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Lochia and Postpartum Bleeding

Postpartum bleeding (hemorrhage)

Lochia and Postpartum Bleeding For new mothers, bleeding after childbirth is a natural process and there is nothing to worry about. During the pregnancy period the mother’s body gets filled with 50% more blood than usual and it is okay with bleeding after giving birth and the body is ready to cope with the latest events. While the birthing process, the placenta separates from the uterus causing the blood cells attached to run free to the uterus and thus creating a blood flow. Generally this is called postpartum bleeding. When the delivery process ends, the uterus starts contracting, closing off the blood vessels and the blood flow stops. If the mother has a cut or episiotomy left in the uterus that might initiate the bleeding again.

One of the most common and worst cases related to postpartum bleeding is postpartum hemorrhage. Blood loss crossing 500 ml mark after vaginal delivery and 1000 ml mark after cesarean section is termed as postpartum hemorrhage. Blood loss matching previously mentioned specifications within 24 hours after delivery is called early postpartum hemorrhage and after 24 hours, it is called late postpartum hemorrhage.

Treating postpartum bleeding

Assess the situation and act according to the following instructions.

  • Manually massage of the uterus to prompt contraction process, apply medications if needed.
  • Supplements of Oxytocin.
  • If there are any, removal of placental pieces from the uterus that got left behind.
  • Compression of the bleeding spots.
  • Closing off damaged blood vessels.
  • Apply Laparotomy if needed. As last resort, go for Hysterectomy.
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What is Lochia

Lochia is one kind of vaginal discharge that happens right after child birth and lasts for 4 to 6 weeks. Lochia is also one kind of postpartum bleeding. Basically, the discharged materials contain fair amount of blood along with placental tissues and mucus. In the first 2 or 3 days, lochia contains mostly blood, making it bright red. The liquid sometimes look like heavy period discharge. If all go well, the blood amount will fall and lochia will get more light like water and will become pinkish in color as the days go by.

Lochia condition progresses through these 3 stages.

  • Lochia Rubra: It is bright red in color as the liquid contains significant amount of blood. Lochia rubra usually lasts for 3 to 4 days after the child birth.
  • Lochia Serosa: This is the lochia which is thin in density. Color has turned into brownish or pink. The lochia contains cervical mucus, exudate, leukocytes, and erythrocytes. Lochia serosa usually continues for 10 days after the delivery. Lochia serosa continuing for weeks is a sign of postpartum hemorrhaging.
  • Lochia Alba: Lochia Alba is termed for the lochia that turns into yellowish-white or whitish liquid. Usually starts at the 2nd week after birth and stays until the 6th week. The liquid contains little amount of red blood cells and mostly contain leukocytes, cholesterol, fat, epithelial cells and mucus. If this condition continues over several weeks, then it may indicate genital lesion.


How to manage Lochia

During the early stages, use sanitary pads equipped for heavy duty. If you haven’t piled up your own stock then buy more quickly. With time passing by, the lochia condition will taper off and then mini pads can be used. Forget about using tampons for at least 5 to 6 weeks, because tampons increase the possibility of infections in the vaginal area and in the uterus.

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Urinate often, keep your bladder clear. After you give birth, during the first few days, your bladder becomes less sensitive. So, sometimes you won’t feel the need to pee even if you are moving with a full bladder. This makes it hard for the uterus to contract and results into serious post pregnancy bleeding. Some mothers add a little bit of salt with their warm bath water to speed up the healing process of wounds in the uterus.

Try to get as much rest as you can. Too much work will cause you to bleed even after your lochia condition has passed over.

When to call the doctor

Following symptoms indicate infections in the uterus. Contact your doctor as soon as possible if these signs show up.

  • Lochia will come with unpleasant smell.
  • Patient will suffer from fever or chills.
  • After one week, heavy bleeding will continue with bright red color.
  • The stomach will feel tender low down in one or both sides.

In some cases the bleeding turns into a far more dangerous disease named postpartum hemorrhage. Get an ambulance if the following symptoms appear.

  • Suddenly, the blood flow increases.
  • The blood is flowing with bright red color after 4 days and the condition doesn’t improve after lying down.
  • The patient starts feeling faint or dizziness.
  • Irregular heart beat or dangerously increased heart beat.
Delores C. West is a compassionate healthcare professional with a focus on women's health and wellness. As a certified nurse-midwife, Delores is dedicated to providing comprehensive care to women throughout their reproductive journey. With a warm and nurturing approach, she empowers her patients to make informed decisions about their health and well-being. Delores's expertise in women's health makes her a trusted resource for individuals seeking personalized and compassionate care. Connect with her on LinkedIn to learn more about her commitment to women's health and wellness.