When Ashley Zinton, a mom of two from Tarrytown, New York, saw “menstrual pads, super absorbent” on her post-birth checklist, she didn’t think she’d ever need such heavy-duty pads. What she understood even less was how quickly she’d go through them.
“I bought a small pack of regular maxi pads,” Zinton says. “I hadn’t used pads since probably the eighth grade. I couldn’t imagine I would actually need those crazy long ones or that I’d need too many of them. I was wrong. My husband ended up running out to the store before we ever even left the hospital!”
Birth is messy, but what comes after birth can be even messier. Postpartum bleeding is something all new moms experience, and the more prepared you are for what to expect, the more time you can spend focusing on the fun stuff, like cuddling up to that new family member.
What is postpartum bleeding?
Postpartum bleeding, technically called “lochia,” begins immediately after you give birth and can include small bits of tissue and mucus, in addition to blood. After the placenta is separated from the uterine wall and the uterus begins to shrink back to its pre-pregnancy state, your body will begin to shed this lochia and it will continue to do so until the uterus is fully healed.
How long does postpartum bleeding last?
You can expect postpartum bleeding to last anywhere from four to six weeks, according to Danielle Joseph-McKay, a licensed doula who provides postpartum support to clients in Long Island, New York. That said, she stresses that this can vary greatly from person to person.
How much and what type of postpartum bleeding is normal?
You can expect the first stage of bleeding to be quite heavy and for it to be a dark or bright red color. The color and consistency will change as the bleeding goes from heavier to lighter over the next few weeks.
“At first, the bleeding is heavier, like a heavy period, but after the first few days, bleeding decreases,” says Dr. Ana G. Cepin, an assistant professor of Obstetrics & Gynecology at Columbia University in New York City. “The lochia will then turn brownish, and it will eventually turn a more whitish color.”
Don’t be alarmed if you see larger bits of blood on your pad. “It’s common for women to pass small blood clots during this time,” says Joseph-McKay.
Joseph-McKay also points out that breastfeeding mothers may experience stronger postpartum cramping and feel fluid “gush” during nursing. There is a scientific reason why new moms feel this during breastfeeding: Nipple stimulation during breastfeeding triggers the release of the hormone oxytocin, which then signals your uterine muscles to contract.
“The cramping is normal and is a sign that the uterus is contracting back to its usual size,” Joseph-McKay says.
Laura McDonald, a mom from Bloomfield, New Jersey, says she was surprised by the amount of cramping she experienced while nursing during the first few weeks after birth.
“I know someone, maybe another mom, had mentioned that I might feel some cramping during breastfeeding, but for me it was really intense,” McDonald says. “To be honest, it made it tough at first to not dread nursing, but I tried to focus on what was happening inside my body. My body was healing itself, and if I focused on that, it really helped. I absolutely felt that ‘gushing’ during it, too, which came with its own set of worries, like bleeding through and ruining anything I was sitting on. I just tried to put on a new pad as often as possible, especially when I was getting ready to nurse. Your baby eats so often in the beginning, though, it’s hard to plan for. So I would say just stay on top of changing out your pads.”
What type of postpartum bleeding is abnormal?
You can expect to experience very heavy bleeding during your postpartum recovery period, and that is normal, but extremely excessive bleeding combined with additional symptoms shouldn’t be ignored, as that could be a sign of postpartum hemorrhage — a very rare, but serious condition.
“Very heavy bleeding, combined with blurred vision, chills or feelings of weakness or fainting can also be cause for concern,” Joseph-McKay says. “The discharge typically has a similar odor to a regular period, but if doesn’t smell quite right, it could signal an infection. Severe pain or fever could also be signs of infection.”
In general, Joseph-McKay says you shouldn’t be passing clots any larger than the size of a golf ball, and if you are noticing the clots are bigger than that, put in a call to your doctor. Cepin says the best thing you can do if you’re concerned is to pay attention to how often you’re soaking through your pads.
“If you are soaking more than two pads in an hour or passing large clots, you should contact your doctor,” says Cepin. “If the bleeding lasts more than six weeks, you should also let your doctor know. This is around the same time you should have your routine postpartum visit, so it’s a great time to review any questions related to your bleeding, discharge and postpartum care in general.”
4 ways to take care of yourself during postpartum bleeding
1. Wear pads, not tampons
Tampons are not recommended during the first six weeks after childbirth, so stock up on a few different types of maxi pads.
“At first, you will need heavy pads, but you can eventually transition to lighter pads,” says Cepin.
2. Use disposable underwear, if needed
Don’t be afraid to try out different types of pads or even disposable underwear. Desperate times call for desperate measures, and you shouldn’t feel ashamed if you need something more heavy duty.
“Lining a Depends with heavy pads can be a lifesaver during those early days when you are spending a lot of time in bed,” says Joseph-McKay. “Regular maxi pads can shift and bunch in panties, but Depends will help minimize the amount of stained underwear going in the trash.”
3. Use a squirt bottle to stay clean as you’re healing
Using a small squirt bottle, known as a peri bottle, to clean yourself after you go to the bathroom will help keep you stay sanitary without causing any trauma to areas that are still healing. Simply fill the bottle with warm water and squirt it in your vaginal area when you sit down to urinate. Keep squirting the water after you’re finished to clean the area and then pat it down gently with dry toilet paper.
4. Take care by eating well and not over-exerting yourself
Joseph-McKay stresses that it’s important for women who have just given birth to take good care of themselves by nourishing their bodies with nutritious food and lots of fluids.
“You are recovering not just from labor, but from nine-plus months of pregnancy,” she says. “Rest and self-care are essential. If a person was experiencing minimal bleeding that has become heavy again, it could be a sign that they are pushing themselves too much and should slow down and rest.”
Read next: 9 things no one warns you about your postpartum body