Heavy periods 40 days after delivery: what to know

Bleeding after birth, called lochia, gradually changes in amount and colour before settling. Menstrual cycles may return at different times, especially when breastfeeding, so bleeding around this stage is not automatically a period. A heavy flow can also occur when tissue remains in the womb, the womb is not contracting as expected, or infection is present. A heavy period is a symptom; it does not by itself identify the cause. Other explanations, including fibroids, polyps, or adenomyosis, may need consideration once immediate postpartum causes have been addressed.

Use pads so you can judge the flow, and record when it started, whether it is increasing, the presence of clots, pelvic pain, fever, or an unpleasant smell. Contact your maternity team, midwife, obstetrician, or GP for advice rather than waiting for the next routine appointment. They may assess your pulse and blood pressure, examine you, check blood count and iron levels, and arrange an ultrasound. Avoid inserting anything into the vagina until a clinician confirms it is appropriate, particularly if you have pain, fever, or have not had a postpartum review.

Go to urgent care now for rapidly worsening bleeding, fainting, marked dizziness, a fast heartbeat, severe abdominal pain, fever, chills, or feeling suddenly very unwell. Seek immediate help if you are soaking pads quickly or passing unusually large clots. These signs can indicate major blood loss or infection. If you are alone with your baby, call someone you trust while arranging care, and do not drive if you feel faint or weak.

Ask: Is this likely to be lochia, a period, or a postpartum complication? Do I need an examination, ultrasound, or blood tests? Could retained tissue, infection, fibroids, or polyps be involved? What bleeding pattern should prompt me to return?