Postpartum Lochia Concerns: When to Seek Medical Advice

Postpartum lochia issues?

Doctor, hello.
Here’s the situation: I gave birth naturally on February 28.
After being discharged, I drank herbal soup for two days.
By March 23, I still had red lochia, so I returned for a follow-up.
The doctor prescribed uterotonics.
On April 2, during my follow-up, there was still a small blood clot that hadn’t cleared.
The doctor prescribed uterotonics and hemostatic medication for me.
By April 6 and 7, there was almost no lochia, just a sudden small amount of blood once.
On April 8, there was a little bit of blood, which was brownish.
On April 9, there was a little, but it was dark red.
The doctor previously mentioned that if the lochia doesn’t stop, I would need to take menstrual regulation medication, but I wouldn’t be able to breastfeed.
I would like to ask Dr.
Liu: does this mean I can’t breastfeed only during the days I take the medication, or do I need to wean completely? Additionally, is this the only method available, or can I observe for another week?

MAGGIE, 30~39 year old female. Ask Date: 2013/04/09

Dr. Liu Yuhong reply Obstetrics and Gynecology

Menstrual regulation medications typically contain hormones (estrogen and progesterone).
Taking these medications can allow for breastfeeding, but it may also reduce milk supply.
As for how to proceed with your concerns, it is essential to consult a physician who can evaluate you in person.
Wishing you good health.

Reply Date: 2013/04/09

More Info

Postpartum lochia, or the vaginal discharge that occurs after childbirth, is a normal part of recovery for new mothers. However, it is essential to monitor the characteristics of lochia and any accompanying symptoms to ensure that there are no complications. In your case, it appears that you have been experiencing ongoing lochia with some variations in color and consistency, which raises valid concerns.

Lochia typically progresses through three stages: lochia rubra (bright red, occurring in the first few days postpartum), lochia serosa (pinkish-brown, occurring from about day 4 to day 10), and lochia alba (yellowish-white, occurring from about day 10 onward). It is not uncommon for lochia to last several weeks, but it should gradually decrease in volume and change in color. If you notice a sudden increase in bleeding, the passage of large clots, or a foul odor, these could be signs of complications such as retained placental fragments or infection, and you should seek medical attention promptly.

In your situation, you mentioned that you have had some dark red bleeding and a small blood clot that has not resolved. This could indicate that there may still be some retained tissue or that your uterus is not contracting effectively. The medications prescribed by your doctor, such as uterotonics, are intended to help the uterus contract and reduce bleeding. If the lochia does not resolve with these medications, your doctor may consider further evaluation, which could include an ultrasound to check for retained products of conception.

Regarding your question about breastfeeding while taking medication, it is crucial to discuss this with your healthcare provider. Some medications can affect milk supply or may not be safe for breastfeeding. If your doctor has advised against breastfeeding while on certain medications, it is typically for the duration of the treatment. However, if the medications are necessary for your health, your doctor will provide guidance on how to manage breastfeeding during this time. In some cases, there may be alternative medications that are safer for breastfeeding, so it is worth discussing your options with your healthcare provider.

As for your desire to observe the situation for another week, it is essential to balance caution with your comfort. If you feel that your symptoms are manageable and you are not experiencing any severe pain, fever, or other alarming symptoms, you may choose to monitor your lochia for a short period. However, if you notice any significant changes or worsening symptoms, it is advisable to seek medical advice sooner rather than later.

In summary, postpartum lochia is a normal process, but it requires careful monitoring. If you have concerns about the duration, color, or volume of your lochia, or if you experience any other concerning symptoms, do not hesitate to reach out to your healthcare provider. They can provide you with the best advice tailored to your specific situation and ensure that you receive the appropriate care. Remember, your health and well-being are paramount, and it is always better to err on the side of caution when it comes to postpartum recovery.

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