After a C-section, the body goes through a normal postpartum bleeding process called lochia, which involves three distinct phases based on the color, consistency, and duration of the discharge. This process is the same whether a person has a vaginal or C-section birth, although C-section bleeding is often slightly lighter overall.
Postpartum Bleeding Stages After a C-Section
Lochia Rubra (Days 1-7) – This stage is marked by bright red bleeding, which may contain small clots. The flow is heaviest during this time. Lochia Serosa (Days 7-14) – The bleeding gradually lightens in color, turning pink or brown as the body continues healing.
You will have some vaginal bleeding (called lochia) for 2-6 weeks after the birth. This is the mucous, tissue and blood that is shed after birth as your womb (uterus) replaces its lining.
Lochia is dark or bright red for at least three or four days. The flow is heavy, and you may also pass small clots. After about a week, lochia is more watery and transitions to a pinkish-brown color. Finally, after about 10 to 14 days, lochia changes to a creamy, yellowish-white color.
Occasionally, a week or two after your bleeding seems to have stopped, you may have a sudden gush of bright red blood. This is the normal process of the placental site scab coming off. This too will taper off over a few days.
Symptoms and Causes
It's normal for postpartum bleeding to have a mild scent, often described as similar to menstrual blood, slightly musty or metallic. This lochia smell is expected and not usually a cause for concern. However, if the vaginal smell postpartum becomes strong, foul, or fishy, it could indicate an infection.
Vaginal bleeding or discharge after pregnancy
You have heavy bleeding—soaking through one or more pads in an hour. You pass clots bigger than an egg or you pass tissue. You have vaginal discharge that smells bad.
Starting exercise too vigorously can disrupt the healing tissues and blood vessels in your vaginal canal and uterus. Having intercourse before six weeks postpartum also commonly causes minor bleeding.
If you have a loss that is a brighter red again, it could be your menstrual period re-starting (see page four). However, if you are worried, contact your GP or health visitor. A small or occasional loss of either brown, pinkish red or a creamy yellow coloured blood loss (lochia).
heavy vaginal bleeding. your wound becomes more red, painful and swollen. a discharge of pus or foul-smelling fluid from your wound. a cough or shortness of breath.
Some signs to recognize prolonged menstruation after a cesarean section include: Menstrual period lasting more than 7 days. Menstrual blood volume greater than 80ml (normally about 50 - 80 ml per cycle). Menstrual blood clots into large lumps.
If you are bleeding heavily (soaking through a pad every hour or two) and you have given birth within the last 6 weeks, go to your hospital's emergency department.
Signs of torn internal stitches may include severe pain, unusual bleeding, swelling, pus, or the wound edges separating. Although this complication is rare, it's important to seek immediate medical advice if you suspect your C-section internal stitches have torn.
A C-section incision is the most painful for the first three or four days after your surgery. By the time you go home, you should start to feel better. But your incision site will still be tender for about three weeks. Keeping your incision clean and dry will help it heal faster and prevent infection.
Normal lochia has a smell similar to menstrual blood and should not cause discomfort. If lochia has a foul or unusual odor, it may indicate an infection in the uterus or from tears in the perineum. In this case, seek medical advice. Pelvic pain.
Lochia is another great indicator. If your lochia was lighter but it returns to being heavy and bright red after exercising, you're doing too much. Heavy, red lochia is an indicator that you have opened up the healing wound from the placenta.
Causes, summarized by the 4 "T's" (tone, trauma, tissue, thrombin), require prompt intervention. Management involves an interprofessional approach, emphasizing accurate blood loss assessment, fluid replacement, and source control.
Head: Sudden onset severe headache, vision changes, confusion and weakness on one side of your body. Chest: Difficulty breathing, chest pain and coughing up blood. Abdomen: Swelling or a feeling of fullness, abdominal bruising and bloody vomit, pee or poop.
Symptoms may include:
Increased bleeding after your lochia starts to decrease can be a sign you're overdoing it and need more rest. Seeing ongoing clots could mean your uterus is having trouble getting back to its pre-pregnancy size. In either case, it's always best to call.
Foul-smelling lochia and signs of abnormal lochia
Lochia usually has a fishy odor similar to menstruation. However, if the lochia has an unusual odor or strange odor, it may be due to an infection in the uterus or an infection due to a tear in the perineum during childbirth.
Keep the area clean by pouring or spraying warm water over the area outside your vagina and anus after you use the toilet. Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement.
Postpartum bleeding stopped and started again
That's because during the first 6 weeks post-birth, you don't stop bleeding entirely. Instead, you might notice your lochia increase in volume or even return to the bright red bleeding you experience in the first week after giving birth.
As previously stated, fibroids can cause vaginal discharge, but as a rule, fibroid discharge is not smelly. Smelly vaginal discharge is a sign of infection and should be treated by a medical professional.