Bleeding after childbirth is an expected part of the period following a vaginal birth or a C-section. For most, the bleeding gradually subsides, but it can be difficult to assess what is normal and when you should react. Here is a practical guide to what to look out for and how to take care of yourself at home.

What many refer to as lochia or postpartum discharge is bleeding and discharge from the uterus as it heals after pregnancy. Initially, it can resemble a heavy period and may contain small blood clots. Over time, it typically becomes lighter and often changes color from red to brownish and later to more yellowish or whitish.

Use large, soft pads (not tampons or menstrual cups, unless specifically advised otherwise by healthcare professionals). Change pads regularly and observe if the amount decreases over days rather than increasing. If the bleeding suddenly increases after having been subsiding, it is worth reacting to.

Heavy bleeding after childbirth can be acute and requires prompt assessment. A rule of thumb for home observation is to be aware of bleeding that feels out of proportion or continues to be very heavy.

Contact emergency services (112) or the maternity ward/on-call doctor immediately if you experience:

• Very heavy bleeding where pads are quickly saturated repeatedly.
• Large blood clots or persistent fresh bleeding that does not settle down.
• Dizziness, feeling faint, palpitations, shortness of breath, paleness, or cold sweats.
• Suspicion of shock or if you suddenly feel unwell.

These symptoms can be related to significant blood loss and should be assessed by healthcare professionals.

There can be several reasons why bleeding after childbirth becomes heavier or lasts longer. For example, it could be due to the uterus not contracting sufficiently immediately after birth, tears occurring, or retained tissue in the uterus. Infection can also play a role, especially if there is also fever or increasing pain.

You don't need to find the cause yourself. Your task is to observe the development and react to warning signs. If in doubt, it is always relevant to contact your midwife, general practitioner, or maternity ward.

You should contact healthcare professionals if:

• The bleeding becomes heavier again after having been subsiding.
• You develop a fever, foul-smelling discharge, or increasing pelvic pain.
• You feel unusually tired or weak, especially if it feels different from ordinary postpartum fatigue.
• You are uneasy about the amount or pattern of bleeding.

When you call, it can help to be able to answer: how many pads you are using, if there are clots, your temperature, and if you have pain or dizziness.

Your body heals best with rest, fluids, and gentle activity. If you notice that bleeding increases with physical activity, it may be a sign that you should slow down and prioritize rest.

Many find it beneficial to rinse with lukewarm water after using the toilet and pat dry instead of rubbing vigorously. This can reduce stinging and promote good hygiene while you are bleeding.

For practical purposes, these products may be relevant during the postpartum period (mentioned here once): Post-birth care pads, intimate wash bottle, and new mum care pack with selected care products.

The information here is based on general patient-oriented knowledge about bleeding after childbirth and when to seek help. For more detailed, Danish healthcare information, you can read, among other sources:

• Sundhed.dk Patient Handbook: Bleeding after childbirth
• Sundhed.dk Patient Handbook: Bleeding after childbirth, abnormal
• Sundhed.dk Doctor's Handbook: Postpartum hemorrhage