All You Need to Know About Bleeding After Delivery

All women experience red-coloured discharge called lochia after giving birth, whether the delivery has been vaginal or C-section. The discharge is nothing but extra tissues and blood in your uterus that was previously necessary for the growth of your baby. 

However, many women experience it differently and that gives rise to a lot of questions. Additionally, heavy bleeding might be a sign of postpartum haemorrhage, which, according to the World Health Organization, is one of the leading causes of maternal death globally.

We understand the stress and that’s why we have answered all the questions related to bleeding after pregnancy here. Sit back and go through all of them to gain a better understanding.

What Should I Know About Vaginal Bleeding After Pregnancy?

After giving birth, a woman typically experiences vaginal bleeding, also known as postpartum bleeding or lochia. This bleeding is caused by the shedding of the uterine lining and can last for up to 6 weeks. 

The amount of bleeding can vary, but it is typically heaviest in the first few days and then gradually decreases over time. Some women may experience heavy bleeding, while others may have very light bleeding.

It's important to note that if the bleeding is heavy or if it becomes heavy again after initially subsiding, a woman should consult an OB-GYN to rule out any complications. 

What is Postpartum Haemorrhage?

Postpartum haemorrhage is a serious and rare condition that arises after giving birth. It should not be confused with vaginal bleeding at all.

Postpartum haemorrhage (PPH) is excessive bleeding after childbirth. It is defined as blood loss of more than 500 ml or blood loss accompanied by symptoms of hypovolemia (low blood volume) within the first 24 hours after delivery.

PPH is a serious complication of childbirth that can lead to death if not treated promptly and properly. Risk factors include previous PPH, multiple gestations, placenta previa, and induction of labour.

Difference Between Postpartum Haemorrhage and Vaginal Bleeding After Pregnancy

Postpartum haemorrhage (PPH) and vaginal bleeding after pregnancy are related, but they refer to different things.

Vaginal bleeding after pregnancy is the shedding of the uterine lining and is a normal process that occurs after giving birth. It can last for up to 6 weeks and the amount of bleeding can vary.

Postpartum haemorrhage (PPH), on the other hand, refers to excessive bleeding after giving birth. PPH is defined as a blood loss of more than 500 mL (about 2 cups) within the first 24 hours after delivery.

PPH can occur due to various causes, such as a uterine infection, a retained placenta, or a tear in the cervix or vaginal wall. It is considered a medical emergency and requires immediate attention. We will be discussing the causes of postpartum haemorrhage shortly. PPH can be life-threatening if not treated promptly.

Causes Of Postpartum Haemorrhage

As mentioned earlier, there can be a variety of causes behind postpartum haemorrhage. We have listed the most common reasons for you, have a look- 

Uterine atony

Normally, after the baby is born, the uterus contracts and clamps down on the blood vessels in the placenta, which helps to stop bleeding. But in cases of uterine atony, the uterus doesn't contract effectively, and the blood vessels in the placenta continue to bleed. This can lead to a significant loss of blood and can be a medical emergency.

Uterine atony is one of the most common causes of PPH, and it's more likely to occur in women who have had a large baby, prolonged labour, a previous history of PPH, or certain medical conditions such as hypertension, diabetes, and obesity.

Treatment for uterine atony typically involves administering drugs to make the uterus contract, such as oxytocin, and manual removal of the placenta. In severe cases, a surgical procedure may be necessary to control the bleeding.

Lacerations

Lacerations after delivery refer to tears or cuts that occur in the vaginal area during childbirth. These can range in severity from small, superficial tears to larger, more serious injuries that may require stitches or other medical attention. Lacerations can occur naturally during delivery as the baby's head passes through the vaginal opening, or they may be caused by instruments such as forceps or vacuum extractors. Factors that may increase the risk of lacerations include a large baby, a small pelvic opening, or a prolonged or difficult delivery.

Retained placenta

Retained placenta occurs when all or part of the placenta remains in the uterus after childbirth. The placenta is a flat, round organ that attaches to the wall of the uterus during pregnancy and provides nutrients to the growing foetus. It normally separates from the uterus and is delivered shortly after the baby is born.

When a placenta is retained, it can cause bleeding and infection. If only a small portion of the placenta is retained, it may be possible to remove it manually, but in some cases, a surgical procedure may be necessary to remove the placenta. 

Uterine inversion

Uterine inversion is a rare but serious complication that can occur during or after childbirth. It occurs when the uterus turns inside out and prolapses through the cervix and birth canal. This can happen when the placenta, umbilical cord, or uterus is not separated properly after delivery, or when the uterus doesn't contract strongly enough after delivery.

Symptoms of uterine inversion include heavy bleeding, severe abdominal pain, and a feeling of fullness or pressure in the pelvic area. The uterus may also feel hard and tender to the touch.

The treatment for uterine inversion typically involves the manual replacement of the uterus to its normal position, which is usually done under general anaesthesia. This is followed by the administration of oxytocin to help the uterus contract and prevent the recurrence of inversion. It is important to note that uterine inversion can cause damage to the uterus, leading to a hysterectomy as a last resort.

Other factors that can increase the risk of PPH include a large baby, prolonged labour, a previous history of PPH, and certain medical conditions such as hypertension, diabetes and obesity.

Treatment of Postpartum Haemorrhage

The treatment of postpartum haemorrhage (PPH) depends on the underlying cause of the bleeding. Here are a few common treatments:

Medications: Oxytocin, a synthetic hormone that helps the uterus contract, is often used to stop bleeding caused by uterine atony, which is a common cause of PPH. Misoprostol, a synthetic prostaglandin, can also be used to help the uterus contract and stop bleeding.

Manual removal of retained placenta: If the placenta is not completely delivered, a healthcare provider may need to manually remove it in order to stop the bleeding.

Blood transfusions: Blood transfusions may be necessary if the bleeding is severe and the woman has lost a significant amount of blood.

Surgery: In some cases, surgery may be necessary to stop the bleeding. This can include uterine artery ligation, which involves tying off the blood vessels that supply the uterus, or a hysterectomy, which involves removing the uterus.

Uterine packing: Packing the uterus with sterile gauze after delivery can help to apply pressure to bleeding sites and stop the bleeding.

Uterine Balloon Tamponade: Insertion of an inflatable balloon catheter into the uterus which is then inflated with sterile water or normal saline to apply pressure on the bleeding sites

It's important to note that early recognition of PPH and prompt intervention is crucial to prevent serious complications, such as shock or death.

Summing Up

Some amount of vaginal bleeding is completely normal after giving birth but excessive is a matter of concern 

We hope that you now have a clear idea of when you should contact a doctor. However, if you still have doubts, please feel free to comment or reach out to us, or contact a doctor right now.

Also, check out our post-pregnancy plans that will cover everything from your diet, mental wellness and fitness, and have a smooth journey ahead.