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Bleeding After C Section: How Long Does It Last And When To Seek Help?

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IN THIS ARTICLE

Is It Normal To Bleed After A C-Section?

Vaginal discharge or bleeding is normal after C-section. After pregnancy, the body discharges, a substance that is known as lochia. It is also normal to have small amounts of draining from the incision after a cesarean. However, if the drainage doesn’t stop after a few days, consult your doctor (1).

In this MomJunction post, we tell you everything about bleeding after C-section, and the precautions you should take to stay safe.

How Long Do You Bleed After A C-Section?

Vaginal delivery bleeding might last until 14 days after delivery, whereas in the case of C-section, you may experience a smaller amount of lochia after 24 hours of delivery when compared to vaginal delivery, and the bleeding might stop four to six weeks after the C-section. The bleeding is heavier and bright red initially, and gradually lightens to red or pink, and then ends as a yellow or white discharge (1).

How Is Bleeding After C-Section Different?

On the first day after a C-section, blood will appear bright red or brownish-red. After a few weeks, the color lightens from pink to yellowish-white. The bleeding might get brighter after you breastfeed the baby (1). Many women find that they bleed less than after a vaginal delivery, but that is not always the case.

How Much Bleeding Is Too Much Or Heavy?

The following symptoms indicate heavy bleeding:

  • You need to change the pad every due to excess flow
  • Passing larger blood clots, such as the size of a golf ball or larger
  • Having symptoms of low blood count, such as shortness of breath, heart racing, lightheadedness, or dizziness.

When To Call A Doctor?

If you notice any of the following symptoms, then call your doctor right away (8):

  • The blood flow continues even after six weeks postpartum
  • Heavy bleeding
  • Large blood clots
  • Vaginal discharge with a foul smell
  • Fever and chills
  • No lochia in the first two weeks

What Causes Bleeding After A C-Section?

For a C-section, an incision of around 6cm to 7cm long is made, approximately 5cm above the pubic symphysis, in the lower abdominal region (2). In this procedure, the placenta is detached from the uterus, and the blood vessels open and bleed, causing a blood pool inside the uterus. This comes out of the vagina as lochia
(3).

The discharge will be heavy for a few days initially and will lighten gradually. The lochia is classified into three stages (4) (5)
:

1. Lochia rubra, which is experienced during the first two or three days after delivery. The lochia rubra is:

  • Mostly blood that is bright red
  • In heavy to moderate flow
  • Contains small blood clots

2. Lochia serosa starts by day four after the delivery and lasts. During this stage:

  • Blood color changes from red to pink or pinkish brown
  • Flow is less
  • Bright red blood or blood clots during these days indicates some problem.

3. Lochia alba. During this phase:

  • The discharge color changes from light yellow to cream
  • Flow almost stops without any smell
  • Any clots or bright red blood with a foul smell could be an indication of a problem.

If you notice a reversal in the stages indicated by the color of the blood, then consult your doctor right away. Also, your first period is expected to return within five to six weeks of postpartum, with heavy flow and blood clots (1). It may be irregular or intermittent, i.e., it could start, stop, and start again.

Bleeding, in some cases, can be internal. Find out more about it next.

Internal Bleeding After A C-Section

Here are some signs of internal bleeding after a C-section:

  • Rapid heartbeat: A drop in the blood pressure that causes rapid heart rate and breathing is one of the symptoms of internal bleeding.
  • Uterine atony: After C-section, oxytocin is given to the patient to promote the contraction of the uterus. If the uterus does not contract, then uterine bleeding will be heavy.
  • Pale skin: Women look pale, and their hands become clammy and cold.
  • Anxiety and weakness: Women may pass out or feel extreme weakness as a result of internal bleeding.

A blood test might also help in determining the hemoglobin level; any drastic reduction in the level may indicate internal bleeding.

After the C-section, use maternity pads when there is bleeding. The number of times you change the pad also helps the midwives or doctors to understand how much blood is lost. Here is what you should do to reduce the chances of any infection.

  • Avoid tampons for the first six weeks
  • Thoroughly wash hands before and after changing the pad.

Incision site: However, your doctor is the best person to evaluate the condition and prescribe the right treatment to prevent any further complications.

Did you experience any unusual bleeding after a C-section? Share your experience with us in the comment section below.

References:

1. Pregnancy: Physical Changes After Delivery; Cleveland Clinic
2. T. R. Vejnović, S. D. Costa, and A. Ignatov; New Technique for Cesarean Section; NCBI(2012)
3. Postpartum Bleeding; Epigee Women’s Health
4. Sherman D1, Lurie S, Frenkel E, Kurzweil Y, Bukovsky I, Arieli S; Characteristics of normal lochia; NCBI(1999)
5. L. W. Oppenheimer, et al.; The duration of lochia; British Journal of Gynaecology
6. What Is Gestational Trophoblastic Disease?; American Cancer Society
7. Cindy Schmidler; Lochia, Postpartum Bleeding and Physical Changes and Healing After Vaginal Birth; HealthPages
8. Postpartum Hemorrhage; Stanford Children’s Hospital