Pregnancy and you blog

Postpartum bleeding: How much is too much?

By Mary M. Murry, R.N., C.N.M. February 4, 2010

After your baby is born, you'll have bright red, heavy bleeding. Although any vaginal bleeding can seem like too much after an entire pregnancy without a period, postpartum bleeding can be downright shocking.

For the first day or two, you'll probably need to wear a hospital-grade pad. As the bleeding slows, you should be able to wear a commercial pad. Even then, however, you may feel a small gush of blood when you stand up. The gush may even overflow your pad. After all, your vagina isn't straight — it's shaped more like a cup. When you're sitting or lying down, the blood pools in the cupped area. When you stand up, the blood may feel as though it's pouring out. Occasionally, you may pass small blood clots as well.

Postpartum bleeding is usually heaviest right after delivery. Don't be alarmed if your bleeding seems to increase when you bring the baby home, though. Simply being up and about sometimes increases postpartum bleeding. Increased bleeding can also be a sign that you've tried to do too much, however. If you soak a pad — front to back, side to side — in an hour, go to bed. If the bleeding continues at the same rate after you've rested or you pass clots larger than golf balls, call your health care provider or return to the hospital.

I recently had a close and personal experience with excessive postpartum bleeding. My grandson Liam was born two weeks ago into my loving hands. Labor and delivery proceeded smoothly, but things didn't go as expected after Liam's birth. My daughter had what's referred to as a retained placenta — a rare condition in which part (or all) of the placenta remains in the uterus for too long after delivery. A retained placenta can cause heavy bleeding and low blood pressure. A mother who has a retained placenta may even pass out or go into shock. Thankfully, we were able to control my daughter's bleeding and prevent other complications.

Should you experience excessive postpartum bleeding in the hospital, count on your health care team to do everything they can to stop the bleeding. If you're concerned about excessive postpartum bleeding when you're recovering at home, contact your health care provider or seek emergency medical care.

Feb. 04, 2010