It is completely understandable to become uneasy when postpartum bleeding comes and goes. In the first few weeks after birth, the body expels what is known as lochia, which can vary in both quantity and color. For many, bleeding fluctuates with activity, rest, breastfeeding, and how the uterus contracts. At the same time, there are clear signs that bleeding should be assessed by a professional.
Lochia and fluctuating postpartum bleeding
Lochia is the body's way of cleansing the uterus after pregnancy. It often starts as heavier bleeding and typically gradually becomes more brownish, and later yellowish or whitish. The process can last for weeks, and it is not uncommon for the bleeding to seem to stop and then start again.
Practical observation at home
It can help to note:
- Color (red, brown, pink, yellowish)
- Quantity (spotting, like a period, or more)
- Presence of small clots (can occur, but should decrease)
- Presence of odor, fever, or increasing pain
If you are in doubt, it is always advisable to contact a midwife, your GP, or the maternity ward for assessment.
Why postpartum bleeding can come and go
When postpartum bleeding comes and goes, it is often due to everyday mechanisms. Increased activity, lifting, long walks, or many stairs can cause bleeding to increase again. Rest, conversely, can make it seem less.
Breastfeeding and afterpains can affect bleeding
Breastfeeding releases oxytocin, which causes the uterus to contract. This can lead to afterpains and temporarily more bleeding, especially at the beginning. This is typically temporary but should fit into an overall process where bleeding gradually decreases over time.
When is postpartum bleeding not normal?
Some symptoms require quick assessment because they can be signs of complications such as infection or heavy postpartum bleeding. It is better to contact healthcare professionals one time too many than one time too few.
Seek immediate help for these signs
Contact emergency services (112 or maternity ward/emergency room) if you experience:
- Very heavy bleeding, e.g., if you soak a large pad quickly and repeatedly
- Large blood clots
- Dizziness, faintness, heart palpitations, or altered general condition
- Severe, increasing pain in the lower abdomen or shoulder pain in combination with malaise
Contact a doctor/midwife as soon as possible if you experience:
- Fever or chills
- Foul-smelling discharge
- Bleeding that becomes redder and heavier again without an obvious explanation, or that does not slowly decrease over time
How to manage fluctuating bleeding in everyday life
If bleeding comes and goes, you can often alleviate it with rest and simple measures:
- Reduce strain for a couple of days if bleeding increases
- Prioritize rest, especially if you also feel fatigued
- Use appropriate pads (avoid tampons and menstrual cups initially, unless you have received other professional advice)
- Keep an eye on the pattern: Is it generally improving from week to week?
A simple rule of thumb
If your body reacts with more bleeding when you increase your pace, it is often a sign to slow down and allow more space for healing.
Relevant products for the postpartum period
The most important thing is that you feel safe and comfortable when managing lochia. Some may benefit from practical products that make it easier to maintain hygiene and change frequently.
A relevant choice can be postpartum pads designed for bleeding after birth, such as Disposable 10x Post Birth Care Pads. If you have soreness and want more gentle cleaning, a peri bottle can be helpful, such as Intimate Care Wash Bottle.