Recovery from pregnancy and birth is different for all women. However, all women will experience some vaginal bleeding in the days and weeks after birth. It’s important that you know what is normal and when you should ask for advice from your midwife or doctor.
After pains – these are cramps or pains in the lower pelvis (area between your hips) which may occur as your womb (uterus) ‘contracts’ allowing it to shrink to its normal size and position.
Postnatal blood loss (lochia) – it is normal for women who have given birth (either vaginally or via caesarean section) to bleed from their womb (uterus) until the lining is renewed. The medical name for this loss of blood is ‘lochia’. It is a combination of mucous, tissue and blood that is shed after birth as your womb replaces its lining.
Caused by an increase in the hormone oxytocin; after pains can vary from mild, period-type pains to something similar to labour contractions. After pains become less frequent and less uncomfortable after a few days, but can continue for about seven to ten days. You should discuss appropriate pain relief (analgesia) with your midwife.
Postnatal blood loss (lochia)
Everyone is different, however, the blood loss (lochia) can last from two to six weeks and usually varies in both colour and amount during this time.
The table below will give you a guide to the amount and colour of blood loss (lochia) that you can generally expect for the first six weeks. If you have any concerns, you should discuss them with your midwife or GP.
You are advised to use maternity towels rather than slim absorbent sanitary towels to allow:
• your perineum (area between your vagina and anus) to heal with minimal irritation
• a more accurate assessment of your blood loss
Use of tampons should be avoided to minimise your risk of an infection.
Reducing your risk of infection: the importance of clean hands
During the first weeks immediately after birth you are at an increased risk of getting a bacterial infection, so good hand hygiene is very important both in hospital and at home. Washing your hands before and after using the toilet/changing your sanitary towel is the simplest, cheapest and most effective way to prevent infection.
It’s important to remember to:
• remove jewellery and your watch before washing your hands
• keep your nails short
•avoid touching stitches, wound dressings, drips or catheters unnecessarily
When washing your hands remember to concentrate on your:
• nail beds
• back of the hands
Wash your hands for around 20 seconds.
Here is a useful video on the best way to wash your hands:
Guide to colour and amount of Bleeding in the Days/weeks after the birth of your baby
The table below describes the normal amount and colour of blood loss as you would see it on a
standard absorbent maternity towel:
Quite a heavy loss, soaking a maternity sanitary towel every few hours.
You may have one or two quite large clots (the size of a tomato) or several smaller ones (about the size of a grape) during the first two to three days after the birth and have no further problems. While clots are not unusual, it is essential to discuss them with your midwife (showing them to your midwife whenever possible).
If any of the following are present:
- slurred speech or confusion;
- extreme shivering or muscle pain;
- passing no urine (in a day);
- severe breathlessness;
- it feels like you're going to die;
- skin mottled or discoloured.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
Please ring your GP surgery or call NHS 111 - dial 111
If you are still concerned about your blood loss, contact your Community Midwife or call NHS 111 – dial 111