According to the Centers for Disease Control and Prevention (CDC),
Though commonplace, a C-section is still major surgery. In some cases, post-partum bleeding can occur.
While most people who have C-sections recover with minimal to no issues, it’s important to be informed — especially if you elect to deliver by C-section. Understanding what’s considered normal bleeding during the recovery period, as well as when to seek help, can reduce your risk of complications.
Some bleeding and discharge after a C-section (known as lochia) is usual after giving birth by C-section. But excess bleeding can be dangerous. In general, the body takes around 4 to 6 weeks to fully recover from a C-section. Of course, everyone’s recovery timeline may be slightly different.
Even though you can’t see internal bleeding, there are other signs that it might be occurring early on in the recovery period. Be mindful if you notice any of the following symptoms:
- tachycardia, or a heart rate that’s more than 100 beats per minute
- shortness of breath or gasping
- bruising on the skin of the abdomen (other than the incision)
- abdomen is bloated or painful to the touch
- feeling faint
- hands or feet are cold or clammy
- vaginal bleeding that suddenly becomes heavier, requiring pads to be changed every hour, or passing large clots bigger than a plum
- reduced urination
When should I be concerned about bleeding after a C-section?
It’s important to remember that light bleeding after delivery — regardless of whether you delivered vaginally or by C-section — is normal. Bleeding for roughly 6 weeks is also normal.
But the amount and color are based on where you are in the recovery timeline and going to determine if your bleeding is normal or not.
In particular, if you’re soaking through a pad every hour for more than 2 hours or passing large clots bigger than a plum, and you exhibit any of the warning symptoms listed above, you may be experiencing internal bleeding and should seek immediate medical attention.
As we mentioned, some bleeding after giving birth is normal. It can last from 4 to 6 weeks during the postpartum recovery period.
Normal bleeding refers to lochia, which includes the blood, mucus, and uterine tissue that’s released after birth. Mild cramping can also accompany this process as the muscles work to return the uterus to its original size.
The first few days after giving birth will usually be the heaviest in terms of bleeding. Initially, the lochia discharge will be made primarily of blood.
C-section recovery usually doesn’t have bleeding as heavy as those who delivered vaginally. But as you progress through recovery, the bleeding should reduce and even shift from being primarily blood to also including vaginal discharge — although this differs from person to person.
For those who opt not to nurse, your menstrual cycle should return to normal shortly after these 6 weeks. But if you opt to fully breastfeed or chestfeed, know that your period may take as long as 6 months past the 6-week recovery period to return.
Late postpartum hemorrhage signs and symptoms
Late postpartum hemorrhage (PPH), also known as secondary postpartum hemorrhage, is less common but can be equally dangerous. But the
Late PPH may also be accompanied by fever or uterine tenderness because of a potential infection. In most cases, common causes for late PPH stem from uterine infections or placental tissue that wasn’t completely removed after giving birth.
Additionally, those with a history of PPH have a higher risk of experiencing it with subsequent pregnancies.
There are a few reasons why internal bleeding may occur after a C-section:
- uterine atony, when the uterine muscle isn’t constricting the many blood vessels that were formed during the pregnancy
- the placental tissue not being completely removed
- an infection in the uterus, potentially at the incision site
Also, note that patient and family history can also influence your risk of experiencing internal bleeding after delivery. This can include:
- personal or familial history of postpartum hemorrhage
- preeclampsia or high blood pressure
- multiple birth pregnancy or large babies
- prolonged labor
- gestational diabetes
- polyhydramnios, or an excessive amount of amniotic fluid building up
If left untreated, or if interventions are taken too late, internal bleeding can be deadly. But taking a proactive approach to internal bleeding can ensure positive outcomes.
The first step is accurately determining the source of the internal bleeding. This can include blood tests, ultrasounds, and physical examinations.
The next step can include a wide range of treatment methods depending on the severity or cause of bleeding, including:
- medications to contract the uterine muscle
- manual uterine massages to help your muscles contract
- repairing any cuts or tears in the vagina, cervix, or uterus
- uterine artery embolization
- blood transfusion
- placing an intrauterine balloon to help stop the bleeding
How long should I have bright red bleeding after a C-section?
Usually, your lochia will be bright red for roughly a week after having a C-section.
After this time, it should change to dark red, brownish, or even pinkish. Eventually, the lochia should be made of mostly discharge and minimal blood as you progress through your postpartum recovery period.
Is it normal to stop bleeding and then start again after a C-section?
Although your bleeding should lighten as your postpartum period continues, it’s not unusual for it to increase slightly occasionally if you’re engaged in more physical activity.
While you’re encouraged to take it easy in the initial days and weeks after giving birth, don’t be surprised if you sometimes notice a bit more bleeding once you resume previous activities.
But the bleeding should never return to the levels it was at immediately following your C-section. If you need to replace more than a pad an hour for 2 hours, you should contact your doctor immediately.
How do I know if something is wrong with my C-section incision?
Initial light bleeding and discharge during the days immediately following delivery are normal. But if the incision begins to change color, bleeds, swells, or becomes extremely painful long after your C-section, you should contact your doctor.
How long does it take for a cesarean to heal internally?
Each person’s recovery timeline will be different. But it will likely take 4 to 6 weeks for your body to fully heal from a cesarean.
How long after a C-section can you develop internal bleeding?
Although most internal bleeding tends to develop within a day of giving birth, you’re technically at risk for up to 6 weeks after delivery. But this would be especially rare. If your bleeding increases rather than decreases during your recovery, you should contact your doctor or midwife.
What is the risk of internal bleeding after a C-section?
According to the March of Dimes, between 1 to 5 in 100 women who give birth have PPH.
Most people who have a C-section will continue through their postpartum recovery period as normal, experiencing few or no risks. But those with a previous personal or family history of postpartum hemorrhaging or experiencing pregnancy complications have a higher chance of experiencing it.
Be watchful of any changes in your bleeding and your vital signs, and seek medical help immediately if bleeding drastically changes or increases.