Vaginal Bleeding After C-Section: What To Expect & How Long It Lasts
It has to go somewhere.
If you’ve never had one, you may not know what to expect when recovering from a C-section. You’ll need to prep your medicine cabinet with aftercare supplies, and as with any kind of birth, you’ll want to have plenty of maxi pads on hand. That’s right: vaginal bleeding after C-section is a thing, just like it is with a vaginal birth, so have those mesh undies and pads ready to go. Here’s what the experts have to say about why vaginal bleeding happens to all birthing parents, and when you can expect it to taper off.
Why do you bleed after C-section?
When you deliver vaginally or via C-section, your baby and the placenta come out. What doesn’t get pushed out or surgically removed is all the lining, blood, and remaining fluids in the uterus. So, regardless of how you give birth, those things will all come out vaginally (as a postpartum discharge called lochia).
“After a vaginal delivery or a C-section, the lining of the uterus is going to slough off. The baby comes out, then the placenta comes out, then the lining of the uterus will come out and over a period of time, everything clears out,” says Dr. Victor Klein, M.D., board-certified OB-GYN at Northwell Health and vice chairman of obstetrics and gynecology at North Shore University Hospital.
“Postpartum bleeding is typically the same regardless of whether a woman delivers vaginally or by cesarean section,” says Angela Wilson-Liverman, DHSc, CNM, FACNM, certified nurse midwife and associate professor in the department of obstetrics and gynecology at Vanderbilt University Medical Center.
How long do you bleed after C-section?
Vaginal bleeding after C-section (or any birth) usually lasts four to six weeks, with the bleeding becoming more irregular near the end, according to Wilson-Liverman.
Klein says that range can be a bit longer for some new parents. “It’s normal to bleed between six and 12 weeks after you deliver, whether by Cesarean or vaginally. Usually by six weeks everything is not bleeding anymore, but you can have irregular bleeding up to 12 weeks postpartum,” he says.
If you’re not a big fan of maxi pads you might be wondering if you can use tampons or cups for the bleeding. But both experts tell their patients to stick to pads only for the first six weeks.
“I do not recommend tampons because of risk of infection, but pads are fine,” Klein says. “Nurses will give you pads after delivery, and people will use pads for the first six weeks. After that, I let them use tampons. I also recommend the same thing about sexual activity — wait for six weeks for everything to go back to normal and to reduce the risk of potential infection.”
“We recommend only using pads for postpartum bleeding until the uterus is completely involuted (returned to its pre-pregnancy size, about that of an avocado). This is to avoid the possibility of introducing infection,” Wilson-Liverman says.
What is considered abnormal bleeding after C-section?
Is it normal to bleed on and off after C-section? If you’ve noticed your bleeding comes and goes, don’t worry. “Yes, postpartum vaginal bleeding can stop and start,” says Wilson-Liverman. “It usually goes from bright red to a yellowish color over the initial four to six weeks postpartum. If it suddenly becomes very heavy — or much heavier than it had been the day before, for example — it might be an indicator that the mother is overdoing physical activity.”
While vaginal bleeding after C-section is totally normal, it’s important to know the red flags that something may be wrong. “If you’re having excessive bleeding — which is hard to quantify, but we say bleeding through several pads in an hour — you should call your provider,” says Klein. “It’s normal [for bleeding] to be intermittent, but if you have very heavy bleeding quickly, or a fever or abdominal pain, then it could be sign of infection, and that could be reason why there’s bleeding.”
So, be mindful of how your vaginal bleeding is changing over time. If you notice anything concerning, call your doctor just to be safe.
What are the signs of internal bleeding after a cesarean?
People who have a C-section are at risk for internal bleeding, Klein says, because in rare cases, a blood vessel may reopen after the procedure ends. If you’re bleeding internally, Klein and Wilson-Liverman say you may notice:
- Your heart racing.
- You feel faint or weak.
- You have bloating or pain in your abdomen.
- Your blood pressure drops suddenly.
- You’re sweating more than usual.
- You’re experiencing pelvic pain.
“This is very important. People bleed after a C-section or vaginal delivery. If it’s coming out vaginally, you know it’s uterine bleeding, not internal bleeding. Internal bleeding is an emergency and you should be seen right away,” says Klein.
Recovering from a C-section will still involve vaginal bleeding, because your body has to get rid of all that *stuff* that kept your baby happy and healthy during pregnancy. So, stock up on postpartum undies and extra long pads, and know that in about six weeks time, things will be getting back to normal.
Angela Wilson-Liverman, DHSc, CNM, FACNM, certified nurse midwife and associate professor in the department of obstetrics and gynecology at Vanderbilt University Medical Center
Dr. Victor Klein, M.D., board-certified OB-GYN at Northwell Health and vice chairman of obstetrics and gynecology at North Shore University Hospital