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Explaining bleeding after giving birth (lochia)

After you’ve given birth, you will continue to lose some blood, which usually lasts for two-to-six weeks. This article discusses why and what factors might affect your blood loss.

It's 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, can last between two to six weeks and usually varies in colour over that time.

Every woman will recover differently from pregnancy and labour, so it’s difficult to say precisely how much blood loss to expect after birth. You might find our Bleeding after birth guide useful in learning more about what to expect.

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 it should 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're worried, contact your GP, midwife or health visitor.

Factors which may affect blood loss after birth

Breastfeeding

If you're breastfeeding, the increased hormones that you produce will affect your womb and and you may feel mild contractions as a result. 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 feed your baby.

Going to the loo

If you experience stinging or difficulty passing urine or you become constipated and have to strain or push, this might affect the colour or amount of your blood loss at that time and make it slightly heavier or redder. You may also pass small blood clots (the size of your little fingernail) or experience pain or cramp in your pelvis if you're constipated, or if you have problems passing urine or where you might have a urine infection.

Exercising

As you begin to do more, especially in the first two weeks after the birth, such as pushing your buggy or going up and down stairs, you might have a heavier loss. Although it may be heavier in amount, the colour should still be the same – either a browish or pinkish red, rather than a bright red colour.

What 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). ‘Actively’ managing your third stage of labour is when the midwife gives an injection of a drug (syntocinon or syntometrine) to help encourage a big contraction that will cause the placenta to come away from the wall of the womb quickly. 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.

If you’re concerned about the colour or amount of your blood loss at any time after birth, contact your midwife, health visitor or GP.

Last updated: 3 February 2015

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 Baby Café website at www.thebabycafe.org.