Explaining blood loss after birth

Blood loss after birth

It is normal for women who have given birth to lose some blood from their womb (uterus) until the lining is renewed. This blood loss, or lochia to give it its medical name, usually lasts from two to six weeks and usually varies in colour over that time. It tends to go from bright red to brownish-pink to pale pink but this will be different for each woman. You may notice in the first few days that your blood has a very slight metallic smell: this is normal. 

Some women continue to have a small loss for several weeks, and the colour tends to stay the same – either a browny-red or pinky-red ¬ – and the blood makes only be a light stain on a pad. If your blood loss turns brighter red again, it could be your periods re-starting. If you are worried, contact your GP, midwife or health visitor.

Factors which may affect blood loss after birth

Breastfeeding

If you are breastfeeding, the increased hormones act on your womb and make it contract. You may feel these contractions as after pains, or they may be painless, in which case the only sign may be a slight increase in the amount of your blood loss or the blood changing to a red colour during or just after a feed.

Going to the loo

If you have stinging or difficulty passing urine or you become constipated and have to strain or push to have any success, this can make your blood loss either slightly heavier or redder in colour. You may also pass small blood clots (the size of your little fingernail) or experience pain or cramp in your pelvis if you are constipated, have problems passing urine or have a urine infection.

Exercising

As you start to undertake more physical activity – such as doing the shopping, pushing the buggy or just going up and down stairs more often – you may experience a heavier loss. Although it may be heavier in amount, the colour should still be the same – either a browny or pinky red, rather than a bright red colour.

The kind of third stage you had

Although there is a lack of robust research on this question, anecdotal reports from some women and midwives indicate that there may be a difference in your blood loss after birth depending on whether your third stage of labour was physiological (natural) or active (managed). The most common suggestion is that blood loss after birth clears up more quickly after a physiological third stage than an active one, where it can continue at a low level for some weeks. However, a number of factors are involved and in the absence of further research we cannot say for certain. 

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

Further healthcare information related to this topic can be found by visiting the MIDIRS website at www.infochoice.org.