Postpartum bleeding happens to all women — it’s a natural part of the transition, regardless of whether you had a vaginal delivery or a C-section. But how do you know if you’re bleeding too much? Once you're home with your mesh panties and pads, you may be wondering why there seems to be so much blood. Where does all the blood come from after having a baby? How much is too much? When should you worry?
Because all that blood can look like a horror film, it’s understandable to have questions about where it's all coming from and how your body is able to survive after losing so much of it postpartum. Dr. Adrienne Zertuche, an OB-GYN at a Division of Atlanta Women’s Healthcare Specialists explains, “During pregnancy, the placenta attaches to the uterus in order to capture oxygen and nutrients from the mother’s bloodstream and pass it via the umbilical cord to the developing baby. After the baby is born, the placenta separates and is removed from the uterus.” Zertuche adds that because the site of the placenta had an excellent blood supply while you were pregnant, it takes it a while to realize it doesn’t need to feed the baby anymore. “In the interim, it continues to bleed lightly and shed tissue called lochia,” she says to Romper.
What the heck is lochia? Dr. James Betoni, a high-risk fetal medicine doctor and the creator of the app Pregnancy Power, tells Romper in an email interview that lochia is “the fluid that is discharged from the vagina for a week or so after childbirth. At first, the lochia is primarily blood, followed by a more mucus-like fluid that contains dried blood, and then finally, a clear-to-yellow discharge."
But how much blood is too much? When should you be worried? Zertuche says most women experience bleeding much like a really heavy period, and sometimes will even pass small clots, but it should get lighter and lighter with each passing day and be completely gone by four weeks. However, "After going home from the hospital, you should call your doctor if you are soaking a pad with blood each hour for two hours, if you pass large blood clots, if you have bleeding that lasts longer than six to eight weeks, or if you have symptoms of a low blood count, like heart racing, shortness of breath, or dizziness or lightheadedness,” she warns. Betoni also says clammy or cold skin, and sweating and overall weakness are signs of possible excess blood loss, and you should contact your healthcare provider.
Are there ways to help manage the bleeding or to make it stop faster? Zertuche says there’s nothing in particular you can do at home, but to make sure you’re eating iron-rich foods or taking an iron supplement to support your body while it's losing a lot of blood. But Betoni says there is something you can do while you’re in the hospital — "Massaging your uterus and taking certain IV and/or vaginal/rectal medications [may help you manage bleeding],” he says. “You should not be having to manage bleeding once discharged — the amount of bleeding should be the normal lochia."
So it's totally normal to bleed like a horror movie postpartum, as long as you're not soaking a pad each hour for two hours or passing really large blood clots. At least there's mesh panties, I guess, right? Grab as many as you can before leaving the hospital.