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Today we’re talking everything you’ve ever wanted to know about POSTPARTUM BLEEDING. Yep, giving birth is only the beginning.
And while you may have enjoyed not having a period for the past 9-ish months (pregnancy spotting and discharge aside), the postpartum period brings the bleeding back – often somewhat unexpectedly, and heavily.
Sure is, and it happens whether you give birth vaginally or via Caesarean section. During your pregnancy, blood vessels connect your placenta to your uterus. When the placenta comes away from the uterine wall after your baby is born, those blood vessels are open, and they bleed. Your uterus contracts to squeeze them shut over a period of up to 10 days, during which time the bleeding should slowly lessen.
The amount does vary from person to person (maybe not the concrete answer you were looking for), but it’s typically not like a normal period (unless your flow is always super heavy).
During the first two days after birth, the bleeding is usually bright red and pretty heavy – as much as the equivalent of one sanitary pad per hour. Over the next few days, the bleeding should slowly reduce and change colour from bright red to a pink or brown, before eventually lightening to a creamy discharge colour.
Bleeding is often heavier in the morning when you get up (thanks gravity), after breastfeeding, or after exercising (if you’re feeling up to doing that in the first six weeks – and hey many of us aren’t).
One thing lots of people aren’t ready for is blood clots, sometimes lots of them and they can be quite large.
For most people, postpartum bleeding will last up to six weeks after giving birth, but that’s not a given. Similarly, while for some, bleeding slowly tapers nicely according to expectations, for others it’s more of a stop/start affair, so just when you think it’s over, it starts up again.
It is. A blood clot is basically a ‘mass’ of blood which sticks together and has a jelly-like consistency; and passing blood clots is perfectly normal after having a baby. Don’t be alarmed if you pass large clots in the first 24 hours after giving birth (we’re talking golf ball sized), they’ll usually become smaller and less frequent as the days go on.
However, if you’re passing larger clots, passing them often or they’re not lessening after the first day or two, always check in with your doctor or midwife, because it can be really hard to know what’s ‘normal’, especially when you haven’t been through it before. Even if you have, no two births or after-births are the same.
There are a few causes of increased bleeding in the postpartum period. One is if your uterus doesn’t contract properly to close off the blood vessels. Another is called retained placenta, which is when your placenta doesn’t come away in its entirety after birth, leaving some tissue still attached to the uterine wall, which prevents your uterus from contracting. If your vagina, cervix or uterus has been injured during birth, of you have an infection, you might also experience excessive bleeding in the postpartum stage.
This is something your midwife will usually check, by feeling your belly for the location of your fundus (the top of your uterus). As the uterus contracts, it gets smaller and is felt lower in your abdomen, and by 10 days after birth, it should have contracted enough to not feel it when pushing on your abdomen. Ask your healthcare provider to show you if you’re at all concerned...or just curious.
First up, if you’re worried or just don’t feel right, don’t feel embarrassed or awkward about asking for help. Just do it.
Guidelines from Queensland Health advise calling your health care provider if, more than 24 hours after giving birth:
I had retained placenta with my first two babies, which means I only passed parts of my placentas – they broke up – rather than coming out in a nice tidy piece, and this caused major bleeding which was, unfortunately, ongoing.
With my first birth, I had a post-partum haemorrhage within hours of giving birth so I was taken into the operating room for a ‘manual removal’ of my placenta which was stuck pretty hard and fast and not cooperating – or coming out the usual way.
After that, my bleeding continued pretty heavily and didn’t really settle but I figured it was normal (first time and all) so I just carried on and lived on Sustagen to try to keep my energy levels and milk supply up as I was trying to breastfeed.
About 10 weeks after giving birth, I was literally unpacking the dishwasher and I passed a clot out of the blue the size of a dinner plate. Horrified, I got in touch with my obstetrician and went back to hospital for another D&C procedure. After that the bleeding finally slowed, then stopped, but it was a rocky intro to first time parenthood.
With my second baby, I had the same retained placenta problems but I was more prepared this time, and I was actually kept in the delivery suite all day after giving birth with a midwife giving my belly a might push every hour to help expel any retained blood and placenta. Lucky I’m not squeamish.
Still in hospital after a few days, my blood clots started getting much bigger and more frequent – rather than smaller and less often – and I was surprised when the nursing staff told me to catch them in a dustpan when I went to the bathroom so they could measure their size and work out my blood loss.
I can’t say carrying my clots down the hospital corridor in a dustpan in the middle of the night is one of the highlights of my parenting life so far, but it did help show that things weren’t normal, so, yep, you guessed it, another D&C was booked in, with a blood transfusion to help me recover and get my energy up more quickly.
By the time baby three came around, my obstetrician advised the hospital that my placenta wouldn’t be coming out of its own accord, so he just went ahead and manually removed it after the birth while my epidural was still in action, and then did another sweep a few hours later. So, it wasn’t quite as easy breezy in reality as that sounds, and it actually hurt like hell the second time, but it worked and I didn’t have to have a D&C or a blood transfusion.
I’m not sharing this to scare anyone, just to highlight the fact that whatever you read or think you know, you just don’t know how things will go, so don’t be too set on the fact that your bleeding should last six weeks and expect that on the first day of week 7 you’ll be sporting a beige thong or hitting the beach...but you might. Just go with the flow (literally), but if your bleeding is persisting, getting heavier or your clots get larger or more frequent (like mine), don’t suffer in silence – there's a reason and the sooner you find out what it is, the sooner you can sort it out and get back to learning how to care for your new baby (and yourself).
How can Modibodi help?
Modibodi reusable underwear has a built-in lining which absorbs fluid – including postpartum bleeding and bladder leaks (if you win the post-birth lottery you’ll likely get both at once) - so you don’t need to use disposable, scratchy, bulky pads.
Our Maxi-24hrs technology, built into the gusset from the front to the back waistband is black (no stains) and absorbs up to 50ml of fluid. It’s also comfortable, breathable and antimicrobial to fight odour and bacteria. Available in different styles to suit different bodies and sizes, this is the best choice for early postpartum bleeding.
We suggest you pack a few pairs into your hospital bag for those first few days so you’ll have a ready supply as depending on your flow, it’s hard to know exactly how long you’ll be able to wear each pair. Buy them in a bundle pack to save.
After that, you might want to move to our Heavy-Overnight absorbency, which has our absorbent lining up to the back waistband. As your bleeding decreases, our Moderate-Heavy absorbency and then Light-Moderate absorbency styles should do the trick.
Even once bleeding subsides, you might still find you experience occasional spotting, light bladder leaks from your weakened pelvic floor or an irregular cycle for a number of months, if not years. Many women choose to wear Modibodi leak-proof underwear for everyday comfort and back-up protection from unexpected leaks – just in case.
If you’re still pregnant, and just reading up on what to expect, our Maternity Brief is crafted from super soft fabric and sits under the hip with a V-shaped dip in the waistband. With its built-in absorbent gusset, it’s designed to absorb pregnancy discharge and leaks.
But we don’t just have leaking bladders and bleeding covered, we’ve got leaky boobs sorted too with our Breastfeeding Singlet. Designed to completely replace irritating, uncomfortable and environmentally-harmful disposable breast pads, it’s a supportive, super comfortable, versatile style with built-in leak-proof cups.
Featuring a cup which adjusts to your changing breast size, wirefree comfort and simple clips for easy one-handed feeding, it will keep you cool, dry and supported - and ready to feed at a moment’s notice, because that’s often about as much notice as you’ll get. 😊 Pack a couple in your hospital bag so you can wear one and wash one.
And remember, our reusable leak-proof underwear and Breastfeeding Singlet make great baby shower gifts for expectant Mums or for Mums of newborns – because a gift that makes a new Mum’s life easier is a gift worth giving.