Bleeding After C-Section: Causes And How Long It Lasts

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Bleeding after C-section is normal. Also called lochia, this bleeding consists of mucus, tissue, and blood that the uterus sheds as it replaces its lining following the delivery (1) (2).

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 may be heavier when the mother wakes up in the morning

Image: iStock

The amount of blood loss after a C-section depends on several factors (1) (3).

  • 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.
Quick fact
1% to 5% of women have a postpartum hemorrhage, which is more likely with a C-section birth (8).

The following bleeding pattern is commonly seen in women after a C-section. However, it may vary from one person to another (1).

Days/weeksColor of the bloodAmount of blood loss
Day 1Fresh red to brownish-red
  • Heavy flow
  • Soaks one maternity pad in a few hours
  • Small blood clots
Days 2 to 6Dark brown or pinkish-red
  • Moderate flow
  • 7-12cm stains on the maternity pad
  • Small blood clots
Days 7 to 10Darker brown or pinkish-red; turns lighter
  • Lighter flow
  • Less than a 7cm stain on the pad
Days 11 to 14Darker brown or pinkish-red; turns lighter
  • Lighter flow
  • Stains start decreasing
Week 3 to 4Pale, creamy white blood
  • Lighter flow
Week 5 to 6Brown, pinkish-red, or creamy yellow
  • Lighter flow and only on some days

Source: nct

What Causes Bleeding After C-Section?

The placental site may be responsible for heavy bleeding

Image: Shutterstock

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.
Use sanitary pads to manage bleeding after C-section

Image: Shutterstock

  • Wash your hands before and after changing the sanitary pads.

When To Call The Doctor?

You should contact your doctor if you notice the following symptoms (3) (6).

  • 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
Contact your doctor if you experience fever and chills after a c-section

Image: Shutterstock

  • Foul-smelling vaginal discharge or blood
  • Severe pain in lower abdomen
Quick fact
Previous postpartum hemorrhages, a BMI above of 35, twin or triplet pregnancy, placenta previa, placental abruption, pre-eclampsia, anemia, and fibroids may increase the risk of postpartum hemorrhage (1).

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.


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