Postnatal Bleeding - What To Expect

Did you know you can expect to bleed for up to six weeks after birth? Christie, one of our resident midwives, shares what’s normal when it comes to postnatal bleeding. 

Vaginal bleeding is normal following birth. The womb needs to shed any residual lining in order to return to it's normal pre-pregnant state. It sheds a combination of blood, mucus and tissue, which is referred to as Lochia. 

Postpartum bleeding can last anywhere between a few days and several weeks (usually up to about 6). It starts heavier and red in colour, becoming lighter and pinkish/brown over time - similar to a period. 

Postnatal bleeding goes through 3 stages: 

1. Lochia Rubra

Dark/bright red in colour, a heavier flow, can contain small clots (size of 50p or smaller), lasts 3-4 days. 

2. Lochia Serosa 

Pinky/brownish red, more moderate flow, lasts 4-12 days, very small or no clots. 

3. Lochia Alba 

Yellow/white discharge, minimal, occasional spotting, lasts 12 days to 6 weeks with no clots. 

So, let's talk about those first few days and how much is normal…

You've probably heard the phrase a lot already, but similar to a heavy period is what we class as “normal”. For example, if you are wearing substantial pads (night-time ones) and are changing every 4 or so hours without leaks and complete saturation but a relatively full pad this is normal for the first 2-4 days. If you are soaking a pad like this in 1-2 hours this is abnormally heavy bleeding and you need to attend triage. 

Bleeding is likely to be heavier when breastfeeding or in periods where you are more active. Also if you have been sitting down for a while you may experience a small 'gush' on standing. 

Clots can be normal, but we're only expecting small ones, similar to a grape. 

When to get support…

If you are passing egg sized clots these would be considered large and you'll need to phone triage for assessment. 

If you are experiencing heavy bleeding and other symptoms of haemorrhage (dizzy, palpations, blurred vision, feeling faint, nausea or vomiting, abdominal pain, pale/clammy skin) please phone an ambulance. 

Managing the bleeding…

In terms of managing the bleeding it is really a case of using pads or postpartum pants for the duration - moon cups and tampons are not recommended in the immediate postnatal period. 

Hand hygiene is so important anyway, but in these first few weeks after having a baby it's more essential than ever to reduce the risk of infection entering your womb or in the skin surrounding your stitches. We recommend hand washing before and after using the toilet for around 2-3 weeks. 

When will my period return? 

Lastly let's talk about your periods returning and what is normal, and the difficulty here is that there is a huge variation. If you are formula feeding your baby it is usual for your periods to return much sooner, as early as 5-6 weeks after the birth of your baby - the same can be said for combination feeding. 

If you are exclusively breastfeeding it can take until your baby begins to wean off the breast for your periods to return. 

Psssst… did you know…

We’ve teamed up with our friends at WUKA to create a New Mum’s Survival Pack for Mother’s Day which includes a pair of WUKA’s Super Heavy Flow Pants - a comfortable and eco-friendly way to manage postpartum bleeding and a post-birth essential. 
Each bundle includes a pair of WUKA’s Super Heavy Flow Pants, PBC’s Postpartum Pack gift card, PBC’s Words for Mothers and a Space Mask. 

If you’re looking for a brilliant present for a new mum or birthing person then this is it - because why get them flowers when you can get them the gift of comfort, sleep and knowledge! 

Order your bundle here.