When should you see a doctor about heavy bleeding after birth?

Lochia normally changes in colour and gradually becomes lighter as the uterus heals. Bleeding that becomes suddenly much heavier, returns strongly after easing, or comes with clots and feeling unwell needs assessment. Possible causes include the uterus not contracting adequately, infection such as endometritis, a perineal tear, tissue left inside the uterus, or postpartum haemorrhage. The appearance of blood alone cannot establish the cause.

Use a maternity pad so the amount and pattern can be observed; avoid tampons during postpartum recovery. Sit or lie down if you feel light-headed, keep someone with you, and ask for emergency transport if you are faint or deteriorating. Note when the change began, whether clots are present, and any pain, fever, or unpleasant-smelling discharge. Tell the clinician whether you had a vaginal birth, assisted birth, or caesarean.

Call emergency services for bleeding that is rapidly soaking pads, fainting, confusion, breathing difficulty, chest pain, severe weakness, or a pounding heartbeat. Contact your maternity unit urgently for increasing bleeding, repeated clots, fever, pelvic tenderness, or discharge with an unpleasant smell, even if you feel otherwise steady.

Ask whether the bleeding pattern fits normal lochia, whether examination or imaging is needed, and how anaemia or blood loss will be checked. Ask which changes should bring you back immediately and how to care for any tear or wound.