Post-Cesarean Pain and Unusual Bleeding: When to Seek Medical Advice

Abdominal incision pain with vaginal bleeding?

It has been eleven months since my cesarean section, and I am experiencing pain at the incision site.
Occasionally, I notice dark red, sticky blood coming from my vaginal area, rather than a watery discharge.
The pain is not constant; it occurs when I exert myself abdominally.
Sometimes there is no pain, and other times it does hurt, accompanied by the symptoms I described.
I have not experienced any pulling or trauma, just normal abdominal exertion.
The amount of blood is not significant, roughly the size of a small pinky finger.
After experiencing pain, I find that I need to wipe about five times in the restroom before the bleeding stops.
Should I schedule a follow-up appointment for this?

Bao Ma, 30~39 year old female. Ask Date: 2023/07/22

Dr. Chen Zhiyu reply Obstetrics and Gynecology

It is recommended to visit the obstetrics and gynecology outpatient clinic for evaluation.
Thank you.

Reply Date: 2023/07/22

More Info

Post-Cesarean pain and unusual bleeding can be concerning symptoms that warrant medical attention. Given that you are experiencing pain at the site of your C-section scar and unusual bleeding from the vaginal area, it is essential to understand the potential causes and when to seek medical advice.

Firstly, it is important to note that after a cesarean section, it is normal to experience some discomfort as the body heals. However, persistent or unusual pain, especially if it is accompanied by bleeding, should not be ignored. The type of bleeding you described—dark red, thick, and occurring after exertion—could indicate several possibilities, including:
1. Scar Tissue Formation: After a C-section, scar tissue (adhesions) can form internally. These adhesions can sometimes cause pain, especially during physical activity or exertion. If the scar tissue is pulling on surrounding tissues, it may lead to discomfort and bleeding.

2. Infection: While it has been several months since your surgery, infections can still occur. Signs of infection may include increased pain, swelling, redness at the incision site, fever, or unusual discharge. If you suspect an infection, it is crucial to seek medical attention promptly.

3. Uterine Complications: The bleeding you are experiencing could also be related to issues within the uterus, such as retained placental tissue or other complications that can occur post-delivery. This can lead to abnormal bleeding patterns and should be evaluated by a healthcare professional.

4. Hormonal Changes: If you are experiencing irregular bleeding, it could also be related to hormonal fluctuations, especially if you are not breastfeeding. Hormonal changes can affect your menstrual cycle and lead to unexpected bleeding.

5. Other Gynecological Issues: Conditions such as fibroids, polyps, or other gynecological issues can also cause pain and abnormal bleeding. These conditions may require further evaluation through imaging or other diagnostic tests.

Given your symptoms, it is advisable to seek medical advice. You should schedule an appointment with your healthcare provider to discuss your symptoms in detail. They may perform a physical examination, and possibly order imaging studies such as an ultrasound to assess the uterus and surrounding structures.
In the meantime, it is essential to monitor your symptoms. If you experience any of the following, seek immediate medical attention:
- Severe or worsening pain
- Heavy bleeding (soaking through a pad in an hour)
- Fever or chills
- Foul-smelling discharge
- Dizziness or fainting
In conclusion, while some discomfort after a cesarean section is normal, the combination of pain and unusual bleeding you are experiencing should be evaluated by a healthcare professional. Early intervention can help identify any underlying issues and ensure appropriate treatment, allowing for a smoother recovery and peace of mind.

Similar Q&A

Post-Cesarean Complications: Understanding Excessive Bleeding Two Months Later

Hello doctor, my wife had a successful cesarean section on March 21. However, she suddenly started bleeding around May 30. Normally, the lochia should have finished by now. We have also had intercourse without any issues, and she is still exclusively breastfeeding. I am unsure if...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the factors contributing to postpartum hemorrhage are numerous. Based on the description provided, it is not possible to make a determination. It is recommended to follow the treatment plan provided by the surgical physician and to wait for the pathology report for further...

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

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. I went to a nearby obstetrician-gynecologist, who said there ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, I apologize for not being able to 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 y...

Post-Endometrial Scraping Bleeding: When to Seek Medical Attention?

Hello, doctor. I underwent a diagnostic curettage of the endometrium on May 20 and took hemostatic and contraction medications for three days. After finishing the medication, the bleeding increased, and I continued to have blood clots. After visiting the doctor on May 25, I was t...

Dr. Wu Xianghui reply Obstetrics and Gynecology
Abnormal postoperative bleeding can have various causes. It is recommended to visit the outpatient clinic for evaluation by the original surgeon.

Understanding Postpartum Complications: When to Worry About Bleeding

I gave birth a month ago, but I have been experiencing continuous lochia without interruption. For the past two days, I have felt slight abdominal pain, so I went to the hospital for an examination. The doctor said there is still blood and fluid in my uterus and prescribed uterin...

Dr. Wang Hanzhou reply Obstetrics and Gynecology
Persistent postpartum lochia should be addressed immediately if there is a significant retention of placental or membrane tissue. Please maintain close communication with your physician; the bleeding is not related to the tubal ligation.