Irregular bleeding after delivery: what to know

Postpartum bleeding, called lochia, may begin red and gradually become lighter, then brownish or pink before fading. It can briefly look heavier after activity or when standing because blood has collected while resting. Breastfeeding can cause temporary cramping and a short increase in flow as oxytocin helps the uterus contract. Bleeding should trend lighter overall; a new return to bright-red, heavy flow or clots after it had settled is worth discussing. Bleeding after a caesarean section can still occur because the placenta leaves a healing area inside the uterus.

Use sanitary pads so you can observe the amount and colour, and note clots, pain, temperature, dizziness, and whether the pattern is improving. Rest when bleeding increases and avoid inserting anything into the vagina until your maternity team says it is appropriate. Keep follow-up appointments, especially if you had induction, assisted birth, retained placenta concerns, or a caesarean section. Postnatal physiotherapy can address recovery needs, but it does not replace assessment of unusual bleeding.

Contact urgent medical care for rapidly soaking pads, repeated large clots, severe or increasing lower-abdominal pain, fever, foul-smelling discharge, shortness of breath, chest pain, marked weakness, or fainting. Seek prompt advice if bleeding becomes heavier rather than lighter, or if you are worried about infection or tissue remaining in the uterus. A severe headache, vision change, or sudden swelling after birth also needs urgent review because pre-eclampsia can occur after delivery.

Ask: Is this bleeding pattern expected for my stage of recovery? Could my symptoms suggest infection or retained tissue? Which amount of bleeding should trigger urgent help? When can I resume exercise, sex, and internal menstrual products? Would postnatal physiotherapy support my recovery?