Prolonged bleeding after childbirth. Types of discharge after childbirth and their duration. Features of the excretory system after cesarean section

The postpartum period is a difficult time in a woman’s life, which is overshadowed by prolonged discharge from the vagina. What discharge is considered physiological and what indicates the need to see a doctor - read in this article.

Lochia — specific secretions from the vagina after childbirth, which are natural process and consist of blood, mucus and endometrium. Such discharge indicates the reverse development of the uterus, its contraction and return to prenatal condition.

Why is there discharge after childbirth?

During pregnancy the uterus is growing, its functions and appearance change. When is it hard and important point childbirth is left behind, its “mission” is completed and this organ returns to its usual state, gradually contracting and decreasing. At the same time, during these contractions, remnants are expelled from the uterine cavity. blood, membranes and mucus.

Immediately after birth, heavy bleeding begins

In addition, in the place where the placenta was previously attached to the uterus, there remains open bleeding wound which is gradually healing. Until complete healing wound surface and the uterus returns to its prenatal state and lochia continues.

What kind of discharge occurs after childbirth?

In the first hours after birth bleeding from the vagina have bright red color, which is explained by slight bleeding caused by physiological damage to the uterus and birth canal during delivery. For the next few days, this bleeding may be absolutely unchanged, V bloody discharge may be observed small clots.

After the lapse of first week postpartum discharge may change its intensity. In addition, bloody discharge is increasingly mixed with slime from cervical canal, due to which the shade of the discharge will become a little lighter and it will not resemble bleeding.

As a rule, departure large clots at this stage is not the norm and it is better to talk about it with a gynecologist.

In the future, the woman in labor will note that the discharge becomes less and less: at first they will resemble menstruation, later they will change their shade to brown, will turn into daub. Through two to three weeks lochia can become yellowish shade (but not purulent!), then white, and soon it will come out of the vagina completely clear slime, indicating the completion of uterine involution.

When does the discharge end after childbirth?

Duration of postpartum discharge Each woman is individual. As a rule, experts talk about average duration such secretions, a component 40 days, but this indicator is not true for everyone.

A variant of the norm is considered to be the duration of discharge, which is from 30 days to two months. There are known cases of lochia lasting two weeks, but these are rather small exceptions to the rule. Most women talk about numbers 30-40 days, claiming that during this time any vaginal discharge had completely ceased.

What does purulent discharge after childbirth mean?

• It is very important to keep track of what color and smell have discharge after childbirth. Since the uterine cavity is a wound, and the discharge is an excellent breeding ground bacteria and infections, there is a huge risk of infection
• If this happens, then the discharge will definitely indicate this with an unpleasant odor and the presence purulent impurities
• The inflammatory process in the uterus, along with purulent discharge, will also be indicated temperature increase. It is important not to confuse it with the process of establishing lactation, when a slight increase in temperature is considered physiological
• If you have any suspicions about endometrial infection, then you need to immediately seek the help of a specialist, because early stages this may indicate remnants of membranes in the uterine cavity and the need for cleaning

Video: Purulent vaginal discharge

Why does yellow discharge occur after childbirth?

In about 10-14 days after childbirth, the discharge becomes yellowish. You shouldn't be afraid of this - it's normal process restoration of the uterus. Such selections only indicate that involution happens naturally and naturally.

But if such discharge begins in the first week after childbirth or required deadline, But resemble pus, then you need to consult a doctor. This may indicate purulent processes that can begin as follows: reasons:

• lack of proper hygiene
• remnants of membranes in the uterus
• the presence of blood clots that partially or completely block the outflow of lochia

After childbirth, it is important to monitor very carefully genital hygiene, which consists of the following actions:

• After each visit to the toilet you must wash yourself
• The pad should not be used for more than 4 hours
• tampons and caps cannot be used to collect secretions - lochia must flow freely from the vagina so as not to be a medium active growth pathogenic microflora
• Until the lochia is completely resolved and the gynecologist has examined you, sexual intercourse should be avoided

Following these rules will help prevent severe consequences: infection and purulent processes.

Causes of greenish discharge after childbirth

The occurrence of problems uncharacteristic for the recovery period greenish discharge from the vagina, indicates the presence of a serious disease - endometritis. Its cause is a bacterial infection of the surface of the uterus, which could be caused by poor contractility this organ. This, in turn, leads to the fact that lochia accumulates in the uterine cavity and begins inflammatory process, flowing into purulent.

Endometritis is also accompanied by additional symptoms:

• temperature rise
• pain in the lower abdomen
• weakness and discomfort
• unpleasant vaginal odor and discharge

Treatment for endometritis should include antibacterial therapy , and its untimeliness can lead to infertility or sepsis and, as a consequence, lethal outcome.

Discharge after childbirth with odor

One of true symptoms endometritis on initial stages is unpleasant smell, which comes from secretions. Of course, the smell of lochia is far from the aromas of vanilla, but putrid, repulsive stench should not come from them.

Any woman will be wary if liquid flows from her vagina with the smell of pus or rot. If you happen to encounter this, then do not waste your precious time, but immediately hurry to the doctor!

A similar smell can also indicate such unpleasant diseases as chlamydia or about others infectious diseases genital organs, so you shouldn’t expect the problem to disappear on its own - it’s extremely dangerous for Your health.

Why is there little discharge after childbirth?

During the first week there should be lochia intense. This indicates that the uterus is contracting well and discharge does not accumulate in its cavity, but comes out. Scanty discharge at this time or their complete cessation should be very alarming - something is preventing the lochia from leaving the uterus.

If in the postpartum period the uterus was poorly examined by an obstetrician, then there is a risk that some part remained in its cavity membrane. Even if its size is small and it does not interfere with the flow of lochia, its presence in the uterus can cause purulent processes.

It could also block the exit of the lochias blood clot, which was formed during the bleeding process. If the problem scanty discharge after childbirth lies in this, then on an ultrasound the doctor will definitely find a clot and the uterus will be subject to cleaning.

Can there be discharge from the breast after childbirth?

During pregnancy, a woman gets to meet her first physiological secretions from the chest, which are called colostrum. It is this incredibly useful natural product that the baby will eat for the first 24 hours before production begins. milk. But can any be the norm? other secretions from the chest?

Other than colostrum and milk, no discharge from the breast not considered normal. If they have greenish color or brightly visible admixture of blood, then you must urgently inform your doctor about this, since the cause of this phenomenon may be breast tumor, hormonal disorders and even cancer.

If there is discharge from the breast purulent fluid has an unpleasant odor, and this occurs against the background of rising temperature, this may indicate the development mastitis- inflammatory process in the mammary gland.

How to prevent severe complications during postpartum discharge?

- a natural process and it should not overshadow the joys of motherhood. In addition, this is also an indicator of how correctly the body and, in particular, genitals return to pre-pregnancy state. Therefore, it is extremely important to monitor your well-being and watch the discharge, and if you notice any deviation from the norm, you should inform your gynecologist.

You should consult if:

• The intensity of the discharge is such that the need arises more often than once every 1.5 hours change the gasket designed for 4-6 drops
• a week later the discharge still continues to be profuse and blood-red
• sharp the discharge has stopped without going through all the described stages of changing color and intensity
• present in the discharge large clots
• smell and color lochia is not normal
• rises temperature
• discharge is accompanied pain and discomfort in a stomach

Take care of your health after childbirth, because Your task- recover faster in order to give as much attention and care as possible to a tiny person, who just came into being.

Video: Lochia after childbirth. What do the doctor's say?

Reading time: 6 minutes

Pregnancy consists of pleasant chores in preparation for childbirth. When you collect the birth bag, do not forget to put a package in it, or better yet two, sanitary pads. A woman needs them after the baby is born. Bloody, brown, yellow or white discharge after childbirth that lasts several weeks is normal phenomenon, meaning that the uterus cleanses itself after the birth of the child.

What is discharge after childbirth

Lochia is the name given to bloody marks that appear immediately after childbirth and will haunt the young mother for another month and a half. At first the discharge will be very copious and bloody. A woman in labor will use one sanitary pad per hour. Over time, their volume will noticeably decrease. Don't be alarmed if you find blood clots or mucus on the pad - this is how it should be. Lochia includes:

• blood cells - leukocytes, erythrocytes, platelets;
• plasma released from the wound surface of the uterus after separation of the placenta;
• remnants of the epithelium located on the inner surface of the uterus;
• ichor;
• mucus from the cervix and cervical canal.

Why does discharge occur?

Lochia is a discharge that indicates the cleansing of a woman’s uterus. The remains of the placenta and epithelium come out through the vagina under the influence of contractile movements of the walls of the uterus. This process is necessary to restore the menstrual cycle and reproductive function. The first menstruation after childbirth will indicate that the body is completely ready for a new conception, so be careful and take care of contraceptive methods.

How long does the discharge last after childbirth?

The average duration of lochia is 6-8 weeks. At first they come very abundantly throughout the week. During this period, while still in the maternity hospital, the woman needs to take care of the availability of sanitary pads and absorbent diapers. Use night-time pads or maximum amount"drops". On the first day, it is best to use a diaper, and then put it under yourself. Sometimes doctors ask to see a diaper, so they control lochia. When standing up or pressing on the uterus, lochia may gush out of the vagina. This is normal for the first days.

Within a few days or a week, there will be less bleeding. They will no longer be bright red, their shade will look like dried blood. A month after birth, the discharge will be reduced, it will be possible to switch to everyday pads, after another week the lochia will be very scanty, their color will become lighter. Do not use tampons under any circumstances, even if you really need to. It may be dangerous. Postpartum discharge- This perfect place for the development of bacteria. In a month or a month and a half, the lochia will end. In this case, you will need to visit a gynecologist and undergo an examination.

In order for the lochia to come out well and the uterus to clear faster, the mother needs to adhere to following rules:

• After giving birth, apply an ice pack to your lower abdomen for the first two days. Cold promotes contraction and rapid cleansing.
• Go to the toilet “little by little” every two to three hours, even if you don’t feel like it. Full bladder prevents uterine contractions and good discharge.
• Walk and just move more. This will prevent blood stagnation in the uterus.
• Put your baby to your breast as often as possible. At first, during feeding, you may feel slight pain in the lower abdomen and a sharp release of lochia. That's how it should be. The baby irritates the nipple, and the woman’s body releases oxytocin, a hormone that causes the uterus to contract.

What kind of discharge should there be after childbirth?

The color of lochia depends on how long it lasts and how it progresses. At first they are scarlet in color and contain many blood clots and pieces of dead epithelium. After a week, the lochia becomes brown. In this case, the amount of lochia decreases to the volume of menstruation. At the end of the cleansing period of the uterus they have yellow with streaks and splashes of blood.

This approximate dates, for each woman everything goes individually. The duration of discharge, its quantity and composition are influenced by many factors. For example:

• the course of pregnancy;
• childbirth;
• method of delivery (natural birth or cesarean);
• intensity of uterine contractions (the stronger they are, the faster the lochia ends)
• structure of female organs;
• presence of lactation (with breastfeeding the uterus contracts more actively, and the discharge passes faster);
• leakage postpartum recovery(presence or absence of inflammation, infections, etc.).

Discharge after caesarean section

Lochia after caesarean section longer than during childbirth naturally. This is due to the fact that during the operation they are damaged muscle fibers uterus. As a result, the organ contracts weakly, the lochia comes out longer than usual, but in a smaller volume. The structure of the discharge itself also changes. After surgery, a woman moves less; this ends up with the blood stagnating and coagulating into clots, which are released along with the discharge.

Postpartum discharge ended and started again

If you notice that the amount of discharge has increased sharply or, conversely, it has stopped, you should immediately call ambulance and don’t wait for the morning if the problem hits you at night or in the evening. Sometimes there are cases when the discharge ends and then starts again. Endometritis, inflammation, and infection may begin. However, the most common cause is lochiometra.

This is a disease after childbirth, in which the discharge does not come out, but stagnates inside the uterus. This can cause inflammation, infections, and other problems. It’s good if the discharge resumes on its own, without medical intervention. However, if the lochia stops and does not continue during the day, you do not need to sit idly by, you need to call an ambulance. With the help of medications that cause uterine contractions, the cleansing will continue in the usual way.

Pathological discharge during postpartum complications

Lochiometra is not the only disease that can occur to a woman after childbirth. Pathological deviations in discharge indicate that something is wrong with the cleansing of the uterus. It could be:

• Discharge with an unpleasant odor. If the lochia has a pronounced purulent yellow or greenish tint, then this indicates an infection in the uterus, i.e. O postpartum endometritis. In this case, you need to call an ambulance or go to the doctor without delay. Associated symptoms – heat, pain in the lower abdomen, weakness.
• Watery lochia. They should alert the young mother, because such signs occur when fluid is released from the lymphatic and blood vessels after childbirth, which seeps through the mucous membrane of the uterus, genital tract and vagina. Transparent lochia may indicate dysbacteriosis (gardenellosis), and they will be accompanied by a fishy odor.
• White discharge. If you have acquired lochia White color and curd consistency, then this indicates possible infection– colpitis or candidiasis (thrush). In this case, the woman will complain of itching, redness in the perineum, unpleasant sour smell. Curd-like discharge will have a similar meaning.
• Black discharge. If lochia lasts as usual and does not have unpleasant odor, but at the same time acquired dark color, then you shouldn’t be afraid, it’s not as dangerous as yellow discharge. This shade indicates a change in blood composition and hormonal changes in the body.
• Abundant bloody lochia bright red color can only be in the first few days after birth. If such lochia appears later, you need to immediately call an ambulance without waiting for the morning. A sharp increase in discharge indicates postpartum hemorrhage.

Hygiene rules during the postpartum period

To avoid postpartum complications, it is important to adhere to the following rules after childbirth to restore the body:

• Wash yourself every time after using the toilet with special means for personal hygiene or baby soap. This will help avoid infection.
• Don't take a bath. This can also lead to inflammation and infection. For the same reason, you should not douche.
• Don't skimp on postpartum pads. Change them as often as possible.
• Don't use tampons. According to reviews from mothers in labor, this is a sure path to endometriosis.
• Dress warmly during the cold season to avoid hypothermia and inflammation.
• Don't lift heavy objects. The maximum weight you can lift is your baby and a camera for happy photos.

Video

Discharge after childbirth, called lochia, is important indicator women's condition reproductive system V recovery period. The amount and nature of discharge are individual for each woman, but in gynecological practice there are norms that indicate natural physiological processes. Diagnostics using visual, instrumental and laboratory methods The study allows the gynecologist to study the nature of lochia and assess the degree of cleansing of the uterus after natural birth And surgical intervention(caesarean section).

Recovery after natural childbirth

The attending physician tells the patient how long the discharge lasts after childbirth when discharged from the maternity hospital so that she can independently observe the restoration of the reproductive system and the healing of the wound surface in the uterus. How long does the discharge last after childbirth and what should its nature be like? These are the main questions that women ask at their first consultation with a gynecologist after the birth of their child.

Normal indicators

Normal discharge after childbirth lasts 5 to 7 weeks. However, a deviation of 1 week up or down is acceptable. Statistics indicate that endometrial restoration in most cases occurs within 6 weeks. Discharge up to 6 weeks after birth is not considered menstrual.

The first menstruation, as a rule, occurs 1.5-2 months after the birth of the child in the absence chest view feeding.

The duration of discharge after childbirth depends on the degree of injury reproductive organs at the time of labor. Bloody issues in this period it is a natural phenomenon and cannot be avoided. They represent a wound secretion, which consists of mucous exudate, fragments of the non-viable inner (decidua) lining of the uterus, burst vessels and blood. On appearance lochia is also affected by the presence cervical mucus And liquid secretion vagina.

Postpartum discharge changes color, consistency and volume as the mucous layer, muscle tone, and previous size of the uterus are restored. Complete absence Lochia indicates the completion of the body’s recovery process after childbirth.

What indicates a deviation from the norm

If the discharge continues longer than the period established in gynecology, its color, smell, or consistency have changed, consultation with a gynecologist is mandatory.

Recovery after caesarean section

The recovery period after surgical delivery lasts slightly longer than in the case of natural delivery. birth process(for one to two weeks). But in most cases it takes up to 6 weeks after birth. The rehabilitation period differs little from that described above.

Discharge after cesarean section in the event of complications develops differs from natural ones.

Deviation from the norm is indicated by:

• renewed scarlet discharge in large quantities;
• purulent discharge after childbirth (green), which smells unpleasant;
• discharge appeared again after 3 months;
• vaginal secretions become watery or white;
• the volume of secretion is insignificant, the discharge is scanty;
• clots of dried blood come out;
• body temperature has risen;
• blood pressure dropped sharply;
• pale skin;
• weakness;
• urinary disturbance;
• thirst for a long time;
• severe pain in the lower abdomen, lumbar region;
• itching and redness of the genitals, postoperative sutures.

After surgical delivery in women who have given birth, sometimes there's blood coming out black color. In most cases this is harmless and is due to a change hormonal levels caused by labor. A blood and vaginal smear test will dispel all doubts.

Normal discharge after childbirth ends after 6 weeks. During this period, the uterus is completely cleansed. To exclude the development of complications, it is necessary to visit a doctor if any disturbing symptoms appear and follow his recommendations:

• sex after childbirth is allowed only after complete healing of the wound surface (protective regime - at least 2 months);
• using a condom in the postpartum period will reduce the risk of infection;
• full-fledged sexual hygiene prevents complications, changes natural microflora vagina;
• treatment of postoperative sutures with local antiseptics prevents secondary infection and promotes rapid tissue regeneration;
• During lactation, the hormone oxytocin is actively produced, stimulating uterine contractions;
• increased physical activity is prohibited until the fourth month;
• timely antibacterial and antifungal therapy prevents the development of generalized inflammation of the reproductive system;
• taking iron supplements on the recommendation of a doctor will compensate for its deficiency in case of massive bleeding;
• vitamin and mineral complexes included in the diet promote the regeneration of uterine tissue;
• good nutrition - required condition for quick recovery of the body;
• elimination of psychotraumatic factors reduces the duration of the recovery period.

Childbirth is a physiological phenomenon. A timely consultation with a doctor will tell you what normal lochia looks like and how to distinguish them from pathological discharge. Compliance with the gynecologist’s recommendations and a protective daily routine contribute to rapid recovery body after the birth of a child.

It is known that during 9 months of pregnancy the uterus increases in size by more than 500 times. However, after the birth of the child and the delivery of the placenta, it does not need such dimensions. The body independently strives to bring the uterus to its original form in order to subsequently be ready for new pregnancy. The recovery process is accompanied by a kind of side effects in the form of discharge from the genital tract - lochia.

What is postpartum discharge and which is considered normal?

During pregnancy, the fetus is connected to the wall of the uterus through the placenta ( children's place). During childbirth, it is rejected, and former place attachment, a large bleeding wound remains. Immediately after the birth of the baby, the uterus begins to rapidly contract, pushing out unnecessary tissue remnants, blood clots, drops amniotic fluid and everything that prevents her from becoming the same size as before pregnancy. These secretions are called lochia.

Lochia should be present in any young mother, regardless of whether the birth was natural or a caesarean section. Every woman is obliged to monitor the nature of the discharge: color, smell, degree of abundance.

The postpartum period lasts 6–8 weeks (42–56 days). It is believed that this time is enough to female body fully recovered.

Normally, changes occur approximately in this order:

1. During the first 5 days, the uterus contracts most intensely, the lochia is bright scarlet due to blood clots (hence the smell of iron), it is abundant - a woman can change pads every hour.
2. On days 6–10, the discharge becomes dark brown, brown or pink-brown, without clots, and not as abundant as in previous days.
3. By the end of the second week, lochia acquires yellowish tint, their number is decreasing.
4. After the 15th day, the discharge becomes spotty, mucous, almost transparent, without a strong odor and continues until the end postpartum period.

Certain conditions related to the norm

During breastfeeding, a reflex release of oxytocin occurs, a hormone that increases uterine contractions. Therefore, when breastfeeding, especially in the first week, a woman will feel discomfort in the lower abdomen, and there will be more lochia. However, in this case, the uterus empties faster, which means that the period of discharge for a nursing mother will end sooner (by about the 6th week).

Multiple pregnancies predispose to slow contractions of the uterus after childbirth. Therefore, lochia in this case can last from 6 to 8 weeks, which is also a variant of the norm. After physical activity, lifting heavy objects (things significantly exceeding the weight of the child), the discharge may increase. But such situations without other complaints about the color and smell of lochia are not a reason to panic.

Any intervention in natural childbirth in the form of so-called cleansing, examination of the uterus for the presence of residual placenta or membranes “dulls” uterine contractions, and therefore can increase the period of lochia. Such things are carried out strictly according to indications, and the postpartum period in such cases also lasts 6–8 weeks.

In conditions operative delivery a suture remains on the uterus, which prevents it from contracting at full strength. Therefore, in women who have had a cesarean section, the discharge may initially be less abundant, but longer lasting. Most often, synthetic uterotonics (uterine contractions) are used in hospitals to help the weakened body cleanse the uterus after surgery. Such lochia should also end by the 8th week after birth.

Read more about discharge after cesarean in the article -.

Video: doctor about discharge after childbirth

What do deviations from the norm look like?

The postpartum period is not always favorable. This could be due to: external factors, and internal. The condition of the uterus will be characterized by changes in postpartum discharge: color, smell, volume, etc. Let's look at them in more detail.

Too short a period of discharge from the genital tract (up to 6 weeks) should alert a woman, especially if the lochia ends abruptly. There are many reasons for this situation:

• blockage of the cervical canal (exit from the uterus) with blood clots, mucus and tissue debris;
• excessive tilt of the uterus forward, which creates a mechanical obstacle to the outflow of lochia (anatomical feature);
• spasm internal pharynx(this, in fact, is the exit from the uterus);
• weak contractility of the uterus due to overstretching (noted with polyhydramnios and multiple pregnancy) or complicated labor (long labor, caesarean section, etc.).

In any of the described cases, lochia accumulates in the uterine cavity. A condition occurs, which in medicine is called lochiometra. In addition to the absence of discharge, pain in the lower abdomen and increased body temperature are added. At this stage, it is better to immediately consult a doctor to find out the reason for the disappearance of discharge and eliminate it.

There are no minor complications in obstetrics. Therefore, a woman must tell her doctor about any problems.

When the discharge continues for more than 8 weeks, its amount does not decrease, but only grows - this is also a reason for urgent appeal for help. Most likely, something is preventing the uterus from contracting normally (blood clots, remnants of placenta, pieces of membranes). This may also be a symptom of an inflammatory process in the uterus - endometritis.

Excessively abundant lochia (in the first 4–5 days more than one obstetric pad per hour is lost) or their sharp increase indicates bleeding. The same reason in the case of the return of the brown ones, and then scarlet discharge 2–3 weeks after birth. This direct reading to urgent hospitalization.

Unpleasant odor of discharge: lochia usually has a neutral odor (in the first days after birth, a musty odor is allowed). Therefore, when sharp putrefactive, sour notes appear, we can talk about the addition infectious process in one or more parts of the female reproductive system.

Bright yellow and green discharge- a sign of inflammation, and the process can concern exclusively the uterus or affect the fallopian tubes and ovaries. Lochia will be added to the changed color putrid smell, elevated temperature(up to fever), constant aching pain lower abdomen and general weakness.

White color and cheesy consistency with sour smell are a sign of vaginal candidiasis (thrush). At this stage, you should take treatment seriously (taking antifungal drugs) to protect yourself from an ascending infection (transition of inflammation to the cervix, into the uterine cavity and higher).

Lochia that is clear as water may indicate gardnerellosis (bacterial vaginosis), which is most often followed by thrush. Such discharge is often accompanied by the smell of rotten fish.

Black color without any other symptoms is scary only in appearance. This variant of the norm occurs due to changes in hormonal levels during the process of recovery of the body. Caused by a change in the composition of cervical mucus.

Photo gallery: pathological lochia

Purulent discharge- a clear sign of accession bacterial infection Bright yellow lochia indicates an inflammatory process in the genital area. With lochia, the curdled discharge of thrush mixes with mucus. Bacterial vaginosis accompanied by the smell of rotten fish

What to do if pathological lochia occurs

At pathological discharge It is necessary to consult a doctor, because each case is unique. Most often carried out additional procedures(Pelvic ultrasound, examination of discharge). If traces of placenta or membranes are detected, you will need instrumental methods treatment. Lochiometra is amenable to conservative therapy.

Any inflammatory process is quite dangerous complication in the postpartum period, requiring the prescription of anti-inflammatory drugs and antibiotics. To reduce the risk adverse reactions for medications in a child, they select drugs that are used to treat newborns in maternity hospitals. You can also express your breasts approximately 15 to 30 minutes after IV and intramuscular drugs and 1–1.5 hours after administration medicines enterally.

A nursing mother should not be afraid to take antibiotics and antifungal drugs, since its further condition depends on it. After all, after childbirth, a woman’s body is so weak that it is often unable to cope with the infection on its own.

Prevention of pathological postpartum discharge

To avoid complications after childbirth, a young mother needs to follow the following rules:

• maintain a hygienic regime: change the pad every 3-4 hours, take a shower daily, wash your face in the morning, evening and after each visit to the toilet;
• exclude taking a bath for the entire postpartum period in order to prevent bleeding;
• for the first 2–3 days, urinate once every 3 hours;
• if there are stitches on the abdomen (after cesarean section) or perineum (after ruptures during natural childbirth), treat them 2 times a day;
• lie on your stomach for at least 20 minutes a day;
• wear a bandage;
• follow doctor's orders.

Lochia is only an indicator of changes in the reproductive system, reflecting the woman’s health status. Normal postpartum discharge lasts 6–8 weeks, does not have a strong odor, gradually decreases in quantity, and changes color from bright scarlet to almost transparent pale yellow. Any deviation from this norm indicates a pathological course of the postpartum period and requires a more in-depth study. A woman at this time should be especially attentive to herself, since now she is responsible for two lives.

Discharge after childbirth is called lochia. Their number decreases over time, which is explained by the gradual healing of the wound surface that forms on the uterine mucosa (endometrium) after the placenta is separated.

Lochia consists of blood cells (leukocytes, erythrocytes, platelets), plasma sweating from the wound surface of the uterus, dying epithelium lining the uterus, and mucus from the cervical canal. Over time, the composition of the lochia changes, and therefore their color also changes. The nature of lochia should correspond to the days of the postpartum period. In the first days after childbirth (4–5 days after normal childbirth and 7–8 days after cesarean section), the woman is in the postpartum ward of the maternity hospital under observation medical personnel. But after a woman is discharged home, she controls her condition herself, and her task is to consult a doctor if necessary. The amount and nature of discharge after childbirth can speak volumes, and it is important to notice alarming manifestations in time.

Discharge after childbirth in the first hours

The first two hours after birth, the woman is in the maternity ward under the supervision of medical personnel, because this period is dangerous due to the occurrence of the so-called hypotonic uterine bleeding, which is caused by a violation contractile function uterus and relaxation of its muscles.

It is good if the discharge after childbirth is bloody, quite abundant, amounts to 0.5% of body weight, but not more than 400 ml and does not lead to a violation of the general condition.

To prevent postpartum hemorrhage, immediately after childbirth the bladder is emptied (urine is drained through a catheter) and ice is placed on the lower abdomen. At the same time, drugs are administered intravenously to contract the muscles of the uterus. Contracting, the uterus closes open blood vessels at the placenta attachment site, preventing blood loss.

If you feel that postpartum bleeding is too heavy (the diaper or sheet is wet), you should immediately tell someone from the medical staff. It is important to know that the woman does not experience any painful sensations, however, postpartum bleeding quickly leads to weakness and dizziness.

Bleeding from tissue ruptures may also occur in the first two hours. birth canal, if they have not been sutured, it is therefore important that the doctor carefully examine the vagina and cervix after childbirth. If any rupture was not completely sutured, a hematoma (limited accumulation of blood in the tissues) of the perineum or vagina may form. In this case, a woman may experience a feeling of fullness in the perineum. In this case, it is necessary to open the hematoma and re-suturing the rupture. This operation is performed under intravenous anesthesia.

If the first two hours after birth (early postpartum period) passed safely, the woman is transferred to the postpartum ward.

Discharge after childbirth: hygiene in the postpartum department

It’s good if in the first 2–3 days the lochia is bloody and quite abundant (about 300 ml in the first 3 days): the pad or diaper is completely filled within 1–2 hours, the lochia comes with clots, has a musty smell, like menstrual flow. Then the number of lochia decreases, they acquire a dark red color with a brown tint. Increased discharge after childbirth when moving is normal. In the postpartum department, the doctor makes a daily round, during which, among other indicators of the woman’s condition, he evaluates the nature and amount of postpartum discharge - for this he looks at the discharge on the diaper or pad. A number of maternity hospitals insist on using diapers, since this makes it easier for the doctor to assess the nature of the discharge. Usually the doctor asks the woman whether there is a lot of discharge during the day.

For prevention postpartum hemorrhage important:

Empty your bladder in a timely manner. On the first day, you need to go to the toilet at least every three hours, even if you don’t feel like it. The fact is that a full bladder prevents normal contractions of the uterus.

Breastfeed your baby on demand. During feeding, the uterus contracts, as irritation of the nipples causes the release of the hormone oxytocin, which has a contractile effect on the uterus. In this case, the woman may feel cramping pain in the lower abdomen. Normally, discharge increases during feeding.

Lie on your stomach. This not only prevents bleeding, but also prevents the retention of discharge in the uterine cavity. After pregnancy and childbirth, the tone of the abdominal muscles is weakened, so the uterus may deviate posteriorly, which disrupts the outflow of secretions. But in the prone position, the uterus approaches the anterior abdominal wall, the angle between her body and the cervix is ​​smoothed, which improves the outflow of secretions.

Place an ice pack on your lower abdomen 3-4 times a day. This measure helps to improve the contraction of the muscles of the uterus and uterine vessels.

Discharge after childbirth will continue after discharge from the hospital.

It’s good if postpartum discharge lasts 6–8 weeks (that’s how long it takes for the uterus to develop back after pregnancy and childbirth).

In the first week after childbirth, the discharge is comparable to normal menstruation, only it is more abundant and may contain clots. Every day the amount of discharge decreases. Gradually they acquire a yellowish-white color due to large quantity mucus, may be mixed with blood. Approximately by the 4th week, scanty spotting is observed, and by the end of the 6–8th week it is already the same as before pregnancy.

In women, postpartum discharge stops faster, since the entire process of reverse development of the uterus is more intense. At first there may be cramping pain in the lower abdomen when feeding, but within a few days it goes away.

In women who have had a caesarean section, everything happens more slowly, as the uterus contracts less well due to the suture.

Hygiene rules during the postpartum period

Compliance simple rules will help to avoid infectious complications. From the very first days of the postpartum period, a variety of microbial flora is found in the lochia, which, when multiplying, can cause an inflammatory process. Therefore, it is important that lochia does not linger in the uterine cavity and vagina.

During the entire period while postpartum discharge continues, you need to use pads or padding diapers. Gaskets must be changed at least every three hours. It is better to use pads with a soft surface rather than with mesh, because the nature of the discharge is better visible on them. Pads with fragrances are not recommended - using them increases the risk of developing allergic reactions. While you are lying down, it is better to use padding diapers so as not to interfere with the release of lochia. Tampons should not be used, as they prevent the removal of vaginal discharge, instead absorbing it, which can cause the proliferation of microorganisms and provoke the development of an inflammatory process.

You need to wash yourself several times a day (after each visit to the toilet). You need to take a shower every day. The genitals should be washed from the outside, but not from the inside, from front to back. You cannot douche, because this way you can get an infection. For the same reasons, it is not recommended to take a bath.

If the volume of discharge is large, it may increase, so don't lift anything heavy.

Following these simple rules will help you avoid postpartum complications.

Warning Signs After Childbirth

Behind medical care should be contacted in the following cases:

• Discharge after childbirth has become unpleasant, Strong smell, purulent character. All this indicates the development of an infectious process in the uterus - endometritis. Most often, endometritis is also accompanied by pain in the lower abdomen and fever.
• Heavy bleeding appears after the amount has already begun to decrease, or the bleeding does not stop for a long time. This may be a symptom that there are unremoved parts of the placenta remaining in the uterus, which are interfering with its normal contraction.
• Appearance cheesy discharge indicates the development of thrush. In this case, itching in the vagina may also appear, and redness sometimes occurs on the external genitalia. The risk of this complication increases when taking antibiotics.
• Postpartum discharge suddenly stopped. After a cesarean section, this complication occurs more often than after a natural birth.
• With strong heavy bleeding(when changing several pads within an hour), you need to call an ambulance rather than go to the doctor yourself.

The above complications do not go away on their own. Treatment is necessary and should be started as early as possible. In some cases, it is necessary to go to hospital.

If complications arise after childbirth, a woman can contact not only antenatal clinic, but also (in any case, at any time of the day) to the maternity hospital where the birth took place.

How is the menstrual cycle restored after childbirth?

The timing is different for each woman. After childbirth, her body produces the hormone prolactin, which stimulates milk production. In addition, it suppresses the formation of hormones in the ovaries, and therefore prevents ovulation.

If the child is on natural feeding, then regular menstrual cycle his mother will recover after childbirth in 5-6 months after birth, and may recover after the cessation of lactation. Before this, menstruation may not occur at all, or it may come from time to time. At artificial feeding(the baby receives only formula milk) menstruation is restored, as a rule, by the 2-3rd month after birth.