Giving birth to your first baby can be a bit of a blur. And while you’ve likely heard the tales of recovery (tearing, swelling, sleep-deprivation and more), certain aspects of pregnancy’s aftermath can come as a surprise — even to the well-prepared.
Just after midnight this past June, I witnessed it firsthand. Mere minutes after delivering my daughter, I was put in an ensemble that moms know oh-too-well: the oversized hospital-grade pad (bigger than any I’d ever seen previously), ice packs and witch hazel. In the middle of the night when I stood to go to the bathroom, I learned why: The pad was soaked — and blood dripped all over the bathroom floor. I panicked.
For someone who’s never had heavy periods in her life (and after not bleeding for basically 10 months as your period takes a hiatus while your body builds a baby) this kind of postpartum bleeding can be jarring. But it’s actually totally normal.
Mild to moderate bleeding after having a baby is called “lochia,” Jessica Shepherd, M.D., OB-GYN and founder of online women’s health forum Her Viewpoint tells SheKnows. And while it’s not technically a period, lochia can start off looking a heckuva lot like one before it dies down to a brown discharge over about six weeks time, Heather Bartos, M.D., board-certified OB-GYN and founder of be. Women’s Health & Wellness in Cross Roads, Texas tells SheKnows.
At the time, I wasn’t quite sure what all the bleeding was about. But as Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine explains to SheKnows, when you have a baby, your placenta — which is attached to the wall of your uterus — separates, causing bleeding. Other tissue, blood and mucus from your healing cervix contributes to the flow, too.
Even though I had an uncomplicated vaginal delivery, women who have C-sections bleed, too. “Your body prepares for a vaginal delivery — that’s how we’re made,” Suzie Welsh, a women’s health nurse and founder of personalized supplement company BINTO tells SheKnows. “That uterine lining still has to shed somehow.”
No matter how you deliver, lochia is generally most intense in the 24 to 72 hours after giving birth. Fortunately, I was in the hospital for most of this time and could ask questions (is this normal?! What do I do about this?) and get assistance every time blood seemingly gushed as I stood or soaked through an oversized pad.
Slowly, even in my time at the hospital, the bleeding did lessen a bit. I learned that as your uterus contracts (it shrinks down to its 20-week size shortly after delivery, says Dr. Bartos), bleeding slows. That’s why, periodically, my doctor would come in and feel my stomach — checking the size of my uterus. Breastfeeding helps slow bleeding, too. As I fed my baby the first few times in the hospital, I felt cramping — a sign of the uterus continuing to contract.
And while scary to me, my doctors told me that my bleeding wasn’t excessive (even though it certainly felt it). By the time I left the hospital, my uterus well on its way back to its normal size, my doctor told me.
What does it mean if your uterus (which is a muscle) isn’t contracting as well as it should? You might bleed more, says Dr. Minkin. “If there is an infection in the uterus, it will hinder the contraction and clotting processes, which control the bleeding.”
So what’s a ‘normal’ kind of postpartum bleeding? Generally, if you’re home and soaking a pad every hour, you’ll want to call your provider, says Dr. Minkin. In these cases, doctors worry about issues like tears in your cervix or in tissues of the vagina or blood vessels in the uterus, or even a piece of the placenta that got stuck behind. You also want to keep an eye out for a temperature that stays over 100 or any clots larger than a golf ball. (While I didn’t see any visible clots in my bleeding, many women do — and it can be a shock.)
While keeping an eye on your bleeding after it starts is important, preparing for it ahead of time can go a long way in aiding your recovery and lessening the blow of shock. I quickly learned that regular pads won’t *quite* cut it in the first few days, even if — like me — your bleeding typically isn’t super heavy. Before you’re discharged, it’s probably a good idea to stock up on the oversized pads from the hospital (and nurses usually are more than willing to send you home with a to-go bag). You’ll want to take home extra pairs of those very-necessary mesh underwear from the hospital, too — you’ll need them that first week or so after delivery. Otherwise, granny panties at home will serve you well in those first few weeks.
If you want to buy your own pads, many companies offer larger pads, too. After my hospital stash ran out, I used Rael’s 100 percent organic pads that come in multiple sizes. And even if you usually opt for leggings, sweatpants or loose shorts will be your best friend in those early weeks of bleeding. The bigger, the better. Also: You’ll want to have all of this ready to go before you have a baby as — trust me when I say — a CVS run will not be something you’ll want to do.
And when should you expect the return of your *actual* period? Doctors say that it really varies from person-to-person. “Some women, breastfeeding or not, will get a period in four weeks after delivery,” says Dr. Minkin. But breastfeeding does tend to delay things, she notes. In fact, for some women it can take six months after stopping breastfeeding (or longer) to get a period since the hormone prolactin, which helps your body make milk, inhibits ovulation.
As for me, at about nine weeks postpartum, my days of lochia are behind me, but I’ve yet to see a return of my monthly cycle. And Dr. Minkin offers others in my position one more piece of advice: While breastfeeding can keep your period at bay, it’s not a foolproof method of birth control. So for new mamas not looking to add another kid to the family right away, it’s best to pick up pads and a form of birth control.
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