- Is it normal to have blood clots post delivery?
- What are the normal symptoms of a blood clot after childbirth?
- What are the symptoms of a dangerous blood clot?
- When to call the doctor?
- How are blood clots after childbirth treated?
- Does c-section increase the risk of a blood clot?
- How to prevent blood clots after childbirth?
- How to care for yourself?
A vaginal discharge consisting of mucus, blood, and placental tissues is common after delivery. Such a postpartum discharge is known as Lochia, which continues for four to six weeks. Blood clots sometimes accompany this vaginal bleeding. A clot is a mass of blood that sticks together, giving a jelly-like appearance.
Are Blood Clots Normal Post Delivery?
Yes, women usually tend to pass blood clots after childbirth (1).
When the body sheds the uterine lining after delivery, blood starts to pool inside the uterus. The remains of the uterine lining, along with the damaged tissues, pass with the blood through the vagina. If the blood doesn’t pass out immediately from the body, it results in blood clotting.
During pregnancy, there is an increase in the platelets. The blood clotting factors are also higher than usual for up to 12 weeks post delivery. According to the American Heart Association, this degree of increase peaks during delivery but remains (2):
- 10.8 times higher during weeks 0-6
- 2.2 times higher during weeks 7-12
- 1.4 times higher during weeks 13-18
Abnormally large clots or one too many clots followed by heavy bleeding can be a cause for concern. Sometimes the blood clot forms inside the vein and cannot be expelled out, resulting in a condition called deep vein thrombosis. These clots then break and spread in the bloodstream and travel to the lungs, giving rise to pulmonary embolism, which is a rare but life-threatening condition.
Next, we tell you how to determine whether or not the blood clots are normal.
What Are The Normal Symptoms Of Blood Clotting After Childbirth?
Blood clots are common after childbirth and the amount discharged will reduce eventually. Here is a guide to help you understand the discharge of blood clots for up to six weeks post-delivery (3).
|Days/Weeks after delivery||Color of blood||Amount discharged|
|First day||Fresh red or brownish red blood.||Considerably heavy loss of blood, soaking the napkins every few hours.|
You may pass one or two large clots about the size of a tomato. The smaller one may be about the size of a grape.
|Days 2-6||Dark brown or pinkish red blood.||Moderate amount of blood loss with the stain measuring 7-12cm on a sanitary pad. Very small clots will be passed once or twice in a day.|
|Days 7-10||Color stays the same or may appear light brown or pinkish red.||Amount of blood loss reduces significantly, without soaking the pad as profusely as earlier. The stain on a sanitary pad measures less than 7cm.|
|Days 11-14||The color gets much lighter. If you are very active, then it may stay a little bright.||The amount of blood is reduced by a degree, hardly staining the sanitary pad.|
|3rd -4th weeks||Blood loss may still be there, with a paler tint or in creamy white color.||There will be very little or no blood loss at all. If the blood loss stops after three or four weeks and fresh blood flow begins, it could indicate the return of your menstrual cycle.|
|At about six weeks||Occasional blood loss that is either brown, pinkish red, or creamy yellow.||A light, pale stain on the sanitary pad that may continue either throughout the day or on some days.|
The color and size of the clot and the amount of blood loss are also affected by the following factors:
- Time of the day: The blood loss can be significantly more in the mornings as the blood pools in the uterus when you lie down and flows down into the vagina when you stand up.
- Breastfeeding: Release of the oxytocin hormone during breastfeeding also triggers the contraction of the uterus with or without pain. It is followed by a slight increase in the discharge of lochia.
- Exercising: Gentle physical activities such as walking can also cause a heavy blood loss during the first two weeks post delivery.
If the blood clots are different than they usually are post-delivery, they could pose risks to your health.
What Are The Symptoms Of A Dangerous Blood Clot?
Abnormal blood clotting could indicate deep vein thrombosis or pulmonary embolism. Blood clots accompanied by symptoms of these conditions could be dangerous. Signs and symptoms you should watch out for include (4):
For deep vein thrombosis (DVT)
- Swelling in one leg or arm
- Reddish or bluish skin discoloration
- Leg pain or tenderness often described as a cramp or Charley horse
- Leg or arm feels warmer on touch
For pulmonary embolism
- Shortness of breath
- Sharp or stabbing chest pain that may worsen when you take a deep breath
- Rapid heart rate
- An unexplained cough with or without bloody mucus
Additional risk factors that increase the risk of DVT and pulmonary embolism include (5):
- Previous blood clots
- A family history of blood clotting disorders
- Maternal obesity
- Increased maternal age (over 35 years)
- Prolonged immobility (like bed rest or long distance travel)
- Multiple pregnancies
- Any medical condition like cancer or infections
Such blood clots can also lead to (6)
- Heart attack – When a blood clot blocks the oxygen and blood flow to the heart.
- Strokes – When a blood clot obstructs a blood vessel that supplies blood to the brain or when a blood vessel in the brain bursts opens. It can be fatal, and about 8 in 100000 women can get it.
Look out for the symptoms and reach out to your doctor as soon as possible.
When To Call The Doctor?
If you notice any of the following symptoms, call your doctor immediately (3).
- Large size blood clots: If you continue to pass large size blood clots after the first 24 hours of delivery, following heavy blood loss.
- Heavy blood flow: The blood flow should reduce gradually as the week passes. If it does not, call the doctor.
- Foul smell: If the vaginal discharge has an offensive odor, which could be due to an infection of the uterus or the perineum.
- Pelvic pain: A urinary infection, infection of the uterus, or constipation can cause the pelvic pain.
Timely diagnosis and treatment can help you get through any serious risks due to dangerous blood clots.
How Are Blood Clots After Childbirth Treated?
If DVT or pulmonary embolism is suspected postpartum, the doctor will suggest a few diagnostic tests before prescribing the ideal course of treatment.
- In case of a suspected deep vein thrombosis, ultrasonography is done. Then, a blood test is carried out to detect the amount of D-dimer, which is a substance released from the blood clots.
- Computed tomography (CT) of the chest is carried out to detect pulmonary embolism. It is carried out after injecting a radiopaque contrast agent, which is a form of a dye, into the vein. The dye helps in clearing any blockage to give clear visibility inside the vein.
Anticoagulants are generally used for treating postpartum blood clotting disorders. Women need to take this medication for six weeks post delivery (7). Heparin, which is injected through the vein or under the skin for the first five to ten days, is the most widely used anticoagulant drug for reducing the clots. Other medications include warfarin, edoxaban, rivaroxaban, apixaban, and dabigatran.
In the case of warfarin therapy, both heparin and warfarin are administered for the first five to ten days, followed by only warfarin afterward. The continuation of the anticoagulant treatment depends on the condition of the patient (8). Women who are on heparin or warfarin therapy can breastfeed their babies.
We address a few commonly asked questions about postpartum blood clots next. Read on.
Does C-section Increase The Risk Of Blood Clots?
Recent studies revealed that women undergoing a c-section were at a higher risk of developing dangerous postpartum blood clots compared to those who delivered vaginally. The risk was especially high in cases of an emergency c-section (9).
According to Dr. Marc Blondon, of Geneva University Hospital in Switzerland, there is an increase in the blood’s susceptibility to clotting during surgery. Thus, women who are considered for a c-section without any medical indication for it, are at higher risks. However, the risk remains low in the majority of women who had undergone a c-section.
The ACOG says that for women with no risks of a blood clot, a pneumatic compression device should be used before delivery. This helps reduce any potential risks. This device is placed on the legs to prevent blood from pooling inside the calves.
If you have had the problem earlier, then you can take some preventive measures during your consecutive pregnancies.
How To Prevent Blood Clots After Childbirth?
Here are some tips you can follow to prevent any blood clotting risks:
- Be aware of the risk factors for blood clotting.
- Stay active and keep moving regularly.
- Stay informed about the family history of this disorder.
- Ensure that the doctor knows about your family history of blood clotting disorders.
- Always look out for any symptoms of a blood clot.
- Do not use tampons for at least six weeks after delivery.
How To Care For Yourself?
Here are some tips you can follow in case of excessive blood flow:
- Stock up sanitary pads for this period and avoid using tampons.
- Keep your bladder empty as it helps in contracting the uterus and aids in reducing the postpartum bleeding.
- Rest as much as you can.
If you have delivered recently and find any symptoms related to blood clotting, then make sure to contact your doctor right away. Getting the dangerous clots treated on time, with the right medications can keep you away from any fatal situations.
Do you have any experience to share with us? Let us know in the comments section below.