Discharge after childbirth: how not to confuse lochia with menstruation

Discharge after childbirth is a completely natural process, but at the same time extremely important from the point of view of the postpartum state of a woman. Deviations from the norm can be an important symptom of a serious problem.

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All expectant mothers need to know how long discharge lasts after childbirth. Otherwise, in the first days after childbirth, heavy bleeding can cause unreasonable anxiety. And vice versa: a woman, who is not familiar with the basics of postpartum self-care, can take an unacceptably frivolous approach to resuming childbirth, after it has already stopped, in the midst of caring for a newborn child.

Discharges after childbirth are due to the fact that the placenta is "born" after the baby is born. The procedure of disconnecting the "child's seat" leaves a large wound surface on the uterus. Discharge after childbirth will continue until the wound heals and the mucous membrane is restored.

What happens immediately after childbirth

Immediately after childbirth, the process of contraction of the uterus begins, during which it is gradually cleaned of fragments of mucus and blood clots. The first two hours after childbirth is a rather dangerous period from the point of view of hypotonic uterine bleeding. Therefore, during this time, the woman is under the close supervision of a doctor. Discharges after childbirth in this period are very abundant - normally, a woman loses about half a liter of blood within two hours. If the allocated volume exceeds the norm, doctors immediately take measures.

How long does discharge last after childbirth

In the first few days after childbirth, the discharge is very abundant. Moreover, along with bright liquid blood, blood clots and mucus stand out. This is normal: this is how the uterus is cleansed. How long will discharge last after childbirth? Until the surface of the uterus heals and the mucous membrane recovers. But the amount of discharge will gradually decrease, and their color will also change: after a few days after childbirth, lochia (so-called discharge after childbirth) will become a little darker in color. About 7-10 days after childbirth, the discharge will turn brownish-yellow in color, have a mucous consistency, and in the third week will turn yellowish-white. But the impurity of blood can still be observed for a whole month after childbirth - this is normal.

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On the 5th-6th week, secretions from the uterus should stop. If this is not the case, be sure to consult your doctor. A change in color should also be alarming. If they suddenly turned from brown to bright red, cloudy, and their number increased sharply, see a doctor immediately. This may indicate the beginning of the inflammatory process.

Inna Vynnychenko

Obstetrician-gynecologist of the Ameda Family Clinic

Discharges after childbirth, or lochia as they are called, are physiological discharges, with the help of which the uterus is cleansed of excess blood vessels, plasma, and epithelium. Lochia are very abundant the first 3 days after childbirth, their quantity decreases and the color changes (bright red, translucent, light brown, brown, yellowish).

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What affects the duration of discharge after childbirth

To the question "How long are the discharges after childbirth?" there is no unequivocal answer. In different women, this period may last for different times. First, the individual characteristics of a woman's body and her ability to quickly recover after childbirth are important. And secondly, many other factors come into play. Namely:

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• special features of pregnancy;
• the method of delivery (in the case of cesarean section, lochia usually lasts a little longer than in the case of physiological childbirth - the uterus is more traumatic);
• the intensity of contraction of the uterus;
• the presence or absence of postpartum complications;
• breastfeeding (the more often a woman puts her baby to her breast, the more intensively the uterus contracts and cleanses).

Source: Legion Media

When to see a doctor urgently

The intensity, duration and nature of discharge after childbirth is a very important indicator of a woman's health in the postpartum period. On average, lochia after childbirth is released within a month and a half. If they stop much earlier or last much longer, consult a doctor.

Too rapid termination of secretions after childbirth may indicate that a woman has begun to develop a lochiometer. This can lead to endometritis (inflammation of the lining of the uterus). Retention of wound contents in the uterine cavity creates a favorable environment for the reproduction of bacteria and, as a consequence, the development of infections. In this case, the contraction of the uterus and its cleansing of the wound contents are caused by medication.

It is necessary to consult a doctor without delaying for a minute, if the discharge after childbirth, having decreased, suddenly became abundant again. This can happen shortly after delivery, or maybe two or three weeks later.

Remember: unexpectedly abundant discharge after childbirth is a serious reason to call an ambulance.

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Changes in the color of postpartum secretions (the appearance, for example, of a putrid smell), pain in the lower abdomen in combination with an increase in temperature - all these can be symptoms of inflammation of the uterine mucosa. If the secretions after childbirth have become granular from bloody ones, this is a symptom of thrush. Ask the doctor!

Inna Vynnychenko

Obstetrician-gynecologist of the Ameda Family Clinic

If the discharge has stopped abruptly, you should consult a gynecologist to rule out a hematoma — an accumulation of blood in the uterine cavity due to a spasm of the cervical canal.
Many factors affect the duration of postpartum discharge: for example, the birth process, the weight of the child, the presence of polyhydramnios, breastfeeding, or the activity of uterine contractions during feeding.

Source: Fotolia

How not to confuse postpartum discharge with menstruation

The question of when the period will appear after childbirth worries all women. After all, the resumption of the menstrual cycle means the possibility of a new pregnancy. Therefore, it is very important to understand the difference between discharge after pregnancy and the beginning of a new menstrual cycle.

Remember: menstruation very rarely resumes two to three months after childbirth. This is possible only if the woman does not breastfeed the baby at all. And even in this case, menstruation starts so early is extremely rare. If discharge still appears, see a doctor! He will help you understand what exactly you are dealing with - with a complication after childbirth and discharge in connection with this or with a restored menstrual cycle.

Source: Fotolia

Inna Vynnychenko

Obstetrician-gynecologist of the Ameda Family Clinic

It is impossible to confuse lochia and menstruation, since the cycle after childbirth is restored only after 6-8 weeks. And in order to be calm, as soon as lochia stopped, you need to visit an obstetrician-gynecologist!

When menstruation begins after childbirth

For a long time it was considered that the norm is the absence of menstruation during the entire period of breastfeeding. However, let's remember that this installation was established at a time when women fed their babies exclusively with mother's milk, without any regimen and complementary foods up to 2-3 years of age. That is, until the moment when the child could switch to "adult" food. And throughout this long period, my mother did not have menstruation - this is the physiological norm, which the endocrine system of a woman is oriented towards.

However, recently the norm has been broken. Among the reasons for this phenomenon, we can mention the active use of hormonal drugs by modern women, medical stimulation of labor, early introduction of complementary foods, and early weaning of the baby from the breast. The listed factors undoubtedly affect the hormonal background of a woman. Therefore, it can be said that there is no "standard" scheme for restoring the cycle, which is the same for all young mothers. Each woman has her own way, which depends on the individual characteristics of the body, but primarily on the method and mode of feeding the child.

Source: Burda Media

Hormones are responsible for discharge after childbirth

Immediately after childbirth, the endocrine system, and in particular the pituitary gland (endocrine gland, or the so-called conductor of the endocrine system), begins to intensively produce the hormone prolactin. As you know, this hormone stimulates the production of milk in the mammary glands and at the same time suppresses the cyclic production of hormones in the ovary, thereby preventing the processes of egg maturation and ovulation (the release of the egg from the ovary). Consequently, menstruation does not occur.

However, the process of prolactin production also has a feedback. If for some reason the intensity of lactation (fed) decreases - for example, the mother was forced to go to work and now feeds the baby less often than once every 4 hours, and in the intervals between feedings she does not express herself, introduces complementary foods, etc., then the production of prolactin decreases.

At the same time, the production of the follicle-stimulating hormone responsible for ovulation, on the contrary, immediately increases. This can lead to the resumption of menstruation. The conclusion is self-explanatory: the more and longer a woman breastfeeds her baby, the slower her cycle recovery is, and vice versa.

Source: Fotolia

The first hesitations

The arrival of the first menstruation allows to talk about the renewal of the cycle. However, ego regularity is not always established immediately. Sometimes, the interval between periods increases to 40-45 days (the norm is 21-35 days) or, on the contrary, decreases to 2-3 weeks. Most often, doctors consider such cycle fluctuations as the norm. It is believed that the correct cyclic nature of menstruation should be established during the first 2-3 cycles, although up to 6 cycles are permissible. However, if even after six months menstruation is irregular, you should consult a doctor. It is important to exclude such diseases as endometriosis, uterine myoma, ovarian tumors.

It should be noted that after childbirth pain during menstruation sometimes disappears. The pain is often caused by a certain position of the uterus — the curvature of the uterus at the back, which makes it difficult for the outflow of menstrual blood. During pregnancy and childbirth, the position of organs in the abdominal cavity changes. The uterus acquires a more physiological position, and the pain goes away.

Why menstruation is not restored immediately

Unfortunately, the recovery of the cycle does not always go smoothly. Sometimes a woman has completely stopped breastfeeding, and her periods never return (or they become very scanty, greasy). Most often, this situation is associated with hyperprolactinemia - increased production of the hormone prolactin. This violation, in turn, can be caused by various reasons. Among them are increased function of prolactin-secreting cells of the pituitary gland, insufficient function of the thyroid gland, and a benign tumor of the pituitary gland (prolactinoma). Modern medicine successfully corrects all these causes of hyperprolactinemia. For its diagnosis, a blood test for the content of prolactin and thyroid hormones is carried out, as well as an examination of the pituitary gland with the help of computer tomography.

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Another complication that leads to a violation of menstrual function after childbirth is postpartum hypopituitarism (Sheehan's syndrome). This disease develops as a result of necrotic changes — "cell death" in the pituitary gland and requires serious hormonal treatment. But, fortunately, Sheehan's syndrome occurs quite rarely (only 0,1% of cases).

Source: Legion-Media

Do not rush to get treated!

After the birth of the child, the work of all endocrine glands, as well as other organs and systems, gradually returns to its "pre-pregnancy" state. These important changes begin from the moment of expulsion of the latter and continue for approximately 6-8 weeks. However, the mammary glands and the hormonal system are an exception: due to lactation, a longer period of time is needed for their recovery.

That is why gynecologists postpone the treatment of some "female" diseases until the full recovery of the menstrual cycle. After all, while the hormonal background is unstable, it is difficult to say how this or that disease will behave.

Source: Burda Media

Take care, mommy!

What method of contraception should be preferred by a nursing mother to avoid an unexpected pregnancy? Of course, only a doctor can give you the best recommendation. During the visit, be sure to warn the doctor that you are breastfeeding! Most likely, the doctor will advise you to use the most harmless means for a nursing mother and her baby: condoms, spermicides (Pharmatex, Patentex-oval, Sterilin, etc.) or an intrauterine spiral (non-hormonal!).

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Is it worth using hormonal means? Doctors do not have an unequivocal opinion. Some specialists speak out against the fact that a nursing woman should use any hormonal means. Arguments - the long-term effect of such means on the mother and child has not yet been studied. Other doctors believe that the use of hormones is quite permissible. The main thing is to choose them wisely. Means that contain only the hormone progestin (these are injections, implants and mini-pills - Exluton, Charozetta and Mikrolute) do not affect milk production. Therefore, if you use hormonal means, then only such. But hormonal drugs that also contain estrogen can reduce milk production and pass into milk. Nursing mothers should not use similar drugs.