Postpartum Bleeding, What Does It Consist Of?
Postpartum bleeding is one of the consequences of childbirth. In smaller amounts, it is a common process that can be treated at home. However, it can produce certain complications if the flow is heavy. We’ll tell you all about it.
Also called postpartum lochia, this expulsion of blood is abundant for the first two or three days and usually decreases as time passes. The maximum period for his disappearance is two weeks.
It’s a completely natural process. Thus, remains that remained in the uterus after birth are discarded : cervical mucus, placental remains and scarring secretions.
For this expulsion to be more efficient, the body generates these postpartum pains. They are nothing more than intense contractions that occur a day or two after giving birth. Its purpose is to contribute to this “cleaning” process.
Three Phases of Postpartum Bleeding
The three stages in which postpartum bleeding is divided are:
- First stage: reddish colored lochia are produced. They contain epithelial cells, leukocytes, and occasionally lanugo (hair of the fetus at birth). Occurs within the first two or three days after giving birth. It can flow constantly or at intervals and it is also possible to contain clots.
- Second stage: pink and serous lochia are expelled. It occurs between the first three and ten days of a baby’s life. They contain erythrocytes and leukocytes and serous exudate.
- Third stage: white or yellowish lochia are generated. They appear in the second week after delivery. Their color is due to the fact that they are mainly composed of leukocytes.
Care to be considered during postpartum bleeding
If you’re wondering what you should do to handle this stage smoothly, here are some recommendations:
- Take showers, not baths: this way you can avoid possible infections. Always with plenty of water.
- Use postpartum swabs to sanitize the area.
- The use of tampons is not allowed.
- Pay close attention to symptoms such as fever or malaise, as they may indicate some type of infection.
- When going to the hospital or medical check-ups, take a suitcase with hygiene items. After delivery, it is advisable to use towels or special dressings for pregnant women.
When bleeding becomes hemorrhage
When the amount of blood lost by a woman after childbirth exceeds 500 ml, experts refer to this not as postpartum bleeding but as postpartum hemorrhage. In cesarean sections, this parameter increases to 1000 ml.
It can occur in the first 24 hours of the postpartum period ; This is called early postpartum hemorrhage. If it occurs after this period, it is called late postpartum hemorrhage. The latter usually occurs less than the former.
Causes of postpartum hemorrhage
One cause of postpartum hemorrhage – perhaps the most worrisome – can be called uterine atony. It consists of the loss of the muscles of the uterus when the baby and placenta are expelled. Arriving at that instance, what this organ naturally does is contract; Thus, the bleeding that occurs is minimal.
When this does not happen, the risks for the mother are great. Doctors must act quickly to stop bleeding. Some can be very intense and compromise the new mother’s life.
On the other hand, it may also be due to other factors, such as the following:
- Injuries: If tissue or blood vessel rupture occurs during childbirth, bleeding is a very likely consequence.
- Tissue retention: occurs when fragments of the placenta or even the fetus remain attached to the uterus.
- Coagulopathies: consist of failures in the clotting process. They can be caused by changes such as pre-eclampsia.
Treatment
Excessive bleeding immediately after childbirth is highly preventable. The method for this consists of uterotonic drugs, such as oxytocin or carbetocin, which are given intravenously. In proper health conditions, it is a simple and routine task for specialist physicians.
Complications due to postpartum bleeding
As we mentioned earlier, certain situations can cause a postpartum bleed to turn into a bleed. That’s where everything gets more complex.
Unfortunately, the World Health Organization (WHO) numbers regarding deaths after childbirth are not encouraging. Worldwide, 830 women die from complications in childbirth or pregnancy. Most of them, 99%, reside exactly in developing countries and rural areas.
Anyway, it is noteworthy that this mortality rate was reduced by 44% between 1990 and 2015. Medical advances have collaborated a lot: the care of specialists can save the lives of women and babies. Today, developed countries hardly suffer from it.
Even with this data, you should be calm. Except in exceptional situations, postpartum bleeding is not a major problem. Just try to apply the recommendations regarding personal hygiene and don’t hesitate to ask questions if you experience discomfort or other symptoms.
