The Masterpiece Mom

Home » Misc » First period after birth heavy bleeding

First period after birth heavy bleeding


What to Expect – Happiest Baby

By Dr. Harvey Karp, MD, FAAP

Pregnancy can have its challenges, but on the celebratory side, you are spared monthly menstrual cycles and the mood swings, cramps, and bleeding that come with them. Of course, now that you’ve had your baby, you may be wondering when your period is likely to return. The short answer is…it depends.

How long does it usually take for periods to return after birth?

The timing of your first period postpartum depends on whether or not you breastfeed. If you’re formula feeding, Aunt Flo should arrive about six to eight weeks after the big day. However, if you’re exclusively breastfeeding—meaning, your baby drinks absolutely nothing but breastmilk (other than vitamins or medicine)—your period will likely be delayed. That’s because prolactin, the hormone released during breastfeeding, delays the restarting of your ovulating. No ovulation = no period.

Some women won’t get a period for the entire time they are breastfeeding. Others will get their period while they are still breastfeeding, particularly after they have introduced bottles of formula, solid foods or when baby starts sleeping through the night.

Can you get pregnant before you have a period?

Yes! Yes! Yes! Once your cycle comes back, you will ovulate two weeks before you get your first period, so you will have no advance warning that you’re fertile! If you’re not ready to get pregnant again, check out your birth control options. Hormonal birth control won’t hurt your baby, but if they contain estrogen they may cause your milk supply to dip. Ask your practitioner about non-hormonal birth control methods—including diaphragms, condoms, certain versions of the pill (progesterone-only pills do not reduce milk supply), and some IUDs—that are totally compatible with breastfeeding.

Can I use breastfeeding as birth control?

In theory, yes, you can use breastfeeding as birth control, but that comes with a big asterisk. Using breastfeeding as birth control is known as the Lactational Amenorrhea Method (LAM), and it relies on the fact that ovulation is delayed if you are exclusively breastfeeding. However, for it to work you must meet certain criteria:

  1. Your baby should be under 6 months (pre-solid-food-introduction).
  2. You need to be exclusively breastfeeding and breastfeeding frequently (at least every four to six hours.
  3. Ideally avoid pacifiers, bottles, and pumping.

If you’re doing all of the above, LAM can be up to 98% effective at preventing pregnancy. Problem is, meeting all three of those requirements can be challenging for some families, so it’s not foolproof. Learn more about using breastfeeding to prevent pregnancy.

What will your first period after birth be like?

Brace yourself…the first period after giving birth is typically heavier than normal because there is extra blood in your uterine lining that needs to be shed. You may enjoy easier periods due to physical changes in the uterus and cervix, although some folks experience stronger cramps.

Here’s another surprise: After your first post-baby period, the next may show up early…or quite late. It can take a few months for your cycle to become regular again. Stash some period protection in your purse so you’re not caught off guard. If you do get your period soon after giving birth, ask your doctor if it’s safe to use tampons. Most women feel that pads are a better option until the vagina is completely recovered from delivery. You’ll typically be cleared to use tampons at your six-week postpartum checkup.

When should you see a doctor about your period?

Though that first period after baby can be a doozy, the flow should not be so heavy that you’re going through one pad per one to two hours. Call your doctor if you’re experiencing any of the following:

  • Big blood clots: It’s normal to see small clots in your first postpartum period, but if they are larger than a quarter or last for several days, it could be a sign of a thyroid problem, infection, fibroids, or polyps.
  • Heavy flow, pain, and spotting: If you are experiencing heavy, painful periods or spotting between periods, you may have developed adenomyosis, which is a thickening of the uterine wall. While not usually dangerous, adenomyosis can be uncomfortable, particularly during sex. Don’t be shy about asking your doctor or midwife. Depending on the severity, they may want to give you anti-inflammatory medications, hormones, or a minor surgical procedure.
  • Prolonged heavy flow: Losing too much blood can cause anemia from iron deficiency. Low iron can make you feel tired, dizzy and irritable. Fortunately, the diagnosis and treatment are pretty simple: if your blood test shows low iron, your practitioner will give you iron supplements and vitamin C (vitamin C helps your body absorb the iron).
  • No period: If your period hasn’t returned three months after giving birth or three months after stopping breastfeeding, talk to your practitioner. This is often totally normal, but there are two rare conditions that can cause your periods to disappear:
    • Sheehan’s Syndrome: Your pituitary gland was damaged during delivery, which disrupts your period. It is treated with hormone therapy.
    • Asherman’s Syndrome: The development of scar tissue in the uterus, often resulting from a D&C (dilation and curettage) procedure done after a miscarriage. Asherman’s can cause fertility issues, so a woman with this syndrome who wishes to become pregnant again may need a surgical procedure called an operative hysteroscopy.

When should I worry about a heavy period after pregnancy?

For the most part, a heavy flow comes with the territory of your first postpartum period. However, a small percentage of folks who give birth experience a postpartum hemorrhage (defined by the loss of 500 mL of blood or more), which can happen anywhere from 24 hours to 12 weeks after giving birth.

Postpartum hemorrhage is typically caused by what’s known as uterine atony—this means the uterine muscles aren’t contracting normally to tighten the blood vessels after Baby arrives. It can be also caused by other conditions (some of which you were likely diagnosed with prior to giving birth):

  • Placental abruption (when the placenta separates early from the uterine wall)
  • Placental accreta, placenta increta or placenta percreta (when the placenta grows too deeply into the uterine wall)
  • Placenta previa (when the placenta sits low enough to cover the cervix)
  • Uterine inversion (a rare condition where the uterus turns inside out following birth)
  • Uterine rupture (a rare condition when the uterus tears in labor)

While it can strike without warning, there are certain risk factors associated with postpartum hemorrhage, such as:

  • Long labor
  • Fast labor
  • History of postpartum hemorrhage
  • Labor induction
  • Episiotomy
  • Preeclampsia
  • Larger uterus (could be from a big baby, carrying multiples, or having excess amniotic fluid)
  • C-section
  • Hispanic or Asian ethnicity
  • Chorioamnionitis

If you experience these signs of postpartum hemorrhage, call your provider immediately:

  • Heavy bleeding that doesn’t slow or stop
  • Drop in blood pressure
  • Blurry vision or chills (could be the result of a drop in blood pressure)
  • Nausea
  • Pale skin
  • Pain or swelling around the vagina or perineum

Final Thoughts on First Period After Birth

Though you may wish your period would just stay away forever, remember that it’s a sign of your body functioning normally after pregnancy. Practice self-care by getting plenty of rest, taking walks to relieve cramps, and snacking on healthy fats (hello, avocado toast!) and iron-rich lentils, prunes, meats, and foods cooked in a cast iron skillet.

Read more about postpartum life:

  • Healing and Recovery After Birth
  • Weird Things That Happen to Your Body After Birth
  • Sex After Birth—Your Questions, Answered!
  • Vagina Changes After Birth

About Dr. Harvey Karp

Dr. Harvey Karp, one of America’s most trusted pediatricians, is the founder of Happiest Baby and the inventor of the groundbreaking SNOO Smart Sleeper. After years of treating patients in Los Angeles, Dr. Karp vaulted to global prominence with the release of the bestselling Happiest Baby on the Block and Happiest Toddler on the Block. His celebrated books and videos have since become standard pediatric practice, translated into more than 20 languages and have helped millions of parents. Dr. Karp’s landmark methods, including the 5 S’s for soothing babies, guide parents to understand and nurture their children and relieve stressful issues, like new-parent exhaustion, infant crying, and toddler tantrums.

Have questions about a Happiest Baby product? Our consultants would be happy to help! Connect with us at [email protected].

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.

First Period After Pregnancy: What to Expect

Overview

From glowing skin to a newfound appreciation for your body, there are many things to love about pregnancy. Another is that you’ll have at least nine months of freedom from your period. But after you deliver, you’re probably curious what will happen with your menstrual cycle.

When your period returns often depends on whether or not you breastfeed. And just like your life after baby, you might find your periods after pregnancy are somewhat different.

When will my period return?

Your period will typically return about six to eight weeks after you give birth, if you aren’t breastfeeding. If you do breastfeed, the timing for a period to return can vary. Those who practice exclusive breastfeeding might not have a period the entire time they breastfeed. “Exclusive breastfeeding” means that your baby is receiving only your breast milk. But for others, it might return after a couple of months, whether they’re breastfeeding or not.

If your period does return quickly after giving birth and you had a vaginal delivery, your doctor might recommend that you avoid using tampons during your first menstruation post-baby.

This is because your body is still healing, and tampons could potentially cause trauma. Ask your doctor if you can return to using tampons at your six-week postpartum checkup.

Why don’t breastfeeding women get their periods as quickly?

Typically, women who are breastfeeding don’t get their periods as quickly because of the body’s hormones. Prolactin, the hormone needed to produce breast milk, can suppress reproductive hormones. As a result, you don’t ovulate or release an egg for fertilization. Without this process, you most likely won’t menstruate.

Will my period affect my breast milk?

When your period does return, you may notice some changes in your milk supply or your baby’s reaction to breast milk. The hormonal changes that cause your body to have your period may also influence your breast milk.

For instance, you might notice a decrease in your milk supply or a change in how often your baby wants to nurse. The hormone changes might also affect your breast milk’s composition and how it tastes to your baby. These changes are usually very minor, however, and shouldn’t affect your ability to breastfeed your baby.

What about birth control?

Some use breastfeeding as a natural birth control method. According to the Association of Reproductive Health Professionals, fewer than 1 out of 100 women will get pregnant annually if they’re engaging in exclusive breastfeeding. Even though breastfeeding reduces your fertility, it’s not an absolute guarantee you won’t get pregnant again.

The key here is exclusive breastfeeding. Other than breast milk, no fluids or solids are given to the baby with exclusive breastfeeding. Even water. Supplements or vitamins don’t interfere and can be given to the baby. Breastfeeding that doesn’t fit this description might not protect against another pregnancy.

If you’re breastfeeding and your period does return, you’re no longer protected against getting pregnant. It’s also important to note that it can be difficult to predict the return of fertility. You will ovulate before your period starts, so it’s entirely possible to get pregnant again before your period returns.

Safe and effective birth control methods are available for those who are breastfeeding. Nonhormonal options such as the copper intrauterine device (IUD), condoms, and diaphragms are always safe for breastfeeding.

There are also some hormonal birth control options that are considered safe during breastfeeding. Your doctor can provide the latest updates on specific types of birth control. In general, low-dose combination pills that contain estrogen and progestin are considered safe after you’ve healed from birth. Progestin-only pills are also safe to use while breastfeeding.

How might my period be different postpartum?

When you do start your period again, chances are the first period after delivery won’t be like your periods before you got pregnant. Your body is once again adjusting to menstruation. You may experience some of the following differences:

  • cramping that might be stronger or lighter than usual
  • small blood clots
  • heavier flow
  • flow that seems to stop and start
  • increased pain
  • irregular cycle lengths

The first period after your pregnancy may be heavier than you’re used to. It might also be accompanied by more intense cramping, due to an increased amount of uterine lining that needs to be shed. As you continue your cycle, these changes will likely decrease. In rare cases, complications such as thyroid problems or adenomyosis can cause heavy bleeding after pregnancy. Adenomyosis is a thickening of the uterine wall.

Women who had endometriosis before pregnancy might actually have lighter periods after giving birth. Light periods can also be caused by two rare conditions, Asherman syndrome and Sheehan syndrome. Asherman syndrome leads to scar tissue in the uterus. Sheehan syndrome is caused by damage to your pituitary gland, which may be the result of severe blood loss.

What causes mildly painful postpartum periods?

Mildly painful postpartum periods can be caused by a combination of several factors. They include:

  • increased intensity of uterine cramping
  • the hormones of breastfeeding
  • the uterine cavity becoming larger after pregnancy, which means there’s more uterine lining to be shed during menstruation

What should I expect from my first period postpartum?

Whether you delivered your baby vaginally or by cesarean delivery, you can expect some bleeding and vaginal discharge after giving birth. Your body continues to shed the blood and tissue that lined your uterus while you were pregnant.

In the first few weeks, blood might be heavier and appear in clots. As the weeks go by, this blood gives way to vaginal discharge known as lochia. Lochia is bodily fluid that can appear clear to creamy white to red in color.

This discharge can continue for about six weeks, which is about the time your period may return if you aren’t breastfeeding. If your discharge had the appearance of lochia, stopped for some time, and then you experienced a return of bleeding, this is likely your period. If you aren’t sure if the bleeding you’re experiencing is pregnancy-related or your period, there are a few ways to tell:

  • Lochia isn’t usually bright red in color beyond the first week postpartum. It’s usually lighter and can be watery or white in appearance. Bright red bleeding that occurs six or more weeks after delivery is more likely to be your period.
  • Pregnancy-related bleeding can increase with increased exertion or activity. If your discharge increases with exertion and decreases when you rest, it’s more likely to be lochia.
  • Lochia also tends to have a distinct odor. Lochia may have a “sweet” smell to it, since it’s mixed with leftover tissue from the pregnancy. Report any foul order to your doctor.

It can also take some time for your cycle to regulate after birth. You might find that you have your first period, skip a cycle, and then have another period that comes sooner than expected.

During your first postpartum year, it can be normal for your periods to fluctuate in length, time between cycles, and intensity of bleeding. This is especially true if you’re breastfeeding.

According to the Cleveland Clinic, most postpartum women will have a “normal” menstrual cycle of 21 to 35 days with bleeding that lasts 2 to 7 days. Period cycles can change from what you experienced before pregnancy.

What postpartum symptoms should I watch out for?

It’s important that you call a doctor if you experience any of the following symptoms:

  • soaking through more than one pad every hour
  • bleeding that’s accompanied by sudden and severe pain
  • a sudden fever
  • bleeding continuously for more than seven days
  • blood clots that are bigger than a softball
  • foul-smelling discharge
  • severe headache
  • trouble breathing
  • pain while urinating

Contact your doctor if you experience these symptoms or anything else that concerns you related to your period. Some of these symptoms may indicate an infection.

The takeaway

A return to your menstrual cycle is just one of the parts of recovery and returning to your prepregnancy body. In some, menstruation may be delayed due to the hormone increases associated with breastfeeding.

Breastfeeding as a form of contraception isn’t foolproof. Having a backup method, such as oral contraception or a condom, can help provide further protection. You can find a great selection of condoms here.

If anything seems out of the ordinary about your first period after pregnancy, contact your doctor. Excess bleeding or indications of infection are especially concerning for a new parent. Listen to your body and play it safe.

Parenthood How-To: DIY Padsicle

Complications after childbirth - causes and consequences

  1. Increased discharge
  2. Retention of part of the placenta in the uterine cavity
  3. Changes in the blood coagulation system
  4. Disorder of uterine muscle contraction
  5. Inflammatory process in the vagina or uterus
  6. Vaginal candidiasis (thrush)
  7. Postpartum endometritis
  8. Laktostasis and mastitis
  9. Postpartum pyelonephritis
  10. Venous thrombosis
  11. Discomfort in the area of ​​postoperative sutures
  12. Urinary incontinence, feces, uterine prolapse
  13. Hemorrhoids

After giving birth, a woman often thinks that all worries and anxieties are behind her. But, alas, sometimes the first, happiest days or weeks of the life together of mother and baby can be overshadowed by various complications. In what cases are postpartum changes normal, and when should you see a doctor?

Labor ends after the third stage of labor, that is, after the birth of the placenta. Following this, the uterus immediately significantly decreases in size, becomes spherical, its cavity is filled with blood clots; the bottom of the uterus at this moment is located approximately in the middle between the womb and the navel. The early postpartum period lasts for 2 hours and during this time the woman is in the maternity ward. Then comes the late postpartum period. This period lasts 6-8 weeks. During this time, there is a reverse development (involution) of all organs and systems that have undergone changes due to pregnancy and childbirth. The exception is the mammary glands, whose function reaches its peak precisely in the postpartum period. The most pronounced involutional changes occur in the genital organs, especially in the uterus. The rate of involutional changes is most pronounced in the first 8-12 days. The uterus and cervix are significantly reduced in size. After the birth of the placenta, a large wound surface remains in the uterus, which takes about 4-6 weeks to heal. During this period, the placental site in the uterus bleeds, spotting - lochia - in the first days is bloody in nature, gradually their color changes from red to reddish-brown, brownish, by the 4th week the discharge almost stops and soon disappear completely. In women who have undergone a cesarean section, everything happens more slowly, because, due to the presence of a suture on the uterus, it contracts worse. Their total amount of spotting during the postpartum period is 500-1500 ml.

What complications can occur after childbirth

You should consult a gynecologist in the following cases:

Increased amount of discharge

discharge does not stop for a long time, large blood clots appeared. When bleeding occurs, you need to contact an obstetrician-gynecologist, preferably at the maternity hospital where the birth took place. If the bleeding is very heavy (several pads are required within an hour), you do not need to go to the hospital yourself, you need to call an ambulance.

Retention of part of the placenta in the uterine cavity

The most common cause of late postpartum hemorrhage (that is, those that occur later than 2 hours after birth) is the retention of a part of the placenta in the uterine cavity. The diagnosis in this case is confirmed by ultrasound. To remove the remnants of the placenta, the walls of the uterus are scraped under general intravenous anesthesia with mandatory subsequent antibiotic therapy to prevent infectious complications.

Changes in the blood coagulation system

In rare cases, the causes of bleeding may be changes in the blood coagulation system of a hereditary or acquired nature, blood diseases. In these cases, complex drug therapy is required.

Violation of contraction of the muscles of the uterus

Development of bleeding associated with impaired contraction of the muscles of the uterus is possible. This is the so-called hypotonic bleeding. In the subsequent period, the hypotonic state of the uterus can be caused by its overstretching due to polyhydramnios, multiple pregnancies, large fetuses, and underdevelopment of the uterus. A decrease in the contractility of the uterus is also caused by changes in its very wall (fibroids, the consequences of inflammatory processes, frequent abortions). These bleeding most often occur in the first hours after childbirth and require active treatment with medications, and in severe cases, surgery.
A sharp, unexpected cessation of spotting should also alert the woman and requires urgent medical attention. In this case, the outflow of blood from the uterus may be disturbed, that is, lochia accumulate in the cavity and the so-called lochiometer develops. Blood clots are a good breeding ground for bacteria, so if the lochiometer is not treated in time, bacteria enter the uterine cavity and endometritis develops - inflammation of the uterine mucosa. After a caesarean section, a lochiometer occurs more often than after a vaginal birth. Treatment consists in prescribing drugs that reduce the uterus, while using antispasmodics to relax the cervix and restore the outflow of lochia. In some cases, it is necessary to resort to vacuum aspiration of the contents of the uterus under general intravenous anesthesia and mandatory follow-up antibiotic therapy.

Learn more about the services:

  • Ultrasound of the pelvic organs

Inflammatory process in the vagina or uterus

The discharge has acquired an unpleasant odor. This may indicate the development of an inflammatory process in the vagina or in the uterus. In the postpartum period, there was a significant increase in the composition of most groups of bacteria, including bacteroids, Escherichia coli, streptococci, staphylococci. Potentially, all of these species can be the cause of postpartum infectious diseases. A common problem for women after childbirth is the development of bacterial vaginosis. Bacterial vaginosis is a pathology of the vaginal ecosystem caused by the increased growth of predominantly anaerobic bacteria (that is, those that grow in an oxygen-free environment) that actively proliferate in the postpartum period in the woman's vagina and can be pathogens in postpartum endometritis or suppuration of the sutures of the vagina and cervix. Diagnosis of bacterial vaginosis is based on measuring the acidity of the vagina and detecting in a smear on the flora specific for this disease "key cells" (these are cells of the vaginal mucosa covered with anaerobic bacteria). Treatment of bacterial vaginosis in the postpartum period is carried out with local preparations.

Vaginal candidiasis (thrush)

The appearance of curdled discharge, itching, burning in the genital area, redness indicates the development of vaginal candidiasis (thrush). The risk of this complication increases with antibiotics. Diagnosis is based on the detection of a large number of yeast-like fungi in a smear on the flora. For treatment, local preparations are used in the form of vaginal suppositories or tablets.

Postpartum endometritis

Purulent discharge, lower abdominal pain, fever. These symptoms may indicate the development of a serious complication - postpartum endometritis (inflammation of the inner lining of the uterus). Most often, endometritis occurs in patients after cesarean section, manual examination of the postpartum uterus, manual separation of the placenta and removal of the placenta (if independent separation of the placenta is difficult due to a violation of the contractile function of the uterus), with a long anhydrous interval (more than 12 hours from the moment of amniotic fluid outflow to the birth of a baby), in women admitted to childbirth with inflammatory diseases of the genital tract (for example, against the background of sexually transmitted infections), in patients with a large number of abortions in the past. The classic form of endometritis occurs on days 1-5. Body temperature rises to 38-39degrees, heart rate increases to 80-100 beats per minute. They note depression of the general condition, chills, dryness and hyperemia of the skin, soreness of the body of the uterus, purulent discharge with a smell. The erased form appears on the 5-7th day, develops sluggishly. The temperature does not exceed 38 degrees, there is no chill. Endometritis after caesarean section always proceeds in a severe form.

An ultrasound examination of the uterus and a complete blood count, which reveal signs of inflammation, help the doctor make a diagnosis. Treatment of endometritis should be started as early as possible. It is carried out in a hospital. Assign bed rest, with acute endometritis cold on the lower abdomen. Postpartum endomeritis is necessarily treated with antibiotics, along with them, agents that reduce the uterus are used. Currently, in many clinics and maternity hospitals, the uterine cavity is washed with cooled solutions of antiseptics. In severe cases, an intravenous infusion of saline solutions is required to improve blood circulation, relieve symptoms of intoxication.

In case of untimely treatment, there is a very high risk of spreading the inflammatory process to the entire uterus, small pelvis, the development of sepsis (the appearance of infectious agents in the blood), up to the death of the patient.

Laktostasis and mastitis

In the postpartum period, there may be pain in the mammary glands, a feeling of fullness, an increase in body temperature. When these symptoms appear, you should definitely consult a doctor - an obstetrician-gynecologist in a antenatal clinic or a surgeon.

Possible causes of pain in the mammary glands and the accompanying fever are lactostasis and mastitis.

Laktostasis (stagnation of milk in the gland), due to blockage of the excretory ducts. Most often, this condition develops when the baby is not properly attached to the chest, violation of the feeding regimen. Laktostasis often affects primiparous women. With the stagnation of milk, the mammary gland increases in volume, its dense enlarged lobules are determined. Body temperature can rise to 38-40 degrees. There is no redness of the skin and swelling of the gland tissue, which usually appear with inflammation. After decanting the mammary gland with lactostasis, the pain disappears, painless lobules with clear contours are small in size, and the body temperature decreases. If lactostasis is not eliminated within 3-4 days, mastitis (inflammation of the mammary gland) occurs, since when milk stagnates, the number of microbial cells in the milk ducts increases dramatically, milk is a good breeding ground for various bacteria, which contributes to the rapid progression of inflammation. With the development of mastitis, the body temperature constantly remains high, accompanied by chills. Symptoms of intoxication appear (general weakness, fatigue, headache). The patient is disturbed first by a feeling of heaviness, and then by pain in the mammary gland, which is accompanied by stagnation of milk. The mammary gland increases in volume, areas of redness are noted on the skin. Pumping milk is painful and does not bring relief, after pumping, dense painful areas remain, and a high body temperature persists. In severe cases, pus impurities can be determined in milk.

To eliminate lactostasis, pumping, local anti-inflammatory ointments, and physiotherapy are used. Mastitis is treated with antibiotics. In some cases, lactation suppression and surgical treatment are required.

Postpartum pyelonephritis

Fever, pain in the back or side, painful urination. These symptoms may indicate the development of postpartum pyelonephritis, that is, inflammation of the kidneys. Critical periods for the development of postpartum pyelonephritis, doctors consider 4-6 and 12-14 days of the postpartum period. The development of the disease is associated with infection in the urinary tract from the genital tract. Most often, the disease develops in puerperas, in the urine of which a small amount of bacteria was found during pregnancy. An ultrasound examination of the kidneys and bladder and a urine test help the doctor make the diagnosis.

Treatment of pyelonephritis is mandatory with antibiotics.

Venous thrombosis

Pain in the legs, swelling, redness on the legs along the vein, increased pain when walking - these are symptoms of a serious pathology - venous thrombosis (formation of blood clots in the veins) and require an urgent visit to a surgeon or phlebologist. The most dangerous periods for the occurrence of thrombosis are considered 5-6 days after childbirth or cesarean section, less often thrombosis occurs 2-3 weeks after childbirth. The causes of thrombosis are changes in the blood coagulation system that occur during pregnancy and after childbirth. Physiologically, in the postpartum period, the activation of the coagulation system occurs. As the body tries to stop bleeding. At the same time, the tone of the vessels of the small pelvis and lower extremities is reduced, the veins have not yet had time to adapt to work in new conditions. These conditions trigger the mechanisms of thrombus formation. An important role in the development of postpartum venous thrombosis is also played by the hormonal background, which changes dramatically after the end of pregnancy.

The risk of developing venous thrombosis is especially high in women with various pathologies of the blood coagulation system, which are detected even before pregnancy or during childbearing. There is a high probability of thromboembolic complications and in the presence of diseases of the cardiovascular system, overweight. The risk of thrombosis also increases in women in the age group after 40 years, in the presence of varicose veins of the lower extremities. The risk of thrombus formation is increased in women who have undergone a caesarean section. An ultrasound examination of the veins, with Dopplerography, that is, an assessment of blood flow in the vessels, helps the doctor in making a diagnosis. For the treatment of venous thrombosis, medications are used, wearing compression stockings.

A severe complication of venous thrombosis is the detachment of part of the thrombus and its movement along the vascular bed. In this case, blood clots, entering the vessels of the lung or brain, cause strokes (impaired cerebral circulation) or pulmonary embolism (blockage of the pulmonary arteries by a thrombus). This serious complication appears as a sharp cough, shortness of breath, pain in the chest, hemoptysis may begin - the appearance of blood streaks in the sputum when coughing. In severe cases, the work of the heart is disrupted and death can occur.

Unpleasant sensations in the area of ​​postoperative sutures

Discomfort in the area of ​​postoperative sutures after caesarean section or in the area of ​​sutures on the perineum. Normally, after suturing vaginal tears, there may be slight pain for 1-2 days, but they quickly pass. Pain in the postoperative wound after cesarean section may be disturbing for 2 weeks, gradually decreasing. Feeling of heaviness, fullness, pain in the area of ​​the postoperative wound may indicate the accumulation of hematoma (blood) in the area of ​​the sutures. This usually happens in the first three days after childbirth and requires surgical treatment - removal of accumulated blood. Pain, burning, bleeding of the sutures, the appearance of discharge with an unpleasant odor, swelling in the area of ​​the sutures, an increase in body temperature indicates the attachment of an infection and suppuration of the sutures. In these cases, you should also consult a doctor to treat the wound and decide on a further method of treatment.

Urinary incontinence, feces, uterine prolapse

Violation of the physiological functions of the pelvic organs of varying degrees (bladder, rectum), which may appear as in the postpartum period - urinary incontinence, feces, uterine prolapse. The problem of genital prolapse occurs when the pelvic floor muscles have lost the ability to contract so much that individual organs or parts of them do not fall into the projection of the supporting apparatus. The most common cause of pelvic organ prolapse is trauma to the pelvic floor muscles during childbirth.

Hemorrhoids

Quite often, after childbirth, women are worried about the appearance of hemorrhoids - varicose veins of the rectum. The predisposing factor in this case is a significant increase in intra-abdominal pressure during pregnancy and during childbirth. In the case of hemorrhoids, formations appear in the anus, which can be painless, but most often - painful, bleeding and itchy. The appearance of intense pain in the anus, bloody discharge from the rectum are a reason to consult a doctor - a proctologist. Most often, uncomplicated forms of hemorrhoids are treated with local medications - creams and suppositories, in case of complications (nodule pinching, bleeding), surgical treatment is required.

In any case, if you experience any symptoms that cause concern, it is advisable to consult a doctor, because any complication is best prevented or treated at the very initial stage.

Causes of heavy periods after childbirth

Pregnancy and childbirth are a period of significant changes in a woman's life. These periods cause a real hormonal storm in the body, and often lead to changes in familiar areas such as the menstrual cycle.

Please remember that the body after childbirth requires special attention. Take care of yourself and in case of any doubt, consult a doctor.

First of all, let's talk about the difference between postpartum hemorrhage (lochia) and menstruation.

What are lochia?

Lochia should be distinguished from heavy first menstruation after childbirth. Lochia is profuse bleeding from the vagina that begins immediately after childbirth. During them, the vagina gets rid of the thick layer of endometrium formed during pregnancy. They are usually dark red in color and abound in blood clots. Lochia is NOT menstruation, they should be considered as a sign of recovery of the body after childbirth. Usually they last 24-36 days, ie. 3-5 weeks. Over time, they become less abundant and change color: they become pink or transparent. Despite the similarity with menstruation, they should be distinguished. During lochia, there are also cramps, as well as during menstruation, because the uterus contracts, returning to its normal size and getting rid of excess endometrium. Lochia differs from menstruation in that it becomes lighter over time, while menstrual blood tends to darken towards the end of the cycle.

What to do when lochia comes?

Bleeding is usually very heavy at first, and in the hospital you will most likely need special gynecological pads or panties for adults. As soon as the bleeding subsides, you can start using the usual sanitary pads.

The body is weakened at this time, so it is especially important to monitor hygiene and change pads in time so as not to infect.

Do not use tampons unless your doctor tells you to. When the lochia is completely weakened and brightened, you can switch to daily pads and wait for the first menstruation after childbirth.

What to expect from menstruation after childbirth?

If you are not breastfeeding, your period is likely to start 1-3 months after giving birth, but if you are breastfeeding only, your period may not return for the entire period of breastfeeding. However, for many breastfeeding women, menstruation also returns after a couple of months. This is due to the hormone prolactin, which is responsible for the production of breast milk. It can suppress other sex hormones, thereby preventing ovulation and thus menstruation. But most often in women who are breastfeeding, the menstrual cycle is restored 6 months after childbirth.

If menstruation returned quickly, and the birth was vaginal (not caesarean section), then you should not use tampons for the first time, because the body is still recovering, and give preference gaskets.

Often after childbirth, the very nature of menstruation changes: in some women it becomes more abundant, and in some it is easier. Often, the cycle is unstable for some time, but eventually returns to normal. Unfortunately, there is no way to predict what changes await a woman after childbirth in this regard.

Childbirth is a huge burden for the body, and it will take some time to recover. There is no gold standard for the postpartum recovery period; it is individual for each woman. If you are in any doubt, it is always best to consult a doctor.

Why do periods change after childbirth?

  • The uterus should return to normal size

  • Breastfeeding affects the cycle and hormones

  • Hormonal imbalance

How can menstruation change after childbirth?

  • Pain in the lower abdomen may become worse or vice versa less

  • Blood clots may appear

  • Unstable menstrual cycle

  • Abrupt onset and end of bleeding

  • More profuse periods

Why are the first periods after childbirth heavy and what is heavy menstruation?

Very often the very first periods after pregnancy and childbirth are more abundant than usual. Heavy periods - such periods when a woman has to use one pad or tampon per hour for several hours in a row (more than 80 ml of fluid per cycle) and / or which last more than 7 days, they are also called "menorrhagia". On the other hand, bleeding in women is different, and what is normal and normal for one is unusual and strange for another, so you should focus on what kind of menstruation is typical for you.

Often, the first menstruation is characterized by increased soreness, because the mucous membrane of the uterus, even after childbirth, is still thicker than its usual state before menstruation.

Most likely, over time, everything will return to normal, but some discomfort is possible in the first months due to the amount of discharge. To avoid trouble with leakage during heavy periods with clots, you can use night panty liners Kotex Ultra Night. They quickly absorb even the heaviest of secretions thanks to their unique 3D center, while special elastic grooves along the pad give it flexibility and provide additional protection against back leaks. Adjustable inner layer adapts perfectly to body shape and posture. Suitable for this occasion Kotex Natural Night: They have the same benefits as Kotex Ultra Night, and are ideal for women with sensitive skin. You can buy these pads in stores and pharmacies, as well as order on the Internet.

What symptoms should I look out for?

Although many cycle changes after childbirth are normal, some symptoms still require medical attention:

  • Sudden heat and high temperature

  • Very heavy periods (you have to change the pad with the maximum degree of absorption more than once an hour, such intense bleeding lasts more than 2 hours)

  • Menstruation lasts longer than 7 days

  • Breathing difficulties

  • Severe headaches

  • Very large blood clots (larger than a ping-pong ball)

  • Sharp, sharp pain at the onset of bleeding

Please remember that excessive bleeding can lead to anemia and weakness, women with heavy periods need to monitor the level of iron and ferritin in the blood.

What methods of correction of heavy periods can doctors suggest?

Unfortunately, sometimes heavy periods after childbirth do not return to normal and begin to interfere with normal life. In such cases, doctors can help you choose the right method for correcting this condition, depending on your state of health, the cause that causes them and personal preferences.

Here are some of them:

  • An intrauterine device is a small device containing the hormone progesterone that a doctor places inside the uterus.

  • Non-hormonal drugs - a doctor may suggest non-steroidal anti-inflammatory drugs and drugs based on tranexamic acid

  • Hormonal preparations such as combined oral contraceptives or progesterone tablets

  • Surgical operations correcting the cause of abnormal heavy periods (curettage of the uterine cavity, removal of fibrosis, etc. )

How can you help yourself at home if you have heavy periods?

Yes, there is little pleasure in heavy menstruation, especially if they are painful, but this does not mean that it is impossible to help yourself during this period.