Postpartum Bleeding and Left Abdominal Pain: What Could Be Wrong?

Postpartum menstruation has started, but there is intermittent bleeding along with left lower abdominal pain?

On December 28, I had a natural delivery, and the lochia lasted about five weeks.
My menstruation started on February 10 and ended on February 17.
On February 20, I had intercourse and then experienced heavy bleeding, so I went to see a gynecologist.
The doctor said there was nothing to worry about and prescribed me a three-day course of hemostatic medication.
On February 26, after using the restroom, I inexplicably bled again (about the amount typical for the third day of menstruation), which was neither too much nor too little.
However, the bleeding stopped by March 2, but I have been experiencing continuous cramping pain in my lower left abdomen.

What could be the cause of my symptoms? I really want to consult another doctor, but I don’t know whom to see.
I definitely won’t go back to the doctor who delivered my baby! During the delivery, I overheard the doctor and other medical staff discussing how my uterus wasn’t contracting and that my pelvic cavity wasn’t adequately opened, which made the delivery difficult.
They also mentioned severe tearing, which left me shocked.
My situation clearly indicated a need for a cesarean section, and I had repeatedly asked if a cesarean could be considered, but the doctor ignored me! The baby's head was two weeks larger than the body, and I have a hereditary history of asthma, which flared up twice during my pregnancy.
I was dilated to one centimeter for four days and then to one and a half centimeters, but they were unwilling to let me go into labor.
After my water broke, the hospital made me wait for 12 hours before the doctor finally moved me to the delivery room, constantly saying that I didn’t have enough strength and that I should wait until I was stronger to deliver, despite them knowing about my asthma! Ultimately, I delivered using vacuum extraction.
The anesthesiologist also administered the pain relief incorrectly, and I had to endure two injections.

Eva, 20~29 year old female. Ask Date: 2017/03/03

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I'm sorry that I cannot provide a diagnosis based on what you've described.
It is possible that your postpartum menstruation has not yet normalized.
If you continue to experience discomfort, I recommend consulting another obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2017/03/03

More Info

Postpartum bleeding and persistent left abdominal pain can be concerning symptoms that may indicate several potential gynecological issues. Given your recent history of childbirth and the complications you experienced during labor, it is essential to consider various factors that could contribute to your current condition.

Firstly, postpartum hemorrhage can occur due to several reasons, including retained placental fragments, uterine atony (failure of the uterus to contract effectively), or lacerations in the birth canal. In your case, the fact that you experienced significant bleeding after engaging in sexual intercourse could suggest that there may still be some retained tissue or that your uterus is not contracting properly. The left abdominal pain you are experiencing could be related to these issues, especially if there is any residual tissue causing irritation or inflammation.

Additionally, the pain you describe could be indicative of pelvic inflammatory disease (PID), which can occur if bacteria enter the reproductive organs, often following childbirth. PID can lead to scarring and adhesions, which might also explain the persistent pain. Another possibility is the development of ovarian cysts or complications related to the ovaries, particularly if there was any trauma during delivery.

Your mention of hearing medical staff discuss your uterine contraction issues and severe tearing during labor raises concerns about potential complications that could have arisen from those events. If the uterus did not contract effectively, it could lead to complications such as uterine inversion or retained products of conception, both of which can cause ongoing bleeding and pain.

It is also worth considering the psychological aspect of your experience. The trauma associated with a difficult delivery and the subsequent complications can lead to heightened anxiety and stress, which may manifest as physical symptoms, including abdominal pain.

Given your situation, it is crucial to seek a second opinion from a different obstetrician or gynecologist. You deserve a thorough evaluation, including a pelvic examination, ultrasound, and possibly further imaging studies to assess the condition of your uterus and ovaries. It is also important to discuss your symptoms in detail, including the nature of the pain, any changes in your bleeding patterns, and any other associated symptoms such as fever or unusual discharge.

In the meantime, if the pain becomes severe or if you experience any new symptoms such as fever, chills, or an increase in bleeding, you should seek immediate medical attention. It is vital to ensure that you receive the appropriate care and support during your recovery from childbirth.

In summary, while there are several potential causes for your postpartum bleeding and left abdominal pain, a thorough evaluation by a qualified healthcare provider is essential to determine the underlying issue and to develop an appropriate treatment plan. Your health and well-being are paramount, and you should not hesitate to advocate for yourself in seeking the care you need.

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