Postpartum Complications: Unexplained Bleeding and Left Abdominal Pain

Postpartum menstruation has started, but there is intermittent bleeding and pain in the lower left abdomen?

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.
I had intercourse on February 20, after which I experienced heavy bleeding.
I visited a nearby obstetrician-gynecologist, who said there was nothing wrong and only prescribed three days' worth of hemostatic medication.
On February 26, after using the restroom, I inexplicably bled again (approximately the amount typical for the third day of menstruation), neither more nor less.
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 am considering seeing another doctor, but I am unsure whom to consult.
I absolutely do not want to see the doctor who delivered my baby again.
During the delivery, I overheard the doctor and other medical staff discussing how my uterus was not contracting and that my pelvic cavity was not sufficiently open, which made the delivery difficult.
They also mentioned severe tearing, which left me stunned.
My situation clearly indicated a need for a cesarean section, and I had repeatedly discussed the possibility of one, 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 had flared up twice during my pregnancy.

I was only dilated to one centimeter for four days and then one and a half centimeters, yet they were unwilling to let me progress to labor.
After my water broke, the hospital allowed me to labor for 12 hours before the doctor finally moved me to the delivery room, continuously stating that I lacked sufficient energy and suggesting I wait until I had more strength to deliver, despite being aware of my asthma condition.
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: 2017/03/04

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: 2017/03/04

More Info

Postpartum complications can be quite concerning, especially when symptoms such as unexplained bleeding and persistent abdominal pain arise. Based on your description, it appears that you are experiencing a combination of symptoms that may indicate several potential issues following your delivery.

Firstly, the bleeding you experienced after engaging in sexual intercourse could be attributed to several factors. One possibility is that the cervix may still be healing from the trauma of childbirth, which can lead to bleeding during or after intercourse. Additionally, if there were any retained products of conception (placental tissue) in the uterus, this could also cause abnormal bleeding. Retained products can lead to a condition known as postpartum hemorrhage, which is a serious complication that requires medical attention.

The left lower abdominal pain you are experiencing could be related to a few different conditions. One possibility is that it could be due to uterine involution, which is the process by which the uterus returns to its pre-pregnancy size. If the uterus is not contracting properly, it can lead to discomfort and pain. Another consideration is the presence of an infection, such as endometritis, which is an infection of the uterine lining that can occur postpartum. Symptoms of endometritis may include fever, foul-smelling discharge, and abdominal pain.

Given your history of significant tearing during delivery and the mention of your uterus not contracting effectively, it is also important to consider the possibility of adhesions or scar tissue forming in the pelvic region. These can cause chronic pain and discomfort, particularly if they are affecting surrounding organs or nerves.

It is understandable that you are hesitant to return to the same physician who delivered your baby, especially given your concerns about the care you received. However, it is crucial to seek a second opinion from another obstetrician or a gynecologist who can perform a thorough evaluation. This may include a physical examination, ultrasound imaging, and possibly further diagnostic tests to rule out any serious complications.

In the meantime, you can take some steps to manage your symptoms. Over-the-counter pain relief medications, such as ibuprofen, may help alleviate some of the discomfort. Additionally, applying a warm compress to the lower abdomen can provide soothing relief. However, these measures should not replace professional medical evaluation and treatment.

If your symptoms worsen or if you experience additional concerning signs such as fever, increased bleeding, or severe pain, it is essential to seek immediate medical attention. Your health and well-being are of utmost importance, and addressing these postpartum complications promptly can help prevent further issues.

In summary, your symptoms of unexplained bleeding and left abdominal pain postpartum could be indicative of several conditions, including retained products of conception, uterine involution issues, infections, or adhesions. Seeking a second opinion from a qualified healthcare provider is crucial for proper diagnosis and treatment. Remember, you deserve to receive the best care possible during your recovery.

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