Many women are curious about how long they will bleed after a cesarean section and what to anticipate from their recuperation. It’s normal to have questions, given the uniqueness of each birth experience.
Lochia, also known as bleeding, is a common occurrence during the postpartum phase, regardless of the delivery method—vaginal or C-section. Although every person’s experience with bleeding is unique, there are some general guidelines that can allay fears and provide comfort.
This post will discuss what to watch out for, how long bleeding usually lasts following a cesarean section, and when it’s critical to call a doctor.
Postpartum bleeding, also called lochia, is the term for bleeding that occurs after a cesarean section and usually lasts for four to six weeks while the uterus heals and regains its pre-pregnancy size. Each woman will experience the intensity and duration differently, with the first few days being heavier and progressively tapering off. It is imperative to keep an eye on the bleeding and seek medical attention if it becomes excessively heavy or persists longer than anticipated, as these signs may point to a potential complication.
- Causes and characteristics of discharge
- Recovery times
- Norm and pathology
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Causes and characteristics of discharge
The female reproductive organ’s reversal in development is indicated by postpartum discharge. Throughout the course of carrying a child, the uterus grows 500 times, and the placenta’s blood vessels are tightly linked to its own blood vessels. This made it possible for the unborn child to get the nourishment and oxygen it needed during the intrauterine development stage.
The woman’s uterus sustains more damage during surgical intervention than it does during a normal physiological childbirth. Firstly, the procedure by which the surgeon obtains access to the baby is the incision of the uterine tissues. Another factor contributing to increased discharge following a cesarean section is the application of sutures to the uterine incision.
After the baby is removed, the doctor manually separates the placenta. In this instance, bleeding results from damage to the vessels that join the uterus to the "baby’s place."
When the need for these dimensions vanishes, the enlarged uterus starts to shrink and will soon need to revert to nearly its original size. Doctors refer to this process as "lochia" and it also happens with increased discharge.
According to the doctor, discharge indicates that the uterus is in reverse involution. An expert physician can accurately assess how this process is progressing and how well the patient is recovering from the procedure based on them.
Blood from damaged placental vessels and the surrounding wound surface typically predominates in the lochia during the first three days following the incision. The discharge has a significant amount of red blood cells, according to a lab analysis. During this time, blood clots in the discharge are also entirely normal.
By the fifth day, the lochia begin to contain serous serum, ichor. If you examine it under a microscope, you will find that the discharge contains a huge number of leukocytes, and dead cells of the uterine epithelium can also be observed in them. By the end of the first week after natural childbirth, cervical mucus appears in the discharge. After a cesarean section, during the same period, particles of surgical threads used to suture the cut wall of the uterus can be found in the lochia. These threads are self -scrapping, but their tips, which were not included directly into the uterine fabric, are separated as the rest of the threads resolve and leave the uterine cavity in the traditional way – through the vagina.
In the initial days following surgical delivery, bleeding is significantly more intense than during a natural childbirth. This is not something to be concerned about because the area of the uterus damaged following surgery is significantly larger.
The woman’s height and weight, as well as the existence or absence of complications, all affect how much blood she loses overall.
The BME (Great Medical Encyclopedia) states that a woman may lose up to 1.5 kg following a natural childbirth as a result of the uterus contracting and lochia discharging. This quantity may be greater following a cesarean section.
Recovery times
Following the procedure, it is advised that the woman begin physical activity as soon as possible. This is because the faster a laboring woman assumes an upright posture, the more efficiently the blood and clots will pass under the effect of gravity.
After 12 hours following the procedure, you can get out of bed, but you should do so gradually. The latter may diverge as a result of overzeal and negligent stitching.
It is advised to change the sterile, maternity hospital postpartum lining every three hours during the first three days. This is significant from more than just the hygienic perspective. Following surgery, there is a greater area of uterine damage, which increases the risk of infection.
Because store-bought pads are not sterile, it is not advised to use them during the first few days.
Red blood cells and mucus are present in the lochia at the time of discharge, which takes place on the fifth day, and the woman no longer has scarlet blood discharge. The discharge process takes a while—up to eight weeks on average. This is precisely the amount of time needed for the uterus to contract (it contracts more slowly after surgery), heal, and leave scars on the area of the uterus where the incision was made.
The woman is given contraction medication during the first few days in order to prevent complications. Uterine contractions are accelerated by oxytocin, and a woman may observe a stronger discharge 10 to 15 minutes after injection.
Health professionals must not only keep an eye on lochia but also the woman’s body temperature during labor, since a sudden rise in temperature can occasionally be the initial sign of infection or inflammation. A control ultrasound examination is deemed necessary prior to discharge in order to ensure that the uterine cavity is clean and that the contraction is happening as intended. During the round, the doctor palpates the uterine area through the anterior abdominal wall.
Within the first five days following surgery, if there are no complaints of pain when urinating, a small amount of blood in the urine is acceptable.
Norm and pathology
The woman is in charge of her own discharge after discharge. Naturally, raising the child will require a lot of time, but you also need to prioritize your own well-being.
Two weeks of staying at home is considered a moderate, uniform discharge. After about a month and a half, with normal uterine involution, the discharge turns mucous, yellowish, and finally colorless. After two months of recuperation, normal vaginal discharge replaces the mucus.
Certainly, an abnormal discharge should prompt a visit to the physician. These comprise the subsequent circumstances:
- heavy bleeding that began suddenly after discharge from the maternity hospital, after the serous lochia stage;
- increased bleeding or bloody "smearing" against the background of high body temperature;
- early cessation of discharge (after 4-5 weeks);
- prolonged discharge (after 9-10 weeks from the date of surgery);
- heterogeneity of discharge, clots, "curdling" after discharge from the maternity hospital;
- any abdominal pain in combination with bloody discharge.
A woman should be especially aware of the color of the discharged lochia during her postoperative recovery period. It is not possible to rule out injury to the internal tissues formed in the incision area if the discharge has turned bright pink or orange. This may occur if a woman lifts weights, if a couple begins having sex too soon, or in spite of laws and regulations.
Examining the discharge for infectious lesions is essential if it has turned green, gray, or brownish, smells bad, or exhibits other symptoms like genital itching. A yellow-green discharge could indicate endometrial inflammation. Another concerning symptom of a recovery process complication is liquid, watery discharge during the recovery phase. A woman should see a gynecologist in any of these situations in order to determine the real cause of the issue and start treatment.
| Factor | Duration |
| Initial heavy bleeding (lochia rubra) | Up to 4 days |
| Moderate bleeding (lochia serosa) | About 10 days |
| Light bleeding (lochia alba) | 2 to 6 weeks |
| Total bleeding time | 4 to 6 weeks |
| When to consult a doctor | If bleeding lasts longer than 6 weeks or is very heavy |
Although it varies from woman to woman, bleeding following a cesarean section is a normal part of the healing process. For four to six weeks, most women will experience bleeding, which is heavier in the beginning and gets lighter over time.
It’s critical to monitor the bleeding and look for any indications of a problem. See your doctor to make sure everything is healing properly if you experience any unusual symptoms, such as large clots or a sudden increase in flow.
Recall that the keys to a speedy recovery following a cesarean section are getting enough sleep, maintaining good hygiene, and listening to your doctor. Taking care of yourself will hasten the healing process and return your body to normal.
