleeding due to the uterus contracting. It’s also important to note that if you’re not breastfeeding, bleeding may stop and then return as a first period, which can be heavy.

If bleeding persists beyond six weeks or suddenly becomes heavier after slowing down, it’s a good idea to reach out to your doctor or maternity care team.

What to expect after 6 weeks postpartum and beyond

As your body continues to recover from childbirth, you may notice changes in your menstrual cycle, especially depending on whether or not you are breastfeeding or using contraception.

• If you are breastfeeding, your period may be irregular or even absent for an extended time.
• If you are not breastfeeding, bleeding may return as soon as four weeks postpartum, and your first period may be heavier than usual.
• Your choice of contraception after childbirth can influence postpartum bleeding patterns.

Always be sure to talk with your healthcare provider if you have questions or concerns. They can help you understand what to expect and ensure your recovery is on track.

What medications help manage postpartum bleeding?

For normal postpartum bleeding, no specific medication is required—your body naturally heals over time. However, some medications can help in cases of excessive or prolonged bleeding:

• Oxytocin: This is often given immediately after delivery to help the uterus contract and reduce blood loss.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen can help with cramping, which is caused by the uterus contracting.
• Tranexamic Acid (TXA): In cases of excessive postpartum bleeding, TXA may be used to help blood clot and reduce heavy bleeding. It is usually only given around the time of delivery.

When to call your doctor about postpartum bleeding

Your postpartum recovery is just as important as your pregnancy and delivery. While postpartum bleeding is normal, there are some warning signs that should not be ignored. Contact your doctor right away if you experience:

• Soaking through a pad in less than an hour
• Passing large blood clots (bigger than a golf ball)
• Bleeding that stops and then suddenly returns very heavy
• A foul-smelling discharge (which could indicate infection)
• Dizziness, rapid heartbeat or extreme fatigue

Take charge of your postpartum health

Postpartum bleeding is a natural part of recovery after childbirth, but knowing what’s normal and what’s not can help you feel more prepared as you juggle the balance of taking care of your new baby and yourself.

If you have questions about your postpartum health, connect with virtual postpartum support, talk with your OBGYN or find one near you.