Vaginal discharge after childbirth. Discharge after childbirth in women. Inflammatory diseases and fungus

As soon as the long-awaited baby is born, the mother tries to surround him with care from all sides, sometimes forgetting that her body also needs increased attention. At this time, hormonal levels, the tone of the uterus and abdominal wall are restored, and any deviations from the norm can become life-threatening. How to determine whether everything is fine in the body of a woman who has given birth to a child?

In the first months, a lot can be judged by the lochia. This is the name for postpartum discharge from the genital tract. How long does the discharge last after childbirth? What is considered normal? Is yellow discharge harmless after childbirth? How can you understand what problems need to be treated based on changes in the amount or duration of lochia?

Normal lochia

There are certain standards by which one can judge whether lochia is normal or whether it indicates the need for urgent medical intervention. The characteristics of the discharge must correspond to the period that has passed since birth.

In the first days, when the woman is still in the maternity hospital, the condition of lochia should be monitored by a doctor. But if he didn’t pay attention to something, it’s better to ask again than to leave the problem unnoticed. And after discharge, all responsibility for observing how postpartum discharge changes falls on the woman in labor herself. Therefore, she also needs to be able to distinguish between normal and pathological conditions, to know how long lochia should last and at what intervals their appearance will change.

Duration and quantity

To understand how long the discharge lasts after childbirth, you need to understand why it appears. First, the remnants of the placenta and waste products of the fetus are expelled, then blood and lymph are released from the damaged inner layer of the uterus. Its recovery takes approximately 40–50 days. Accordingly, lochia continues for the same amount of time - from 6 to 8 weeks - after childbirth.

The intensity of the discharge depends on how much time has passed after childbirth:

  • The first two hours, when the woman in labor must still be in the maternity ward under the close supervision of a doctor, are especially dangerous. There is a lot of discharge; in relation to body weight, it is approximately 0.5%, but not more than 400 ml. Large losses will definitely affect the general condition.
  • For another 2 or 3 days, lochia continues to be abundant - 300 ml in 3 days. At this time, it is better to use diaper pads rather than pads to make it easier for the doctor to assess the volume of lochia.
  • The next week the amount of discharge is approximately the same as during menstruation. Every day their volume decreases little by little. For hygiene purposes, it is more convenient to use regular pads with a high degree of moisture absorption rather than diapers. But it is strictly contraindicated to use tampons.
  • When the first month has passed after childbirth, lochia should still be observed, but it is already very scanty.
  • After 8, or at most 9 weeks, the release of lochia should stop.

How long the discharge lasts after childbirth depends on the severity of the body’s ability to recover, the woman’s nutrition, and daily routine. They should not be too long (lasting more than 9 weeks) or too short (less than 5 weeks).

Color, smell and consistency

The appearance of the discharge also depends on how long the lochia lasts after childbirth and on its composition.

Norm of qualitative characteristics of postpartum discharge:

  • The first few days they are liquid, bright red, with the smell of blood. This is due to the fact that they contain a large percentage of pure blood. Small blood clots and mucus may occur. Such lochia is considered normal only for a few days.
  • By the middle of the first week, their color should change and turn brown. The smell of lochia at this time is similar to normal menstruation.
  • When a month has passed after childbirth, the lochia becomes mucous, cloudy, and grayish in color. Over time, there are fewer of them, and the color approaches transparent.

By the end of the postpartum period, the discharge is very scanty and mucous, the same as that of any healthy woman before pregnancy.

Signs of pathology

Any deviation from the parameters described above may indicate the presence of serious problems. Throughout the postpartum period, there is a risk of bleeding, infection of the genital tract or uterine cavity. In order to prevent the development of severe complications, it is important to know how long lochia lasts normally, and to consult a doctor at the first suspicion of pathological changes.

Possible deviations from the norm:

  1. Reducing or increasing the duration of lochia secretion.
  2. Abrupt cessation or increase in volume.
  3. The discharge stopped, and after a while it started again.
  4. Change in color.
  5. The appearance of an unpleasant odor.
  6. Change in consistency.

You should consult a doctor in any case, even if only one characteristic has changed, for example, just the color has changed.

Quantitative changes

The most common complication of the early postpartum period is the development of bleeding. In this case, you feel that the diaper gets wet very quickly, and you may feel a little dizzy. There is no pain at all. This condition can be caused by blood diseases or too weak uterine contractions. In order for stronger contractions to begin, drug therapy (an injection of a dose of Oxytocin) is necessary.

Deviations from the norm in a later period:

  • If for some reason the remains of the placenta are not completely expelled immediately after birth, bleeding may develop in a more distant period. Its sign will be a sharp increase in the volume of discharge.
  • An abrupt cessation of lochia, especially if not even a month has passed after giving birth, may be a sign that something is preventing them from coming out. This could be a backward bend of the uterus, cervical spasm, or a neoplasm. In any case, this can lead to infection of the endometrium and the development of endometriosis.
  • If the lochia has not stopped 8 or 9 weeks after birth, you need to undergo an examination to find out why the endometrium is not recovering at the required speed.

Often, women in labor are happy when the lochia ends quickly. But in fact, with normal recovery processes, healing of the uterine mucosa occurs after at least 40 days. If lochia stops earlier, this should be alarming, not pleasing.

Changes in color or odor

The color of lochia may suddenly change if some undesirable processes occur in the uterine cavity or cervix. Often, especially if yellow discharge appears after childbirth, an unpleasant odor is felt. No matter how harmless such deviations may seem, any of them is a bad sign and cannot go away without medical help.

Possible color changes:

  • Bloody discharge after childbirth is considered normal only in the first few days. If a week has passed after childbirth, and they remain bright red, this is already a pathology, a sign of impaired epithelial healing or problems with hematopoiesis. If the lochia has already changed color, but then turns red again, there is a high probability that bleeding has occurred.
  • Black color scares women in labor the most. But it is relatively harmless, since it speaks of changes in the composition of the blood caused by hormonal changes.
  • Yellow discharge after childbirth occurs when bacteria enter the uterine cavity and endometriosis develops. A faint yellow tint to the discharge after 2 weeks is considered normal. Yellow discharge after childbirth is often accompanied by an unpleasant putrid odor.
  • Green discharge after childbirth, mucous or purulent lochia is a sign that the infectious process is progressing, the inflammation is already advanced. In such a situation, there is a risk of developing sepsis. This is due to the fact that the infection can very easily enter the bloodstream through the endometrium, which has not yet recovered.
  • The white color of lochia, especially if they have become cheesy, indicates infection with the fungus Candida. This discoloration may be accompanied by itching and burning in the genital area.
  • Brown discharge after childbirth usually appears 3 or 4 days after delivery and stops when 3 weeks or at most a month have passed after delivery. If more than a month has passed and the brown discharge after childbirth has not become light, this may indicate slow regeneration of the endometrium.

Each of the above changes is dangerous to the health and even life of a woman, so you should immediately consult a doctor. Remember, the baby needs a healthy mother who monitors both his condition and her own.

Discharge after 2 months

When 2 months have passed after childbirth, there should be no postpartum discharge. At this time, the risk of bleeding is already very low, especially if the postpartum period went well and the discharge has long stopped. But what then does the discharge mean at this time?

After a woman gives birth to a child, her menstrual cycle quickly returns. If she breastfeeds, ovulation is suppressed. But when the child is bottle-fed from the very beginning, menstruation can resume after 2-3 months. Therefore, mucous bleeding 2 months after the birth of a child can be normal menstruation.

If a woman is breastfeeding, the discharge that has returned does not look like a period, or there is any other reason to doubt that there is no problem, it is best to contact your doctor. Such cooperation will help you successfully recover from pregnancy and happily raise your baby.

What happens normally?

The uterus continues to contract, and the woman may feel slight contractions, especially during breastfeeding, when the baby sucks intensely. Immediately after birth, the uterus weighs 1 kg. Over the next six weeks, she returns to her normal weight - 50-60 g. After this, the discharge becomes less intense. Postpartum discharge, called lochia, continues for 5-6 weeks after birth until the uterus completely returns to its normal size and the wound formed at the site of the separated placenta heals. In the first 2-3 days they are bloody. During this period, the main component of lochia is blood from vessels that have ruptured at the placenta insertion, so the discharge is intensely red. Increased discharge when standing up and other movements is a normal process.

Then, until the end of the first week after birth, the discharge becomes dark red with a brown tint, then yellowish-white, due to the admixture of a large number of leukocytes. From the 10th day, the discharge is watery, light-colored, and an ever-increasing amount of mucus is mixed with it. The discharge becomes increasingly scarce and by the end of the third week almost stops, soon disappearing completely. The total number of lochia in the first 8 days of the postpartum period reaches 500-1400 g; they have a specific smell of rotten leaves.

When is medical intervention required?

The following situations are pathological, that is, requiring medical intervention:

  • There is no postpartum discharge due to spasm of the internal os of the cervix or blockage of the cervical canal with pieces and membranes (if not all membranes came out during childbirth) and blood clots.
  • The temperature rises to 38-39°C, but overall health may be quite satisfactory. This condition is called lochiometra. With rare exceptions, it is not an independent disease, it is only one of the manifestations of metroendometritis (inflammation of the mucous membrane and walls of the uterus).
  • Discharge from the uterus remains bloody until 5-12 days after birth. Body temperature rises to 38-39°C. Sometimes there is chills when the temperature first rises. The pulse quickens to 80-100 beats/min. The general well-being of the postpartum woman does not suffer significantly. The woman experiences uterine pain, which persists for 3-7 days. When examined in the blood, the number of protective blood cells of leukocytes and ESR (erythrocyte sedimentation rate) increases, the uterus is slightly enlarged. Such symptoms indicate a mild course of postpartum endometritis - inflammation of the inner lining of the uterus.
  • From the 3-4th day, discharge from the uterus becomes brown and subsequently becomes purulent in nature. On the 2-4th day after birth, the maternity hospital patient is bothered by headaches, weakness, and pain in the lower abdomen. There is a disturbance in sleep and appetite, the heart rate increases to 90-120 beats/min. Body temperature often rises to 39°C or higher, accompanied by chills. The examination reveals an increase in the number of leukocytes and ESR in the blood. Upon examination, tenderness and increased size of the uterus are revealed. Such phenomena are characteristic of severe endometritis.

Thus, in most cases, pathological postpartum discharge is a manifestation of postpartum inflammation of the uterus.

Factors contributing to the occurrence of endometritis

During pregnancy, especially towards the end, and in the early stages of the postpartum period, women experience a decrease in the body's immunological defense, which is a favorable factor for the development of inflammatory complications in the postpartum period. Restoration of immunological protection to a normal level occurs only by the 5-6th day of the postpartum period during vaginal delivery, and after a cesarean section - by the 10th day. In postpartum women after cesarean section, an additional risk factor for the development of postpartum inflammatory complications is surgical trauma, which entails a more significant decrease in immunological reactivity and its slower recovery than after vaginal delivery.

There are several factors, the presence of which increases the likelihood of postpartum endometritis.

These include:

  • malnutrition;
  • bad habits;
  • infectious and inflammatory diseases;
  • inflammatory kidney diseases;
  • diseases of the internal secretion organs;
  • violation of fat metabolism;
  • diseases of the bronchopulmonary system of an inflammatory nature;
  • anemia (decreased hemoglobin amount);
  • immunodeficiency states;
  • inflammatory diseases of the female genital organs;
  • presence of sexually transmitted diseases;
  • long-term use of an intrauterine contraceptive before pregnancy;
  • a large number of instrumental interventions for abortions and spontaneous miscarriages;
  • previous caesarean section. Features of the course of this pregnancy can also have a negative impact on the possibility of postpartum endometritis.

These features include:

  • anemia;
  • gestosis (a complication of pregnancy, often manifested by edema, increased blood pressure, and the appearance of protein in the urine);
  • exacerbation of chronic infectious diseases during pregnancy;
  • acute infectious diseases suffered during pregnancy;
  • colpitis and cervicitis (inflammation of the vagina and cervix);
  • polyhydramnios;
  • threat of miscarriage;
  • surgical correction of isthmic-cervical insufficiency (sutures on the cervix);
  • low location or placenta previa is the location of the placenta when the latter closes the exit from the uterus.

Features of the course of labor can also affect the possibility of postpartum endometritis. The risk of developing a complication increases 3 times if the labor process lasts and the water-free interval lasts more than 12 hours. Other risk factors during childbirth include: large blood loss, manual examination of the uterus after childbirth, weakness of labor, repeated births, polyhydramnios, multiple births - in short, all situations in which infection can enter the uterus and poor contraction of the uterine muscles after childbirth. Caesarean section is also a significant risk factor for the development of postpartum endometritis. A predisposing factor for the occurrence of endometritis is also the retention of parts of the placenta and membranes in the uterus.

Treatment

Treatment of any form of postpartum endometritis is carried out in a hospital. Patients are administered antibacterial drugs, drugs that contract the uterus, and solutions that help eliminate toxins. A nutritious diet with a high content of proteins and vitamins is important.

In some cases, as part of the treatment of postpartum endometritis, surgical treatment of the uterine cavity is required, which includes hysteroscopy (examination of the uterine cavity using an optical device), vacuum aspiration of the contents of the uterus - removal of the contents using a special vacuum device, the tip of which is inserted into the uterus. This is an operation that is performed under general anesthesia and washing the uterine cavity with antiseptic solutions. When parts of the fertilized egg are retained in the uterus and become further infected, there is a danger of toxins and biologically active substances entering the patient’s body from the source of infection, which contribute to an increase in intoxication and aggravation of the course of the disease. In this case, they are removed by scraping or vacuum aspiration (using a special vacuum device). Removal of parts of the placenta is carried out under general anesthesia.

How to avoid problems

In order to eliminate, if possible, the influence of factors predisposing to the appearance of endomyometritis, every pregnant woman needs to be observed by a doctor and follow all his prescriptions.

If during pregnancy and during childbirth factors that contribute to the development of endometritis are identified, the woman after childbirth is prescribed medications that promote uterine contraction.

After childbirth, a woman must follow the rules of personal hygiene: change the pad every 2 hours, urinate (so that a full bladder does not interfere with uterine contractions). After each urination, you must wash yourself.

As early as possible (4-6 hours after birth, 10-12 hours after cesarean section), you need to start getting up and walking.

Before discharge from the maternity hospital, an ultrasound examination (ultrasound) is usually performed. This is necessary in order to:

  • assess the condition of the uterine cavity, the presence of clots and placental remains in it;
  • determine whether the uterus has contracted well, i.e. measure it and compare the resulting dimensions with the size of the uterus, which should be by this time.

Fulfilling all these conditions will help a woman avoid problems with postpartum discharge, and, consequently, the complications of which they are symptoms.

Every new mother worries not only about the health of her baby, but also about her own well-being. One of the most common questions that maternity ward workers hear is: “How long does the discharge last after childbirth?” This is exactly what will be discussed further. You will find out how long after childbirth there is spotting. Also find out what color they acquire later. It is definitely worth considering several options for the process.

How long does discharge last after childbirth? Answer from gynecologists and obstetricians

If you consult a doctor with this question, you will find out the following information. Discharge after delivery continues for just over one month. Doctors usually call the time period 42 days. However, every woman’s body is individual. Some mothers recover faster. For others, the rehabilitation process is delayed. Discharge has a completely different duration in the event of the development of a pathological process or complication.

Lochia is the contents of the reproductive organ, which comes out after the separation of the child's place. This includes blood from the wound surface, mucus from the walls of the uterus, remnants of decidual tissue and membranes that did not come out during the expulsion of the placenta.

The color of normal lochia is an important indicator

How long does discharge last after childbirth, you found out. However, this is not all the information you need to know. The consistency and color of the mucus plays a big role. It is by this indicator that one can suspect a pathological process that developed as a result of delivery. Quite often, in maternity hospitals, midwives regularly examine the discharge of new mothers. If a pathology is suspected, information is provided to the doctor. Such women are prescribed additional tests in the form of ultrasound, blood tests and gynecological examination.

First five days

How long does bleeding last after childbirth? A little less than one week. It is this gap that doctors report. While the mother is in labor within the walls of the maternity ward, the mucus that comes out has a rich red color. It may also contain admixtures of clots and lumps.

Often such discharge acquires an unpleasant odor. This is the absolute norm. Indeed, during this period, what was in the cavity of the reproductive organ for the long nine months of gestation is separated. However, if after five days the mucus (consistency and color) has not changed, then we are talking about a complication.

Two weeks after birth

How long does the discharge last after childbirth (after heavy bleeding has stopped)? When the remaining tissue and blood come out, we can say that the wound surface has almost recovered. Now the discharge has a pinkish-red tint. It is worth noting that they should not contain clots. Unpleasant odor is also eliminated.

Such discharge continues for about two weeks. During this period they are no longer so abundant. This allows a woman to refuse postpartum pads and use regular hygiene products.

After a month

You already know how long after childbirth there is bleeding. This period is approximately three weeks. By the end of the first month, the discharge acquires a mucous consistency and an orange color. They look more like ichor. This mucus indicates that the internal cavity of the reproductive organ continues to rapidly recover.

This mucous ichor can normally be secreted for about one week. Remember that all deadlines are very conditional. So, for some women, by the end of the first month, the discharge ends completely.

Fifth week after birth

How long does the discharge last after childbirth, and what color should it be? Normally, by the fifth week after the baby is born, the lochia becomes white. They got their unusual name because of the mucous consistency of the transparent discharge. A new mother can observe this phenomenon for about another week or two.

During this period, a woman no longer requires sanitary pads for menstruation. She could very well benefit from daily protective inserts. The amount of such mucus is very small. Up to 5-10 milliliters can be released per day. For clarity, one teaspoon contains 5 ml.

When does lochia end? What does this depend on?

How long the discharge lasts after childbirth and the smell of this fluid are very important indicators. Usually lochia ends one and a half months after the birth of the child. This deadline is the deadline. If after the specified time the lochia is still present, then there is a possibility of pathology developing. Early termination of discharge also does not mean anything good. What determines how long the discharge lasts after childbirth?

Reviews from doctors say that the weight of the baby and the course of pregnancy play a big role. when a mother gives birth to a large child (more than 4 kilograms) or has polyhydramnios, the reproductive organ is greatly stretched. Because of this, the recovery process takes longer. Often, to speed up the contraction of the uterus, such women in labor are prescribed oxytocin after the baby is born. This drug helps mucus leave the cavity of the reproductive organ faster.

How long does the discharge last after childbirth (caesarean section)? In the case when the baby is born with the help of surgeons who cut through the woman’s abdominal wall, lochia may be of a slightly different nature. In this case, the duration of bleeding may increase to two weeks. This is due to the fact that in addition to the wound surface from the placenta, there is also a scar in the uterus. It is worth noting that with this method of delivery there is a high risk of developing infections and complications.

Possible pathologies

Sometimes after the birth of a baby, a woman faces problems. Statistics show that approximately every fifth new mother is sent by doctors for gynecological curettage. In what cases is it really necessary?

If after giving birth the discharge has not become less abundant after a week, but still contains lumps, we may be talking about incomplete separation of the placenta. After expulsion of the child's place, obstetricians should carefully examine it for damage. If they are present, then manual cleaning is carried out directly on the birth table. If pathology is detected late, curettage is performed using anesthesia. How long does the discharge last after childbirth (after cleaning)? With this combination of circumstances, lochia ends somewhat faster. All due to the fact that an artificial separation of mucus and areas and tissues remaining in the uterus was performed.

Also quite often, women in labor encounter inflammatory diseases. In this case, the infection can be acquired long before birth. However, after such a complex process, which is accompanied by the formation of a wound surface, pathological microorganisms begin to actively multiply. In this case, the discharge may have not only an unusual character, but also a strange consistency. Simultaneously with the lochia, pus is released. The blood takes on a brownish-green color and a fishy odor. Treatment must be carried out using antibacterial agents.

Lochia or postpartum discharge may end in less than a month. In this case, blood comes out in small volumes. This is explained by the fact that the cervical canal closes very early. Pieces of tissue and mucus simply cannot penetrate through the small hole. Quite often, women who give birth by caesarean section encounter this phenomenon. In this case, the fairer sex undergoes the same gynecological curettage.

In order for lochia to come out as it should after childbirth, a woman must follow certain rules. The following tips will help your postpartum discharge to be emptied in a timely and complete manner.

  • Immediately after giving birth, you should use an ice compress on the abdominal area.
  • When you are transferred to the room, assume a prone position. This will allow the uterus not to bend and release its contents.
  • Breastfeed your baby. Sucking provokes the production of oxytocin, which enhances the contractility of the reproductive organ.
  • Follow your doctor's recommendations and take prescribed medications.

Summing up the article

You now know how long discharge lasts after childbirth. You also found out what color they should be. If you have recently become a mother, then after one month you should definitely visit a gynecologist. The doctor will examine and evaluate your discharge. By then they should already be light and slimy. If you suddenly notice increased bleeding or the addition of an unpleasant odor and foam, then you should visit a medical facility as soon as possible. You may need some medication adjustment. Remember that during this period you cannot swim in open water and be exposed to heat. Good health to you and a speedy recovery!

Within a few weeks after the birth of the child, the woman’s uterus is restored to normal, the remains of the dying endometrium are removed, and the surface of the wound at the site of the placenta heals. A woman’s successful recovery or the appearance of any complications can be judged by the nature of the discharge from the genitals. It is important to know what they should be normally. In this case, the duration and abundance of discharge, as well as its color, smell and consistency, matter. In case of trouble, you should consult a doctor as soon as possible.

Content:

What should lochia be like?

The discharge that occurs in a woman after giving birth is called lochia. Their appearance is caused by the fact that during childbirth, damage occurs to the mucous membrane and vessels of the uterus, especially at the site of attachment of the placenta. Discharge after childbirth is associated with the cleansing of the uterus from the remnants of the fetal bladder, exfoliated epithelium, and blood clots. They also contain mucus produced in the cervical canal.

Lochia exists until the wound in the uterine cavity heals and it returns to its normal state (the size is restored, the epithelium is renewed). If the process of cleansing the uterine cavity goes without complications, then lochia stops after about 5-8 weeks.

How long the cleansing of the uterus continues and lochia forms depends on the following factors:

  • the ability of the uterus to contract (individual for each woman);
  • woman’s age, condition of uterine tissue;
  • blood clotting, state of the hematopoietic system;
  • physical activity of a woman;
  • lactation.

In appearance, lochia in the first 3 days resembles menstruation. Their volume gradually decreases from 500 ml to 100 ml per day.

Video: What is discharge like during the postpartum period?

Types of normal postpartum discharge

Bloody lochia. The first postpartum discharge is bright red and smells like fresh blood. Consist of blood clots and particles of dead tissue. The color is due to the high content of red blood cells.

Serous lochia. Lighter brownish-pink discharge appears around day 4. The content of red blood cells decreases, but the number of leukocytes increases. The discharge has a musty smell.

White lochia. The discharge becomes yellowish-white on the 10th day after birth. They have a more liquid consistency. There is no smell. Gradually they become more and more scanty and smearing. After 5-6 weeks, they already contain only mucus from the cervical canal of the cervix.

Contractions of the uterus, causing the removal of lochia from its cavity, lead to the appearance of pain in the lower abdomen in women in the first days after childbirth. The pain resembles contractions. Moreover, the pain is more severe after repeated births.

Sometimes women develop black lochia after the 3rd week. If there are no painful symptoms or unpleasant odor, then such discharge is not considered a pathology. They can appear as a result of hormonal processes occurring in the body and changes in the composition of mucus secreted by the glands of the cervical canal of the cervix.

Postpartum uterine bleeding and its causes

In the first 2 hours after birth, there is a risk of severe uterine bleeding (hypotonic), which can be caused by poor contraction of the uterine muscles after it relaxes during pregnancy. To prevent this from happening, the woman is given a drug to increase uterine contractility (oxytocin). In addition, the bladder is emptied through the catheter and a heating pad with ice is placed on the lower abdomen. During contraction of the uterus, damaged blood vessels are compressed, dangerous blood loss is prevented, the signs of which are increasing weakness, dizziness, and headache.

The cause of continuous bleeding in the first hours after the birth of the child can also be cervical ruptures if they went unnoticed or were poorly sutured. In this case, local hemorrhages occur in the tissues of the vagina and perineum. If there is bleeding, the doctor, after a careful examination, discovers and opens these hematomas, and re-sutures the tears.

The consequence of uterine bleeding is anemia - a lack of hemoglobin, a violation of the oxygen supply to the body tissues. If a woman in this condition breastfeeds her child, then he will also develop anemia.

Prevention of postpartum hemorrhage

The contraction of the uterus and the reduction of blood discharge after childbirth is facilitated by frequent emptying of the bladder.

It is important to breastfeed your baby. When the nipples are irritated, oxytocin is produced, a pituitary hormone that increases uterine contractions. During feeding, this causes the woman to experience pain in the lower abdomen, reminiscent of contractions. Moreover, the pain is stronger in those women who have already given birth before.

If bleeding persists, cool the lower abdomen with ice.

The danger of stagnation of secretions in the uterus

Medical help should be sought urgently not only if a woman is bleeding too heavily, but also if the bleeding suddenly stops completely after a few days.

Stagnation of lochia in the uterus is called lochiometra. If it is not eliminated, inflammation of the endometrium (endometritis) may occur. The absence of lochia is a symptom of a serious postpartum complication. To achieve restoration of bleeding, the woman is injected with oxytocin, which enhances contractions, and no-shpa is administered to relieve cervical spasm.

In order to avoid stagnation of secretions in the uterus, it is useful for a woman to lie on her stomach. Due to weakening of the abdominal muscle tone after pregnancy and childbirth, the uterus tilts back, and the outflow of blood is disrupted. When a woman lies on her stomach, the uterus takes a position in which the outflow improves.

Pathological discharge during postpartum complications

Signs of complications during this period are:

  1. Yellow color and strong unpleasant odor of discharge. They indicate either stagnation of lochia in the uterus and their suppuration, or an infectious infection of the woman during childbirth. The inflammatory process in the uterine mucosa (endometritis) is usually accompanied by fever and pain in the lower abdomen. If you postpone a visit to the doctor for a long time, then due to the appearance of pus in the discharge, it turns green.
  2. After childbirth, bleeding increases instead of decreasing. Sometimes they reappear. This happens even 2 months after the birth of the child. It is possible that this is the first menstruation (the likelihood of early menstruation is high in women who do not breastfeed). However, often such discharge indicates incomplete removal of the placenta from the uterus, due to which its contractions are difficult.
  3. White, cheesy discharge may appear if a woman takes antibiotics for health reasons, which provoke a deficiency of lactobacilli in the vagina and the appearance of thrush. A woman is bothered by itching and burning in the external genitalia and vagina.

Video: Thrush, treatment methods

Factors contributing to the occurrence of endometritis

During pregnancy and childbirth, a woman's immunity sharply decreases. This provokes the occurrence of an inflammatory process in the endometrium of the uterus after childbirth. The body's resistance to infections begins to increase by the end of the first week in women who gave birth naturally and on the 10th day after cesarean section.

The likelihood of endometritis increases if a woman has other serious diseases (endocrine glands, kidneys, respiratory tract). The occurrence of endometritis is promoted by obesity, anemia, vitamin deficiency, and smoking. In addition, inflammation often occurs in women who have had many abortions or had curettage for medical reasons.

Sometimes the cause of stagnation of lochia and the occurrence of an inflammatory process is the low location of the placenta in the uterus, when the exit to the cervical canal is blocked. If labor continues too long after your water has broken, there is also an increased risk of endometritis.

Treatment of this disease is carried out only in a hospital. Antibiotics and uterine contraction enhancers are used. Disinfecting solutions are injected into the cavity. In some cases, vacuum aspiration or curettage of the uterus is performed to completely remove the endometrium.

Discharge after caesarean section

Bleeding lasts longer and complications occur more often if a woman gives birth by Caesarean section. Contractility of the uterus is hampered due to the suture and swelling of the surrounding tissues. The risk of infection during childbirth and inflammation of the mucous membrane of the uterine cavity increases.

However, despite the peculiarities of this method of delivery, spotting after childbirth should appear within 2 weeks, but no more. Just like during normal childbirth, the color of the discharge gradually changes from bright red to pale brown, and then turns white.

Normal menstruation after a cesarean section occurs at about the same time as after the birth of a child naturally. They occur later if the woman has had postpartum complications (uterine bleeding, endometritis, blood poisoning) or has diseases of the thyroid gland or liver.

Video: Features of discharge after cesarean section

Prevention of complications

In order to reduce the risk of complications after childbirth, a woman’s condition should be monitored by a doctor from the very beginning of pregnancy. Regular examination allows you to monitor your blood composition, detect and treat gynecological and other diseases, and strengthen your immune system.

If after the onset of labor it turns out that uterine contractility is insufficient, then drugs that enhance labor are used. They also help speed up the cleansing of the uterine cavity after the birth of a child.

In order to avoid stagnation of secretions in the uterus, a woman is recommended to begin getting out of bed and walking within 4-5 hours after a normal birth. After a caesarean section, this can be done after 10 hours.

Before discharge from the hospital, an ultrasound is performed to study the condition of the uterine cavity and assess its size in order to monitor the recovery process. For several weeks, the woman is recommended to rest more and avoid activities related to abdominal tension and heavy lifting.

Compliance with the rules of hygienic care of the body and genitals (frequent washing with warm water, daily bathing in the shower) is of great importance.

Warning: The woman should not take a bath for several weeks. Warming up the body, firstly, increases blood flow, and secondly, with such bathing, the likelihood of infection in the internal genital organs increases.

Douching during this period can cause great harm. It also contributes to the rapid spread of infection and the occurrence of endometritis.

On the first day, it is recommended to use diapers instead of sanitary pads to avoid leakage. In addition, it is easier to monitor the nature and volume of discharge. In the future, the gaskets must be changed at least every 2 hours.

The use of tampons is strictly prohibited during the entire period of lochia's existence. By blocking the exit from the uterus, they delay the outflow of secretions and the recovery process, creating a greater threat of an inflammatory process.

If there is a sudden change in the nature of the discharge, increased pain in the lower abdomen, increased body temperature, or dizziness, the woman requires urgent medical attention.


Postpartum recovery is a special state of a woman, when organs and systems return to their normal, “non-pregnant” state. Normally, it should take place without medical assistance, but under the scrupulous supervision of the woman. The main indicator of health is postpartum discharge, which varies depending on the condition of the uterus. It is important to know what their duration, appearance, color, intensity, smell should be at each moment of time.

Discharge after childbirth (lochia) is caused by healing and cleansing of the uterus. The process goes through several stages and is natural. It is popularly believed that a woman “cleanses” for 40 days. Official medicine tends to agree, and calls the average period 42 days. More “blurred” boundaries from 5 to 9 weeks. Anything that lasts less or longer than the specified periods is pathology.

The woman’s task is to carefully monitor the lochia. Any deviation from the norm is a signal of trouble and is a reason for an immediate visit to the gynecologist.

You should sound the alarm if discharge after childbirth:

  • Finished in less than a month
  • Lasts longer than 2 months
  • Let's go green
  • Became cheesy white
  • Have purulent inclusions
  • Acquired an unpleasant odor (putrid, sour)
  • Sharply increased in volume
  • Blood appeared again

An indicator of a woman’s health in the postpartum period is normal (up to 37) body temperature. If it is elevated or you think that there is “something wrong” with your discharge, go to the gynecologist. It’s better to worry unnecessarily than to miss the problem.

Uterine healing process

The healing process of the wound cavity of the uterus is conventionally divided into 3 stages:

  1. from 1 to 7 days after birth - red discharge
  2. 2-3 weeks after birth – brown discharge
  3. Final stage – white lochia

The established dates are approximate, since they depend on the body, the complexity of childbirth, the method of delivery, and breastfeeding. Only your gynecologist can give an individual consultation when studying your medical history.

The first lochia

Cleansing the uterus begins immediately after the birth of the child - this is the expulsion of the placenta on the birth table. The obstetrician carefully examines its integrity. If breaks are found, then suspicion arises of incomplete separation of the placenta. The uterine cavity is cleaned to remove the remaining placenta.

For the first two hours after giving birth, the woman is monitored in the delivery room. Its purpose is to prevent bleeding. To do this, uterine contractions are stimulated by injection, and ice is placed on the abdomen. The discharge is copious, mostly blood.

How long does bleeding last after childbirth? Intense lochia of a bright red color ends in 3-4 days. At this time, the blood still does not clot well, and the wound surface remains extensive. By day 4, the lochia darken, acquiring a brownish color.

Clots in the first week (especially after sleep) are considered normal, as is the pungent smell of blood. Large clots larger than a chicken egg in volume should cause caution. Lochia comes after childbirth so abundantly that the pad is changed once an hour.

Second phase

The second stage of uterine cleansing lasts up to 3 weeks. The discharge consists of ichor, mucus, remains of dead cells with a small admixture of blood. The volume is comparable to normal menstruation or less. Color – brown. The smell is similar to musty, but not putrid or sour.

End of the recovery period

After the third week, before stopping, the lochia lightens to a white-transparent or yellowish color. Consist of mucus. In terms of quantity they are characterized as spotting. During this period, a woman can switch to panty liners.

Lochia after cesarean

Recovery after a cesarean section goes through the same stages, but more slowly. With this type of delivery, a scar is added to the wound in the uterine cavity on its wall, which delays healing. Discharge lasts longer after childbirth.

Pathological conditions

Discharge after childbirth ended early

Discharge after childbirth stops earlier if the woman was cleansed in the maternity hospital. With this intervention, the uterine cavity is artificially cleansed of the remains of the placenta, dead endometrium, and waste products of the child. This may speed up healing somewhat.

In other cases, the disappearance of lochia before the 35th day does not indicate a strong, quickly recovered body, but an early closure of the cervical canal. With this pathology, the discharge is deprived of its natural outlet and accumulates in the uterine cavity.

It should be understood that lochia consists of dead tissue. If gynecological cleansing is not carried out, the contents of the uterus will begin to decompose. This leads to infection or even sepsis.

Inflammatory diseases and fungus

The inflammatory process in a woman who has given birth can develop for various reasons: chronic infections, colds, insufficient hygiene, decreased immunity. The discharge acquires a characteristic “fishy” smell, greenish color, and changes consistency. After a while, high fever and pain in the lower abdomen are added. Without proper treatment, inflammatory processes in the uterus can lead to infertility.

The appearance of thrush is indicated by itching, a sour smell from the discharge, and a change in the consistency of the lochia to a curd-white consistency.

Bleeding

The appearance of blood in the lochia after the first week always indicates pathology. If you are in a maternity hospital, inform the doctors about this. If you notice blood at home, call an ambulance immediately.

Prevention of complications

Preventive measures in the postpartum period are reduced to:

  • Compliance with medical orders
  • Following hygiene requirements
  • Sufficient physical activity
  • Abstinence from sexual intercourse

A natural “reducer” is breastfeeding. With frequent latching of a baby, a woman's uterus receives powerful oxytocin stimulation.

And remember! A woman’s attentive and responsible attitude to her health is the key to a happy life for her children.



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