Vaginal bleeding (also known as lochia) is normal for up to six weeks after giving birth. Lochia is expelled by the uterus as it contracts back to its pre-pregnancy size. The uterus sheds the lining that supported the pregnancy and any residual mucous

The bleeding, which starts immediately after birth, is initially red or reddish-brown and can be quite heavy for the first few days. During this stage, women often need super-absorbent maternity pads, which should be changed regularly (avoid using tampons or menstrual cups until after the lochia has passed as they can cause infection.) Passing small blood clots is common. In the first 24 hours after birth, they can be the size of a plum but should get smaller and occur less frequently as bleeding decreases over the first few days. Midwives on the post-natal ward will check your bleeding each day during your stay in hospital.

Over the next few days and weeks, the discharge should slow down and decrease in volume. The lochia will gradually change to a pink or brown colour and then eventually a yellow/ white discharge. For women who are breastfeeding, the bleeding may get heavier and look a brighter red colour for a short time after they feed their baby. This is because breastfeeding releases hormones that cause the uterus to contract.

Postnatal bleeding occurs after both vaginal and Caesarean section.

Postnatal bleeding is a natural part of the body’s recovery process. However, in a small minority of cases, excessive bleeding or infection can occur. Signs to look out for and report to your obstetrician include:

• heavy uncontrolled bleeding or passing of large blood clots (eg size of a tennis ball)
• the amount of bleeding or pain suddenly increasing
• feeling shaky or feverish
• the vaginal discharge having an unpleasant smell.

As well as avoiding the use of tampons for six weeks, the risk of infection can be decreased by changing your pad frequently and washing your hands before and after you do so.

Women often ask us about swimming after having a baby, especially over the summer months and our usual advice is that it is safe to swim in the ocean or public pool when the loss is minimal and only brown or pink. This is usually somewhere between 4-6 weeks after the birth.

For more information on postnatal care, visit: https://www.womensogs.com.au/patient-education/