Being a new mum is fantastic, but sometimes there are some not-so-glamourous things that come with the territory. One of these things is bleeding after birth.
On the upside, it’s something that every new mother goes through, and it’s completely normal. It makes sense when you think about it – after you’ve given birth and have gotten rid of the placenta, there are still open blood vessels where it was attached to the wall of the uterus. These bleed into the uterus until the area is healed, while the uterus shrinks back to its non-pregnancy size. And the 50 per cent extra blood you had when you were pregnant has to exit your body somehow!
All about lochia
The initial bleeding after birth is called lochia, and you’ll experience this for around four weeks. For the first few days you’ll notice a heavy flow, coloured dark red, with some clotting, which is why it’s recommended to bring two or three packs of maternity pads to hospital. Around the end of the first week it should start to taper off, becoming lighter in flow and colour; as time passes, it will fade to a brown, yellowish or even almost-white discharge.
You might notice a ‘gush’ out when you stand up – this is normal. And if you’re breastfeeding, you might notice that you lose more blood after feeds; this is caused by your hormones doing their work to help shrink your uterus even faster.
At first you’ll need to change your maternity pad every hour or two, then can drop back to once every three or four hours. By the time it lightens up, you can use a maternity liner. It’s important you don’t use tampons for at least six weeks after the birth, as this can cause an infection.
If your lochia smells bad, you’re still noticing a lot of blood loss after the first four weeks, or the blood is bright red, you should speak to your doctor or midwife as soon as you can, as you might have an infection. This is especially important it you also have a temperature or are generally feel unwell. Likewise, if your blood loss is so heavy that you’re going through more than one maternity pad an hour, you should get medical help immediately – this can be a sign of haemorrhaging.
Your period and ovulation
There’s no rule as to when your period returns post-baby – it can vary from woman to woman, and pregnancy to pregnancy!
But there are some general guides: women who bottle-feed can see their period return within six weeks of birth, and most will have them back by week 10, which is also when many breastfeeding mums can start expecting them back. Breastfeeding mums can take longer to start menstruating again because breastfeeding makes the body release the milk-producing hormone prolactin, which, in turn, keeps your levels of progesterone and oestrogen – the hormones responsible for ovulation and menstruation – low.
Once your period returns, it can take even longer for it to get into a regular cycle. Bottle-feeding mums can take around six months, while breastfeeding mums can take 12-18 months. Again, though, this varies from mum to mum.
So does this mean that before your period returns, you can have unprotected sex and not get pregnant? Um, not quite. Your first egg will be released two weeks before your period starts, so if you have unprotected sex without realising that you’re ovulating, you could get pregnant before you’ve even had your first period!
It’s a good idea to speak to your doctor or midwife about contraception even before you start thinking about sex again, so you can be confident in your choice ahead of time.