Postpartum Bleeding and Blood Clots: What’s Normal and When to Seek Help
After delivery, it’s not uncommon for women to experience postpartum bleeding and the formation of blood clots. This is a natural part of the post-birth recovery process as the uterus contracts to return to its normal size and sheds excess blood and tissue. However, it’s crucial to differentiate between normal postpartum bleeding and clotting and signs that may indicate a more serious issue.
What’s Normal?
Postpartum bleeding often involves the formation of small blood clots in the uterus. These clots are generally small and not a cause for concern. In the initial days after childbirth, healthcare providers will monitor the amount of blood loss and clotting to ensure it’s within expected ranges.
Normally, blood clots should be smaller than the size of a golf ball for the first few weeks after giving birth. It’s important to report any unusual or large blood clots to your healthcare provider, as they can determine if it’s indicative of a more serious problem.
Risk Factors
While postpartum bleeding with small blood clots is common, some individuals may be at a higher risk of experiencing heavy bleeding and clot formation after birth, a condition known as postpartum hemorrhage (PPH). Factors that increase the risk of PPH include:
- Prolonged labor
- Obesity
- Preeclampsia (high blood pressure during pregnancy)
- Blood clotting disorders
- Conditions affecting the uterus or placenta
It’s important to note that PPH can still occur in individuals with no known risk factors, so vigilance is essential.
What to Expect Over Time
Understanding the timeline of postpartum bleeding and clotting can help you differentiate between what’s normal and what may require medical attention:
- Day 1 after birth: Expect heavy bleeding with small blood clots (about the size of two halves of a golf ball).
- First week after birth: Bleeding reduces to a moderate flow, with smaller blood clots (approximately a quarter of the size of a golf ball).
- Second week after birth: Blood flow further decreases to a mild level, with blood clots smaller than a quarter.
- Two to six weeks after birth: Gradual reduction in bleeding, and it may stop altogether for some time. No blood clots should be present at this stage.
- Sixth week after birth: You may experience symptoms similar to menstruation returning. Any heavy bleeding or large blood clots at this point should be reported to your healthcare provider immediately.
Managing Postpartum Bleeding
It’s generally not recommended to use tampons unless your healthcare provider approves. Instead, opt for pads, sanitary towels, or period underwear to manage postpartum bleeding. Be diligent about changing them regularly and maintain proper hand hygiene to ensure a clean recovery.
Risks of Heavy Postpartum Bleeding and Clotting
Experiencing excessive bleeding and passing large blood clots after childbirth can be indicative of postpartum hemorrhage. The risks associated with PPH include:
- Rapid loss of a significant amount of blood, leading to a dangerous drop in blood pressure
- Shock
- In severe cases, death if left untreated
PPH typically occurs within the first 24 hours after birth but can also develop days or weeks later due to inadequate uterine contractions.
In Hospital with Postpartum Blood Clots: Treatment
If you’re experiencing excessive bleeding or blood clots after delivery, your healthcare provider will recommend treatment, often in a hospital or medical facility. Treatment may include:
- Ensuring the removal of any remaining placental fragments
- Uterine contraction stimulation through medication or massage
- Blood transfusion if blood loss is significant
- Intravenous (IV) fluids for hydration
- Surgical intervention to identify and address the cause of bleeding
- In rare, life-threatening cases, removal of the uterus to control bleeding
Results of Postpartum Hemorrhage
Postpartum hemorrhage is a treatable condition if addressed promptly by your medical team. However, it’s a serious concern, as a rapid drop in blood pressure can lead to complications and, in rare instances, even death.
It’s estimated that approximately 1 to 5 out of 100 people who give birth will experience PPH, making it a leading cause of maternal mortality.
Seek Help if Uncertain
Key symptoms of postpartum bleeding issues include heavy bleeding, the passage of large blood clots, and signs of shock. If you experience any of these symptoms or feel uncertain, don’t hesitate to seek medical assistance. Other symptoms that warrant immediate attention include:
- Fainting
- Low blood pressure
- Cold and clammy skin
- Changing more than two pads in an hour
- Blurred vision
- Dizziness or weakness
- Rapid heartbeat
- Difficulty breathing
- Confusion
- Severe headache
Postpartum Care
The postpartum period, typically the first 12 weeks after childbirth, is a significant phase of physical, mental, and emotional adjustment. Remember that you can always seek help for yourself or your baby during this time. Attending postpartum checkups ensures you receive the necessary support and follow-up care for a smooth recovery.
When Does Postpartum Bleeding and Clotting Stop?
Most individuals can expect postpartum bleeding and clot formation to gradually decrease over several weeks. Typically, bleeding and clotting should resolve or stop altogether by about six weeks after childbirth. At this point, you may also notice the return of your menstrual cycle.
Summary
Postpartum bleeding and blood clots are common occurrences after childbirth. Understanding the expected timeline and recognizing abnormal symptoms can help you distinguish between normal postpartum recovery and potential complications. While some bleeding and small clots are typical, large blood clots or excessive bleeding should always be reported to your healthcare provider promptly to ensure your well-being and safety.