Bleeding after cesarean delivery may be heavy and bright red during the first week after birth and become lighter and brownish over time. It usually continues for 24 to 42 days after birth; however, some women may bleed for a little longer (1).
Read this post to know more about the causes of bleeding after C-section and ways to manage it.
How Heavy Is The Bleeding After A C-Section?
- Bleeding is heavy and bright red after breastfeeding because the oxytocin released during the process compresses the uterus, thus producing more blood.
- Any physical activity may cause bleeding during the first two weeks after delivery.
- Heavier bleeding may also be experienced after you wake up in the morning because the blood may accumulate in the vagina while you are sleeping at night.
The following bleeding pattern is commonly seen in women after a C-section. However, it may vary from one person to another (1).
|Days/weeks||Color of the blood||Amount of blood loss|
|Day 1||Fresh red to brownish-red|
|Days 2 to 6||Dark brown or pinkish-red|
|Days 7 to 10||Darker brown or pinkish-red; turns lighter|
|Days 11 to 14||Darker brown or pinkish-red; turns lighter|
|Week 3 to 4||Pale, creamy white blood|
|Week 5 to 6||Brown, pinkish-red, or creamy yellow|
What Causes Bleeding After C-Section?
During delivery, the placenta detaches from the uterus lining (endometrium), leaving behind an open wound of around 8.5in in diameter (placental site). This wound takes time to heal. As the uterus heals, the residual tissue slowly comes out in the form of uterine bleeding and vaginal discharge (4). In the case of vaginal delivery, up to a half-quart (500ml) of blood is lost, whereas in the case of cesarean delivery, up to a quart (1000ml) of blood is lost (5).
Bleeding after birth (lochia) can be divided into three stages (4).
1. Lochia rubra
- This stage lasts for the first four days after delivery.
- You may experience regular abdominal cramps as the uterus begins to contract to its original size.
- The lochia is bright red with clots caused due to the pooling of blood.
2. Lochia serosa
- This stage lasts for around ten days.
- You may notice the blood changing from bright red to pink or brown. The color change occurs as the number of white blood cells in the blood increases.
- The placental site continues to heal during this stage.
- If you are not breastfeeding, you may notice the discharge of cervical fluid. However, if you are breastfeeding, the cervical fluid may not be seen yet.
3. Lochia alba
- This is the final and the longest stage.
- The lochia turns yellowish or whitish. It mainly consists of white blood cells, cervical mucus, and epithelial tissue.
- The placental site continues to heal rapidly.
How To Manage Bleeding After C-Section?
Bleeding after C-section can be managed by using maternity pads. These pads offer more comfort than regular sanitary pads and allow you to check the amount of blood loss (3).
You may keep these pointers in mind to decrease the risk of infections (3).
- Avoid the use of tampons or menstrual cups for the first six weeks after childbirth.
- Change the sanitary pads at regular intervals.
- Wash your hands before and after changing the sanitary pads.
When To Call The Doctor?
- Sudden heavy bleeding (soaking of one pad in one to two hours)
- Large blood clot (bigger than the size of a golf ball)
- Change in the color of the blood (changes to bright red)
- Dizziness and weakness
- Chills with fever
- Foul-smelling vaginal discharge or blood
- Severe pain in lower abdomen
Frequently Asked Questions
1. What if I bleed longer than six weeks after a C-section?
It is normal for a woman to bleed for four to six weeks after a C-section. Some women may bleed for a little longer. However, the bleeding should stop by 12 weeks after birth (3). If the bleeding continues beyond that or becomes heavier, it is advisable to consult a doctor as it might indicate signs of infections.
2. What are the symptoms of postpartum hemorrhage after a cesarean delivery?
After the delivery of a baby, the uterus normally contracts and expels the placenta, and the blood vessels in the area where the placenta was attached compress due to uterine contractions. However, in around 4% of women, the uterine contraction may not be strong enough (uterine atony), leaving the blood vessels to bleed freely. This condition can lead to postpartum hemorrhage (7).
Some symptoms of postpartum hemorrhage include (7)
- Excessive bleeding
- Severe drop in blood pressure
- Elevation in heart rate
- Decrease in red blood cell count
- Tissue pain and swelling in the vaginal and perineal area
Bleeding after a cesarean birth is a normal process in which the uterus expels the extra tissue and blood and returns to its original size. Good nutrition, proper hydration, and adequate rest can help you recover faster during the postpartum period. However, you should regularly monitor the amount and duration of your blood flow.
- Bleeding after birth: 10 things you need to know.
- Recovery after cesarean: first 6 weeks.
- Bleeding after a c-section: what to expect.
- Everything You Need to Know about Postpartum Bleeding, aka Lochia.
- Postpartum hemorrhage: How much bleeding after delivery is normal?
- Bleeding after birth.
- Postpartum hemorrhage.
- Postpartum hemorrhage.