Bleeding after birth: honest answers to the questions you might not ask out loud

Is this much blood normal? It is one of the first private questions many mums ask, often silently in a hospital bathroom at three in the morning. Bleeding after birth, called lochia, happens whether you gave birth vaginally or by caesarean. It is your body shedding the lining of the womb and healing the place where the placenta was attached. Here are honest answers to the questions mums most often ask, and clear signs for when to call for help.

How long does bleeding after birth last?

For many women it lasts somewhere around four to six weeks, sometimes a little longer. It is usually heaviest in the first few days and then gradually tapers off. Every woman is different, so try not to compare your timeline too closely with a friend's.

What colour should it be?

In the first few days it is usually bright or dark red, and you may pass small clots. Over the following week or two it typically becomes pinkish or brown and more watery. Later it often turns yellowish or creamy white before stopping. It should smell like an ordinary period, not foul or fishy.

Why does it get heavier when I feed?

Feeding, especially breastfeeding, releases a hormone that helps the womb contract. You may notice cramps and a gush of blood during or after feeds in the early days. This is normal and is part of the womb shrinking back down.

Why did it suddenly turn red again?

A brief return to brighter bleeding can happen when you have been more active, for example after a long walk or a busy day of visitors. Treat it as your body asking you to slow down. If it becomes heavy, or does not settle with rest, call your midwife or doctor.

What should I use?

• Use maternity pads or heavy-flow pads rather than tampons or menstrual cups until your postnatal check, to lower the risk of infection.
• Change pads every few hours and wash your hands before and after.
• Keep dark towels and an old sheet nearby for the first nights; it makes accidents less stressful.
• Stock up before you run out. Ask a friend to drop a pack round rather than going to the shop yourself.

When is bleeding a warning sign?

Most bleeding after birth is normal healing. But heavy bleeding can happen days or even weeks after birth, and it needs urgent attention. Call emergency services or go to your nearest hospital straight away if:

• you soak through a pad in an hour or less
• you pass clots bigger than a plum
• you feel faint, dizzy or very pale, or your heart is racing
• bleeding suddenly becomes much heavier rather than lighter

Call your midwife or doctor the same day if:

• your bleeding or discharge smells unpleasant
• you have a fever, shivers or tummy pain that is getting worse
• your bleeding is still heavy or bright red after the first week or two
• you are worried for any reason at all

It helps to tell someone at home what these signs are, so they can act if you are too tired to think clearly. You might even write them on a card by your bed.

When will my period come back?

This varies a great deal. Some mums who are not breastfeeding see a period within a couple of months, while many who breastfeed wait longer. You can become pregnant before your first period returns, so if this matters to you, talk about contraception at your postnatal check.

A very present help

God is our refuge and strength, a very present help in trouble. (Psalm 46:1, KJV)

Very present. Not distant, not waiting until you have tidied yourself up. In the bathroom, in the night, in the waiting room if you need to be checked, God is near. Knowing the warning signs is not a lack of faith; it is good stewardship of the body he has given you. You can be calm and watchful at the same time.

A prayer for my healing body

Lord, thank you that my body knows how to heal. Help me to rest when it asks me to, and give me courage to call for help quickly if something is wrong. Be my refuge tonight and every night. Amen.