In the six weeks after giving birth, your body is healing. During this time, you can expect some bleeding, known as lochia, as well as blood clots. A blood clot is a mass of blood that sticks together and forms a jelly-like substance.
The most common source of blood after giving birth is from your uterus, since it sheds its lining after birth. If you had your baby vaginally, another source can be damaged tissues in your birth canal. If blood doesn’t immediately pass through the vagina and out of your body, it has a tendency to form clots. Sometimes these clots can be especially large immediately after giving birth.
While blood clots are normal after pregnancy, too many blood clots or very large blood clots can be cause for concern. Here’s what you need to know about blood clots after birth.
Blood clots often have a jelly-like appearance. They may also contain mucus or tissue, and can be as large as a golf ball.
The amount of blood clots and bleeding you experience after birth should change as the weeks pass. As a general rule, you can expect to have some degree of bleeding and discharge for up to six weeks after giving birth. Here’s what you can expect:
- The first 24 hours: Bleeding is usually the heaviest at this time, and the blood will be bright red. You may bleed enough to soak about one sanitary pad per hour. You may also pass one to two very large clots, which can be as big as a tomato, or numerous small ones, which may be close to the size of a grape.
- 2 to 6 days after birth: Blood loss should slow down. The blood will be darker brown or pink-red instead of bright. This indicates that the blood is “old” and not the result of continued bleeding. You may still continue to pass some small clots. These will be closer to the size of a pencil eraser.
- 7 to 10 days after birth: The bloody discharge may be pink-red or light brown in color. Bleeding will be lighter than the first six days of your period. At this point, you should not be soaking a sanitary pad on a regular basis.
- 11 to 14 days after birth: Any bloody discharge will generally be lighter in color. However, at this point you may feel like being more active. This could result in some red-tinged discharge. The amount of bleeding should be less than during the first 10 days after birth.
- 3 to 4 weeks after birth: Blood loss should be minimal at this time. However, you may have a cream-colored discharge that could be tinged or streaked with brown or light red blood. Sometimes bleeding will stop altogether during these weeks. You may also get your period again at this time.
- 5 to 6 weeks after birth: Postpartum-related bleeding will usually stop by weeks five and six. However, you may have an occasional brown, red, or yellow blood spotting.
During the weeks after giving birth, women often notice more bleeding at certain times, including:
- in the morning
- after breastfeeding
- after exercising (if your doctor has cleared you to return to regular physical activity)
When to call your doctor
While you can expect some degree of blood clots after giving birth, you may experience symptoms that require a call to your doctor’s office.
The following symptoms could be a sign of infection or excessive bleeding:
- bright red blood following the third day after birth
- difficulty breathing
- fever higher than 100.4ºF (38ºC)
- foul-smelling vaginal discharge
- separation of stitches in the perineum or abdomen
- severe headaches
- loss of consciousness
- soaking more than one sanitary pad per hour with blood
- passing very large clots (golf ball-sized or larger) more than 24 hours after giving birth
Women who’ve recently given birth also have an increased risk for blood clots in their arteries. These systemic clots can affect your blood flow and lead to conditions such as:
Symptoms of a systemic blood clot in the postpartum period include:
- chest pain or pressure
- loss of balance
- pain or numbness only on one side
- sudden loss of strength on one side of the body
- sudden, severe headache
- swelling or pain in only one leg
- trouble breathing
Each of these symptoms can indicate a possible medical emergency. If you experience any of these symptoms after birth, seek immediate medical attention
Many women wear a large sanitary pad to collect the blood after giving birth. Some medical supply stores sell sanitary pads with a special cooling material to help reduce postpartum swelling. Postpartum sanitary pads or overnight pads are available at most drugstores.
If you experience prolonged or excessive bleeding or clotting, your doctor will likely perform an ultrasound to test for pieces of retained placenta. The placenta is the organ that nourishes the baby during pregnancy. All of the placenta should be “delivered” in the postpartum period. However, if even a miniscule piece remains, the uterus can’t properly clamp down and return to its pre-pregnancy size. As a result, bleeding will continue.
An operation for retained placenta is known as a dilation and curettage, or D and C. This procedure involves using a special instrument to remove any retained tissue from the uterus. Even if you don’t have a piece of retained placenta, it’s possible that you could have a cut on your uterus that isn’t healing. In these instances, your doctor may have to perform an operation.
Another cause of continued uterine bleeding after delivery of the placenta is uterine atony, or the uterus failing to contract and clamp down on the blood vessels formerly attached to the placenta. This bleeding can pool in the uterus and develop into blood clots.
To treat uterine atony with blood clots, the blood clots need to be removed by your doctor. They may also prescribe certain medications to make the uterus contract and reduce bleeding.
Blood clots can be a normal part of the postpartum period. If something doesn’t seem or feel right to you following delivery, call your doctor.
While you can’t prevent bleeding and blood clots after birth, there are some steps you can take to reduce bleeding.