Discharge after childbirth then. Discharge after childbirth: prolonged and abundant lochia - is this normal? Find out which discharge after childbirth is considered pathological

After the birth of a child, women are faced with various physiological problems that worry them and bring discomfort. However, they must know all the nuances to distinguish the natural state from pathology.

Question of the day: how long does the discharge last after childbirth, and what does it look like during normal postpartum recovery? Every new mom goes through this, which is why it's so important to know what to expect.

Girls will have lochia no matter how the child was born - naturally or with surgery. The reason for their occurrence lies in the restoration of the uterus and its cleansing of membranes. After the baby is born, a wound from the placenta remains on the surface of the organ. Until it heals and the mucous membrane returns to normal, you can observe wound contents coming out of the vagina. Visually, it may resemble menstruation, but it contains remnants of membranes, ichor, and mucus. After some time, their abundance and color will change.

If the process of cleansing and reduction takes place without complications, then the duration of lochia is 5-8 weeks.

Moreover, the abundant ones end within up to 3 weeks, after which they are not so strong. Of course, this happens individually, taking into account factors such as:

• lactation;
• age and physical activity;
• blood clotting;
• child's weight;
• complications during pregnancy.

It is important to be able to diagnose what is normal and what is a sign of pathology, so always pay attention to these characteristics:

1. Composition (1-4 days - blood, clots; 2 weeks - clots and mucus; a month later - smears (possibly blood).
2. Color (1-4 - bright scarlet, 2-3 weeks - brownish, after a month - white or transparent).
3. Smell (in the first week - bloody, musty, beware of the rotten and pungent smell!).

Average duration

How many days does discharge last after childbirth? On average, about 42. At the same time, it is the period when they change their color and volume that is important, because you need to make sure that the body is cleansed correctly and on time.

How long it takes for lochia rubra to last is another important question. Immediately after the baby is born, the placenta separates very actively, and there is a lot of bloody secretion from the vagina.

This is not very convenient, but it is important so that the gynecologist can determine whether everything is fine. At this time, about 400-500 ml of liquid pours out of the girl.

Up to 3-4 days they appear scarlet in color, clots can be seen in them, but this is not a sign of pathology. During this period, a woman has to change a special pad every hour on average. In addition, the girl may smell a sweetish or musty odor - there is no need to be afraid, but if the odor is putrid, consult a doctor immediately.

How long does serous lochia last? They should last from 4 to 10 days. Their volume decreases, their color changes - now they are brown-pink or brown. The number of leukocytes increases, so there should be no more blood clots during this period. You can already use regular gaskets

After 10 days, white, spotting lochia appears. They are odorless and do not cause discomfort, and last about 20 days. This is the final stage of wound healing. After finishing.

Risk of uterine bleeding

In the first hours after the birth of the baby, there is a high risk of uterine bleeding if the uterus contracts poorly after relaxing during pregnancy. To prevent this, put ice on their stomach. During contractions of this organ, blood vessels are compressed, this prevents excessive blood loss and its consequences: anemia, dizziness, weakness.

It is important on the first day not to be ashamed of your secretions, show them to the doctor and keep him informed about your condition all the time. This will also affect how long you will have to spend in the hospital after giving birth.

Pathological conditions

We have already discussed the situation with natural healing, but there are various deviations, if you notice them in time you can maintain your health. Some of them indicate pathologies that require medical intervention.

Secretion occurs after 5 weeks or a little longer. If they last less or suddenly stop, visit your gynecologist. The reason for this may be insufficient contractility of the uterus, then the blood and placenta do not come out and form stagnation. It must be eliminated immediately. To avoid stagnation, girls are advised to get out of bed and walk more often.

If lochia comes out after childbirth for more than 2 months, you should be examined by a doctor immediately.

After all, after such a time, you must leave them in the past. The cause of blood can be menstruation if there are no clots, pus, or unpleasant odor in it. Rupture of seams can also affect its appearance. In any case, pay attention to the color, smell and consistency of what comes out of the vagina, and report to doctors.

Yellow or greenish secretions with a pungent aroma will tell you about endometritis, a dangerous inflammation. If your temperature also rises and your stomach hurts, call an ambulance. No matter how long the lochia comes out after the birth of a child, it can either be stagnation or an infectious infection - neither of which bodes well. Treatment of this disease takes place only in a hospital, with the help of antibiotics and a disinfectant solution, and

Lochia after caesarean section

Many girls are interested in how long the discharge should be after surgery. In such cases, they take longer because contractility is hampered due to the suture and swelling of the tissue. However, even under such circumstances, it is considered normal if the end is after 9 weeks. They can be red for up to 10 days, but not longer, then, as with the natural appearance of a baby, they change shade to brown, then to white.

Menstruation occurs after artificial ones, as with normal childbirth, if the woman did not have complications in the form of inflammation, infections, or bleeding. After all, the body of a girl who has undergone surgery is more unstable and weakened.

How long mothers will discharge after childbirth, regardless of the method of birth, is influenced by breastfeeding.

Lactation stimulates uterine contractions and fluid comes out better. So take note.

How long lochia lasts after childbirth depends on the new mother herself and her compliance with certain rules. Below you will find some important tips that are highly recommended.

• To reduce the risk of complications after the birth of a child, a pregnant woman should be supervised by a doctor from the beginning. A woman should visit him regularly and take the medications prescribed by him. The gynecologist will assess her individual condition and tell her when the discharge should end after childbirth in her case.
• Before leaving the hospital, you need to do an ultrasound, which will help assess the current state of the uterus. Over the course of several weeks while it actively heals, you should rest more, avoid heavy lifting, and avoid putting pressure on your abs.
• Observe personal hygiene rules. While there is discharge, you need to wash yourself more often, after each trip to the toilet. and limit yourself to a warm shower.
• Do not use tampons. They delay the flow and thereby increase the risk of inflammation.
• Start walking 4-5 hours after the baby is born, so that there is no stagnation. If you have had a caesarean section, this should be done after 10 hours.
• Feed your baby your milk.
• Immediately inform doctors if the nature of the secretions changes, you feel a putrid odor, bleeding increases, and the temperature rises.
• It is not recommended to have sex in this state. Intimate relationships are possible even when the discharge stops after the birth of the baby.

Conclusion

Let's summarize and figure out how long discharge lasts after childbirth, how long bloody lochia lasts and what it is. This process is natural, just like the birth of the baby itself. After his birth, the uterus throws out unnecessary tissue, placenta, mucus, ichor, and blood comes out. All this is similar to normal periods, except that they are more abundant.

In the first hours their volume reaches 500 ml. Such secretions last up to 4 days, then their color changes and there are fewer of them. After 2-3 weeks, they turn white or transparent and should be finished in 42 days. Be careful and, if you see signs of the pathologies described above, immediately inform your doctor.

After childbirth, any woman experiences specific discharge from the genital tract. They occur regardless of the method of delivery - naturally or through surgery. They may last for different periods of time, have different colors, character or smell. You need to know how long the discharge lasts after childbirth, what nature it has at different times after the birth of the baby, and how to recognize signs of deviations from the norm. Any doubts should be a reason to consult a gynecologist.

Postpartum discharge from the genital tract is a natural process. At the final stage of the birth process, the placenta departs from the uterine wall, which was previously closely connected to the inner surface of the organ and penetrated by blood vessels carrying blood to the fetus. Underneath there is an open wound surface that begins to bleed. This becomes the source of lochia. Gradually, the vessels of the former placental site become empty, contract, and become covered with a new layer of endometrium. Normally, discharge continues for 6 weeks, maximum 2 months.

Lochia

Lochia has a different origin than menstruation and differs from them in color, volume and duration. It is necessary to pay attention to the color and consistency of the discharge, as well as the absence or presence of an unpleasant odor. A timely visit to a doctor with any questions about this can not only preserve health, but also save the life of the mother.

Lochia appears as a result of the fact that after the separation of the placenta, the vessels connecting it and the wall of the uterus remain open and blood is released from them. It passes from the uterine cavity through the open cervix into the vagina.

Postpartum lochia consists of the following components:

• exfoliated endometrium (inner uterine lining), which thickens significantly during pregnancy;
• blood and ichor from the uterine wall to which the placenta was attached;
• dead and necrotic tissue;
• mucus and blood released from the healing cervix;
• parts of the membranes and fetal epithelium.

Lochia is not menstruation and is not controlled by hormonal changes. After childbirth, it will take some time before the pituitary gland, hypothalamus, and ovaries begin their regular activity and the normal cycle is restored. For breastfeeding mothers, the first period occurs approximately six months after birth. If the child is bottle-fed, menstruation can resume after 6 weeks (read more about the timing of the restoration of menstruation after childbirth).

In rare cases, menstrual-like light bleeding is observed within a month after the birth of a newborn. They are easily confused with terminal lochia, but at this time the woman can already become pregnant.

Less intense postpartum lochia is observed with premature birth, and stronger than normal - with multiple pregnancies and after surgery.

The first hours after

As soon as the placenta is born, the gradual contraction () of the uterus begins. This effect is enhanced by placing the newborn to the breast. Often an ice pack is placed on the mother's stomach; this is necessary to prevent severe bleeding.

The volume of blood loss in the first hours should not exceed 500 ml. At this time, the postpartum discharge is bloody and mixed with clots and mucus. This is how the remnants of the placenta and amniotic membranes are removed from the uterus.

In the first hours, the patient may feel an unpleasant odor of escaping blood. This is largely due to the influence of hormonal levels. The level of oxytocin and prolactin increases in the blood, increasing the sensitivity of olfactory receptors. In the normal course of the early postpartum period, the woman is transferred to the department after 2-3 hours.

First days

At first, intense release of lochia is observed. The cervix is ​​not yet completely closed, and the uterine wall is still a wound surface. This creates the preconditions for the development of postpartum endometritis. To prevent infection, all hygiene rules must be followed. If the nature of the discharge changes, you must immediately inform your gynecologist.

What should be the normal discharge after childbirth:

• In the first 4 days, lochia is a mixture of blood clots, parts of the membranes, meconium, decidua, and discharge from the cervical canal. Painful cramps in the abdomen may be felt, reminiscent of menstrual pain, caused by intense contractions of the uterus.
• During the 1st week, the lochia are colored a rich dark red color, they are quite thick, they contain an admixture of mucus, and there may be lumps or clots. When the baby is latched to the breast, the intensity of their secretion increases. This is a normal process of cleansing the birth canal.
• A woman should be prepared for the fact that when getting out of bed, a large amount of blood may be released at once. Therefore, it is recommended to stock up on a large number of special hygiene products, as well as oilcloth for the bed.

The normal duration of bleeding is up to 7 days. If they last more than a week, or uterine bleeding occurs, or large blood clots pass, this may be signs of retention of part of the placenta in the uterus. This condition often leads to infection and requires immediate medical attention.

To speed up the separation of lochia, a prone position is recommended, as well as the use of a postpartum bandage. It supports the internal organs, preventing the uterus from taking an abnormal position, which contributes to the retention of blood in it, for example, bending to the side or backwards.

First month

After 7 days, the wound surface begins to be covered with endometrium. The uterus has already contracted quite well, although it is still located above the womb. During the 2nd week, the number of lochia gradually decreases. Discharge from the genital tract changes color from red to darker, brown, and there is normally no unpleasant odor.

If in the first days of the postpartum period a woman had to change a sanitary pad every 2 hours, now one pad can be used for 4-5 hours. Before each change of hygiene product, it is recommended to wash with warm water and soap.

After 10 days, the discharge becomes yellowish. It contains fewer red blood cells and more white blood cells, cervical mucus, and serous fluid.

How long does this discharge last?

This stage lasts about 3-4 weeks.

Discharge a month after childbirth is observed in most women. However, their intensity is reduced so much that a woman can use panty liners. Their character is mucous, without foreign inclusions and odor. If lochia lasts more than 6 weeks, you should see a doctor.

At this time, the uterus is already returning to normal size, so abdominal pain or increased discharge when feeding the baby is not observed. At the end of the month, the cervical canal closes completely, which blocks the path of possible infection.

Each woman experiences the postpartum stage individually. It is considered normal if the discharge persists for 6-8 weeks. They may end earlier - by the end of 4-5 weeks.

During caesarean section

The operation is accompanied by additional damage to the uterine vessels, so the bloody discharge after such childbirth is more intense during the first 7 days. Its color and consistency are normal. Subsequently, the process of cleansing the uterus proceeds in accordance with physiological indicators. After a maximum of 2 months, any vaginal discharge should stop.

Changes in the amount of discharge

The most common reasons for this are retention of parts of the placenta inside the uterus or the addition of an infectious process. In this case, the following deviations from the norm are possible:

1. A small amount or premature termination may be associated with a mechanical obstruction to the outflow of intrauterine discharge. Usually this is a large blood clot that blocks the internal os of the cervical canal. Blood can accumulate in the uterus even if it is in an incorrect position as a result of subinvolution. The likelihood of such a complication increases with abnormalities in the structure of the uterus and various neoplasms (cysts, tumors).
2. Abundant flow of mucous fluid may be a sign of perforation (perforation) of the uterine wall, for example, if postoperative sutures fail. Abundant lochia is also observed with blood clotting disorders. This sign may be a symptom of a life-threatening condition and requires immediate medical attention.

Any pathological changes should be eliminated as quickly as possible. Some of them require drug treatment, while others require curettage or surgery.

Changes in the nature of discharge

Postpartum recovery occurs individually, but there are general signs characteristic of the normal course of the postpartum period or pathological abnormalities.

• Light yellow color of discharge

Characteristic of the final period, it replaces brown spots and gradually lightens to completely colorless mucus. Saturated yellow discharge can signal the onset of an inflammatory process in the uterus. They appear already on the 4-5th day and are accompanied by pain in the lower abdomen, and also have an unpleasant putrefactive odor. The cause of this condition is endometritis, injury to the wall or cervix. The yellow color of lochia can also appear when the cervical canal is blocked, when blood cannot be released from the uterus, and a putrefactive process begins. Another reason is cervical and vaginal ruptures, complicated by inflammation.

• Greenish discharge

Normally not observed. They indicate inflammation of the inner wall of the uterus -. It is often caused by a bacterial infection, which is caused by poor contractility of this organ. As a result, lochia is retained in the uterine cavity, and an inflammatory process begins with the formation of greenish pus. Purulent discharge is a reason for immediate consultation with a doctor. The disease is often accompanied by fever, abdominal pain, weakness, and an unpleasant odor of discharge from the genital tract. If left untreated, it can cause infertility or blood poisoning.

• Brown discharge

Normally they appear in the 2nd week, changing to bright red, and at the end of the second week they gradually lighten. If the brown color persists for more than a month, the cause may be an inflammatory process (endometritis), fibroids, uterine flexion, or decreased blood clotting. Copious dark brown discharge in the early postpartum period indicates incomplete separation of the placenta and requires urgent medical intervention - curettage of the uterine cavity.

• Mucus discharge

They begin in the 3rd week and gradually become normal for a healthy non-pregnant woman. Early appearance of mucus may be a sign of internal damage to the cervix or vagina. Excessive mucus discharge is an important sign. This condition requires urgent medical attention.

• Continued bloody or pink discharge

They are a sign of uterine hypotension associated with its excessive stretching or wall weakness. Another reason for prolonged weak bleeding is the presence of placenta remnants in the uterine cavity. Pink fluid can appear as a result of bleeding disorders, excessive physical activity and early sexual intercourse. Sometimes the first menstruation appears on days 21-28.

• White discharge

Most often caused by, they have a sour odor, and small light clots are detected in them. Candidiasis is not life-threatening, but it does cause a lot of unpleasant sensations, such as itching in the perineal area. Therefore, it is necessary to consult a doctor and select antifungal therapy that is safe for breastfeeding.

Hygiene

Lochia is a physiological phenomenon; they are necessary for cleansing the uterus and its healing. During them, it is important to follow hygiene rules:

1. It is necessary to stock up on sanitary pads in advance and change them regularly. In the first days you will need products with high absorbency.
2. Tampons and menstrual cups should be avoided as they increase the risk of infection.
3. It is recommended to avoid sexual intercourse for the first 6 weeks.
4. At this time, you should avoid physical exercise and significant stress.
5. In the first month you cannot swim in a pool or pond.
6. You should wash regularly with warm water and soap, and movements should be directed from front to back. It is not recommended to use perfumed intimate hygiene products; baby soap is best.
7. It is recommended to urinate regularly, even in the absence of a pronounced urge. This will help prevent the spread of urinary tract infection.

It is worth stopping the use of blood thinners, such as aspirin, and at the same time increasing the amount of iron in your diet.

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.

After giving birth, a young mother has many questions: is everything okay with the baby? How to properly put a baby to the breast? What to do with the umbilical wound? How long does the discharge last and when does it stop after childbirth?

When does the discharge end after childbirth?

Often after giving birth, a woman does not pay any attention to herself - all of it goes to the newborn. Meanwhile, the postpartum period is fraught with many dangers for the postpartum woman. Immediately after the placenta leaves, the woman begins to experience very strong bleeding - lochia. Blood oozes from the wound at the placenta's attachment to the uterus, the epithelium that lined the uterus during pregnancy begins to be rejected - all this, mixed with mucus from the cervical canal, flows out of the genital tract.

When does the discharge go away after childbirth? Normally, the duration of discharge after childbirth should not be more than 6-8 weeks.

In the first two hours after birth, while the woman is still in the maternity ward or on a gurney in the corridor, doctors observe the nature of the discharge. This period is especially dangerous for the development of hypotonic bleeding, when the uterus stops contracting. To avoid complications, a woman is placed on her lower abdomen with an ice pack and drugs that improve uterine contractions are administered intravenously. If blood loss does not exceed half a liter and its intensity gradually decreases, then everything is in order, the postpartum woman is transferred to the postpartum ward.

Within 2-3 days after childbirth, women's discharge has a bright red color and a musty smell. The bleeding is quite severe - the pad or diaper has to be changed every 1-2 hours. In addition to blood, small clots may be released from the genital tract. This is normal - the uterus is gradually cleared of everything unnecessary and reduced in size.

In subsequent days, the lochia gradually darken, becoming brown and then yellowish (due to the large number of leukocytes). After a month, the discharge after childbirth looks more like mucus, and in some women it may stop altogether. On average, after 1-2 months the uterus returns to its pre-pregnancy size. 5 months after birth, the discharge may already be of a menstrual nature, since usually by this time the monthly cycle is restored.

For several weeks after childbirth, while the uterine mucosa (endometrium) is being restored, the young mother continues to have discharge from the genital tract. What are these discharges and in what cases can they become a sign of trouble?

Discharge from a woman's genital tract after childbirth is called lochia. Their number decreases over time, which is explained by the gradual healing of the wound surface that forms on the endometrium after the separation of the placenta.

Lochia consists of blood cells (leukocytes, erythrocytes, platelets), plasma sweating from the wound surface of the uterus, dying epithelium lining the uterus, and mucus from the cervical canal. Over time, the composition of the lochia changes, and therefore their color also changes. The nature of lochia should correspond to the days of the postpartum period. In the first days after childbirth (4-5 days after vaginal delivery and 7-8 days after cesarean section), the woman is in the maternity hospital in the postpartum department under the supervision of medical staff. But after a woman is discharged home, she controls her condition herself, and her task is to consult a doctor if necessary. The amount and nature of discharge can speak volumes, and it is important to notice alarming symptoms in time.

Discharge after childbirth in the maternity unit

For the first 2 hours after birth, the woman is in the maternity ward - in the same box where the birth took place, or on a gurney in the corridor.

It is good if the discharge immediately after childbirth is bloody, quite abundant, amounts to 0.5% of body weight, but not more than 400 ml, and does not lead to a violation of the general condition.

To prevent postpartum hemorrhage, immediately after childbirth, empty the bladder (discharge urine through a catheter) and put ice on the lower abdomen. At the same time, drugs that contract the muscles of the uterus (Oxytocin or Methylegrometril) are administered intravenously. By contracting, the uterus closes open blood vessels at the placenta attachment site, preventing blood loss.

Note! In the first two hours after birth, a woman is in the maternity ward under the supervision of medical personnel, because this period is dangerous due to the occurrence of so-called hypotonic uterine bleeding, which is caused by a violation of the contractile function of the uterus and relaxation of its muscles. If you feel that the bleeding is too heavy (the diaper is wet, the sheet is wet), you should immediately tell someone from the medical staff about it. It is important to know that the woman does not experience any pain, but bleeding quickly leads to weakness and dizziness.

Also, in the first 2 hours, bleeding may occur from tears in the tissue of the birth canal if they have not been sutured, so it is important that the doctor carefully examine the vagina and cervix after childbirth. If any rupture was not completely sutured, a hematoma (a limited accumulation of liquid blood in the tissues) of the perineum or vagina may occur. In this case, a woman may experience a feeling of fullness in the perineum. In this case, it is necessary to open the hematoma and re-suturing the rupture. This operation is performed under intravenous anesthesia.

If the first 2 hours after birth (early postpartum period) went well, the woman is transferred to the postpartum ward.

Discharge in the postpartum ward

It’s good if in the first 2-3 days the lochia is bloody, it is quite abundant (about 300 ml in the first 3 days): the pad or diaper is completely filled within 1-2 hours, the lochia may be clotted and have a musty smell like menstrual flow. Then the number of lochia decreases, they acquire a dark red color with a brown tint. Increased discharge when moving is normal. In the postpartum department, the doctor makes a daily round, during which, among other indicators of the woman’s condition, he evaluates the nature and amount of discharge - for this he looks at the discharge on the pad or pad. A number of maternity hospitals insist on using diapers, because this makes it easier for the doctor to assess the nature of the discharge. Usually the doctor checks with the woman the amount of discharge during the day. In addition, in the first 2-3 days, discharge may appear when the doctor palpates the abdomen.

To prevent postpartum hemorrhage, it is important to follow the following recommendations:

• Empty your bladder in a timely manner. During the first day, you need to go to the toilet at least every 3 hours, even if you don’t feel the urge to urinate. A full bladder prevents normal contractions of the uterus.
• Breastfeed your baby on demand. During feeding, the uterus contracts as irritation of the nipples causes the release of oxytocin, a hormone produced in the pituitary gland, an endocrine gland located in the brain. Oxytocin has a contractile effect on the uterus. In this case, the woman may feel cramping pain in the lower abdomen (in multiparous women they are stronger). Discharge increases during feeding.
• Lie on your stomach. This not only prevents bleeding, but also prevents the retention of discharge in the uterine cavity. After pregnancy and childbirth, the tone of the abdominal wall is weakened, so the uterus can deviate posteriorly, which disrupts the outflow of secretions, and in the position on the stomach, the uterus approaches the anterior abdominal wall, the angle between the body of the uterus and the cervix is ​​eliminated, and the outflow of secretions improves.
• Place an ice pack on the lower abdomen 3-4 times a day - this measure helps improve the contraction of the muscles of the uterus and uterine vessels.

Women whose uterus was overstretched during pregnancy (in pregnant women with a large fetus, in multiple pregnancies, in multiparous women), as well as those in whom labor occurred with complications (weakness of labor, manual separation of the placenta, early hypotonic bleeding) in the postpartum period, the drug Oxytocin is prescribed intramuscularly for 2-3 days so that the uterus contracts well.

If the amount of discharge increases sharply, you should definitely consult a doctor.

Note! If the amount of discharge has sharply increased, you should definitely consult a doctor, as there is a danger of late postpartum hemorrhage (late postpartum hemorrhage includes those bleeding that occurred 2 or more hours after the end of labor). Their reasons may be different.

Bleeding may be a consequence of retained parts of the placenta if it was not diagnosed in time (in the first 2 hours after birth). This bleeding may occur in the first days or even weeks after birth. The share of the placenta in the uterus can be detected by vaginal examination (if it is located close to the internal os and the cervical canal is patent) or by ultrasound. In this case, a portion of the placenta is removed from the uterus under intravenous anesthesia. In parallel, infusion therapy (intravenous drip administration of liquids) is carried out, the volume of which depends on the degree of blood loss, and antibacterial therapy to prevent infectious complications.

In 0.2-0.3% of cases, bleeding is caused by disorders in the blood coagulation system. The causes of these disorders can be various blood diseases. Such bleeding is the most difficult to correct, so preventive therapy started before birth is very important. Usually a woman is aware of the presence of these disorders before pregnancy.

Most often, hypotonic bleeding occurs due to insufficient contraction of the uterine muscles. In this case, the bleeding is quite profuse and painless. To eliminate hypotonic bleeding, reducing drugs are administered, blood loss is compensated by intravenous fluid administration, and in case of severe bleeding, blood products (plasma, red blood cells). If necessary, surgical intervention is possible.

If the discharge stops, you should also consult a doctor. A complication of the postpartum period, characterized by the accumulation of lochia in the uterine cavity, is called lochiometra. This complication occurs due to overstretching of the uterus and its bending backwards. If the lochiometra is not eliminated in time, endometritis (inflammation of the uterine mucosa) may occur, because postpartum discharge is a breeding ground for pathogens. Treatment consists of prescribing drugs that contract the uterus (Oxytocin). In this case, it is necessary to eliminate cervical spasm, for which No-shpa is administered 20 minutes before Oxytocin.

Postpartum discharge at home

It’s good if postpartum discharge lasts 6-8 weeks (that’s how long it takes for the uterus to develop back after pregnancy and childbirth). Their total quantity during this time is 500-1500 ml.

In the first week after childbirth, the discharge is comparable to normal menstruation, only it is more abundant and may contain clots. Every day the amount of discharge decreases. Gradually they acquire a yellowish-white color due to a large amount of mucus, and may be mixed with blood. Approximately by the 4th week, scanty, “spotting” discharge is observed, and by the end of the 6-8th week it is already the same as before pregnancy.

In women who are breastfeeding, postpartum discharge stops faster, as the entire process of reverse development of the uterus occurs faster. At first there may be cramping pain in the lower abdomen when feeding, but within a few days it goes away.

In women who have undergone a cesarean section, everything happens more slowly, since, due to the presence of a suture on the uterus, it contracts less well.

Hygiene rules during the postpartum period. Following simple hygiene rules will help avoid infectious complications. From the very first days of the postpartum period, a variety of microbial flora is found in the lochia, which, when multiplying, can cause an inflammatory process. Therefore, it is important that lochia does not linger in the uterine cavity and vagina.

During the entire period while the discharge continues, you need to use pads or diapers. Gaskets must be changed at least every 3 hours. It is better to use pads with a soft surface than with a mesh surface, because the nature of the discharge is better visible on them. Pads with fragrances are not recommended - their use increases the risk of allergic reactions. While you are lying down, it is better to use padding diapers so as not to interfere with the release of lochia. You can put a diaper on it so that the discharge comes out freely, but does not stain the laundry. Tampons cannot be used, as they prevent the removal of vaginal discharge, instead absorbing it, which can cause the proliferation of microorganisms and provoke the development of an inflammatory process.

You need to wash yourself several times a day (after each visit to the toilet), you need to take a shower every day. The genitals need to be washed from the outside, but not from the inside, from front to back. You cannot douche, because this way you can get an infection. For the same reasons, it is not recommended to take a bath.

During intense physical activity, the volume of discharge may increase, so do not lift anything heavy.

You should seek medical help in the following cases:

• The discharge acquired an unpleasant, pungent odor and purulent character. All this indicates the development of an infectious process in the uterus - endometritis. Most often, endometritis is also accompanied by pain in the lower abdomen and fever,
• Heavy bleeding appeared after its amount had already begun to decrease or bleeding does not stop for a long time. This may be a symptom that there are parts of the placenta that have not been removed in the uterus, which interfere with its normal contraction,
• The appearance of curdled discharge indicates the development of yeast colpitis (thrush). In this case, itching in the vagina may also appear, and redness sometimes occurs on the external genitalia. The risk of this complication increases when taking antibiotics,
• Postpartum discharge suddenly stopped. Complications are more common after a cesarean section than after a natural birth.
• For heavy bleeding(several pads within an hour) you need to call an ambulance, and not go to the doctor yourself.

Restoring the menstrual cycle after childbirth

The timing of the restoration of the menstrual cycle is individual for each woman. After childbirth, a woman’s body produces the hormone prolactin, which stimulates milk production in the female body. It suppresses the formation of hormones in the ovaries, and therefore prevents ovulation.