Should you worry if your postpartum bleeding stopped then started again? Here’s everything you need to know, plus other helpful postpartum tips.
That’s especially true for postpartum bleeding.
It’s normal and natural to experience vaginal bleeding after birth, but it can also be dangerous in certain circumstances.
So, here’s everything you need to know about postpartum bleeding, including what to do if your postpartum bleeding stopped then started again.
What is postpartum bleeding?
After delivery, every new mom will experience postpartum bleeding and vaginal discharge called lochia. This is true for those with a vaginal delivery and for women who gave birth via cesarean section.
However, women who experience a vaginal birth may have heavier and longer postpartum bleeding.
There are several factors that can cause bleeding after birth. Some are normal and beneficial and others may indicate a serious health problem that needs to be addressed.
- One normal and natural cause of postpartum bleeding is the body ridding itself of the extra tissue, blood, and mucus necessary for pregnancy.
- Bleeding also happens when the placenta separates from the uterus. This separation leaves open blood vessels at the site of detachment that leech out blood. During postpartum, uterine contractions continue in order to close off those open vessels.
- However, it is also possible to have postpartum hemorrhaging, a dangerous condition where excess bleeding can become life-threatening.
Hemorrhaging can be caused by uterine rupture (the uterus tears during labor), tears in the vagina or cervix during delivery, or uterine atony. Uterine atony is the most common cause of postpartum hemorrhage. This is when the uterus fails to contract after birth to close off those exposed blood vessels.
Luckily, postpartum hemorrhaging (PPH) is rare (only 1-5% of women experience excessive postpartum bleeding), but it’s definitely something to keep an eye on after birth.
How long does postpartum bleeding last?
Postpartum bleeding can last up to 6 weeks, but the heaviest flow is typically within the first 3-10 days. If the bleeding doesn’t stop around the time of your postpartum follow-up appointment, be sure to let your doctor know.
The color of lochia tends to change with time and can indicate where you are in your postpartum recovery.
Here are the lochia stages of postpartum bleeding divided by color:
- Stage one is Lochia rubra. This blood is dark red, similar to a very heavy period, and typically lasts about 4 days. You may experience cramping and even pass some blood clots. This is normal and nothing to worry about, as long as the clots are smaller than an egg.
- Then, there’s Lochia serosa. Blood will be a pinkish shade and your flow will likely be lighter. This lasts about 2 weeks.
- The last stage is Lochia alba. Your discharge will be a yellowish or brown color with a little bit of blood. This stage expels those white blood cells responsible for repairing the uterus.
How To Deal With Postpartum Bleeding
In addition to postpartum bleeding, there are several postpartum body changes new mothers have to endure. Thankfully, most are temporary.
And while lochia lasts longer than most women would prefer, there are plenty of products to help deal with the discomfort.
First, you’ll want to have lots of maternity pads or sanitary pads on hand. You can often stock up on these from the pads provided to you by the hospital. Be sure to snag some of the mesh panties from the hospital, too.
Here are some other postpartum essentials your hospital may provide:
- Tucks Pads
- Ice packs
- Peri bottle
- Dermoplast spray
- Inflatable donut cushion
- Stool softeners
If your hospital doesn’t provide these items, make sure you purchase them before you go into labor so you have them right after birth and waiting at home.
Remember to avoid soaking in a bath or using tampons until after your six-week appointment. These activities increase the risk of infection and can be detrimental to your health.
What To Do If Postpartum Bleeding Stopped Then Started Again
It’s not unusual for postpartum bleeding to change with activity level, to stop and start again, or to be characterized by intermittent spotting or bleeding. The lining of the uterus is in the process of healing, and sometimes that healing does not occur at the same time throughout the entire lining.
You may experience bleeding from the placenta site scab coming off the uterine wall, for example. This may occur a week or two after your bleeding seems to have stopped, and may manifest as a sudden gush of bright red blood. This bleeding should taper down within a few days.
Other causes for breakthrough bleeding are changing levels of hormones and increased physical activity. Renewed bleeding often occurs between weeks 5 and 8 postpartum as this is the time new moms start to feel stronger and more like themselves again and may push themselves too hard.
You may also experience a change in blood flow in the following circumstances:
- In the morning right after waking,
- During physical activity like exercising,
- or while breastfeeding.
Most women won’t experience their first postpartum period for several months, especially if they’re nursing. However, non-lactating women typically start their normal cycle much sooner.
If you’re not breastfeeding and experience renewed bleeding around the 2-month mark, it may be the return of your menstrual cycle and not lochia. Keep an eye out for changes in basal body temperature, changes in cervical mucus, or symptoms you normally experience around the time of your menstrual cycle, as it may be the return of Aunt Flow.
If bleeding stopped and started again under any of the circumstances above and is a light flow, you likely don’t need to do anything different or have cause for concern.
Bleeding After A C-Section
As mentioned above, women who have had a cesarean delivery will experience the same blood loss as a woman who delivered naturally. So if your bleeding after a c-section stopped and then started again, it’s likely the normal process of the placental site scab coming off.
Women who’ve had a c-section will also have an incision on their lower abdomen. It’s normal for the incision to leak a small amount of clear or bloody fluid in the first few days following delivery, but a large amount of puss or discharge is not normal and is cause for seeking medical attention right away.
When To See a Doctor
If postpartum bleeding doesn’t stop around the normal time, be sure to let your doctor know. And if you notice these signs or symptoms, go to the emergency room right away or call 911:
- Heavy bleeding that’s bright red beyond the third day after birth
- Large clots bigger than a plum or egg
- Soaking through more than one pad in an hour and it doesn’t slow down or stop
- Severe pain
- Changes in vision
- Clammy skin
- Rapid heartbeat or elevated blood pressure
- Weakness or extreme fatigue
- Feeling faint
These symptoms can indicate a serious medical condition like postpartum hemorrhage or severe infection.
Bright red blood and heavy bleeding should taper off around day 3 or 4, postpartum.
If you’re still experiencing bright red blood after this timeframe, reach out to your doctor right away to rule out postpartum hemorrhage.
Postpartum hemorrhage (PPH) usually occurs within the first 24 hours after birth but can happen as far out as 12 weeks, postpartum. Only 1-5% of women will experience PPH and late postpartum hemorrhage is extremely rare.
It may be hard to tell the difference between a period and lochia, but there are some signs to look out for.
If you experience a change in basal body temperature, changes in cervical mucous, or symptoms you normally have before your menstrual cycle, it may be your period. Renewed bright red bleeding after 6 weeks postpartum might be menstrual bleeding, especially if you’re not breastfeeding.
If this information was helpful, be sure to check out:
- Postpartum Body Changes You Need to Know
- What Postpartum Depression Feels Like
- The Best Breastfeeding Tips
- 3 First Time Mom Books Worth a Read
- The Ultimate List of Mom Hacks
We’ve covered what postpartum bleeding is, what’s going on if postpartum bleeding stopped and started again and when to be concerned. Did I miss any of your questions? Let me know in the comments!