Heavy bleeding one month after delivery

Postpartum bleeding can continue for weeks, but it should usually lessen rather than become suddenly heavy. Bleeding that increases after a quiet period may be related to retained placental tissue, delayed healing inside the uterus, infection, or a separate problem such as the return of menstruation. A tear or wound around the vagina and perineum can also bleed, particularly if it is painful or has opened.

A clinician may ask when the bleeding changed, how many pads you use, whether clots are present, and whether you have fever, pelvic pain, weakness, or an unpleasant discharge. Examination and tests help distinguish normal recovery from a complication.

Contact your maternity team, obstetrician, or a same-day medical service. Rest, drink fluids, and use pads rather than tampons so bleeding can be monitored. Do not place anything in the vagina until you have been assessed if bleeding is heavy or painful. Keep a note of the start time, pad changes, clots, temperature, pain, and medicines. Perineal Repair may be relevant when bleeding is linked to a wound or tear.

Call emergency services for fainting, severe dizziness, confusion, shortness of breath, a racing heartbeat, cold clammy skin, severe pelvic or abdominal pain, or bleeding that rapidly soaks pads. Seek urgent assessment for fever, chills, worsening pain, offensive-smelling discharge, or a wound that is opening. Even without these symptoms, heavy bleeding at this stage should be reported promptly rather than treated as an ordinary period.

Ask: Could this be a delayed postpartum haemorrhage or my period returning? Could retained tissue or infection be involved? Do I need an examination, blood count, or scan? How should I monitor the bleeding at home? Which symptoms mean I should return immediately?