Postpartum Menstrual Flow: What to Expect After Childbirth

Menstrual flow

After having a child, my menstrual flow returned a month later.
However, for the first three days, it was very light, just a drop here and there.
Then it started to increase, and by the third and fourth days, the flow was similar to what I usually experience.
It has now been eight days since it started.

Nu11, 10~19 year old female. Ask Date: 2015/12/30

Dr. Lü Lizheng reply Obstetrics and Gynecology

The response indicates that the irregular menstruation may be the cause of the changes in the amount and duration of bleeding compared to previous cycles.
If the bleeding is excessive or lasts too long, it is advisable to seek medical treatment.
Other possibilities include incomplete miscarriage or uterine inflammation, so please consult a healthcare provider for examination and confirmation.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/12/30

More Info

After childbirth, many women experience a range of physical changes, including alterations in menstrual flow. It is common for postpartum bleeding, known as lochia, to occur for several weeks after delivery. This bleeding can vary in color, consistency, and volume, and it is important to understand what is typical and what may warrant further medical attention.

In your case, you mentioned that your menstrual flow started about a month after giving birth, with the first three days being very light, followed by an increase in flow that resembled a typical menstrual period by the third or fourth day. This pattern can be considered normal for many women. After childbirth, the body undergoes significant hormonal changes as it transitions back to a non-pregnant state. The first menstrual period postpartum can be irregular and may not resemble your pre-pregnancy cycles.

Typically, lochia consists of three stages:
1. Lochia Rubra: This occurs in the first few days postpartum and is characterized by bright red blood, similar to a heavy menstrual flow. It may contain small clots and is primarily composed of blood, decidual tissue, and mucus.

2. Lochia Serosa: This stage occurs around days 4 to 10 and is a pinkish-brown discharge. It consists of a mix of blood, mucus, and white blood cells.

3. Lochia Alba: This is the final stage, which can last from about 10 days to six weeks postpartum. It is a yellowish-white discharge that consists mainly of white blood cells and mucus.

The return of your menstrual cycle can vary widely among women. Some may experience their first period as early as four to six weeks postpartum, while others may not see it for several months, especially if they are breastfeeding, as breastfeeding can suppress ovulation due to elevated levels of the hormone prolactin.

Regarding the duration and flow of your period, it is not uncommon for the first few menstrual cycles after childbirth to be different from what you experienced before pregnancy. You may notice changes in the flow, duration, and even the symptoms associated with your period. Some women report heavier or lighter flows, and some may experience more intense cramps.

However, if you find that your menstrual flow is excessively heavy (soaking through a pad or tampon every hour), accompanied by large clots, or if you experience severe pain, it is essential to consult with your healthcare provider. These could be signs of complications such as retained placental tissue or other underlying issues that may require medical intervention.

In summary, the pattern you described seems to align with what many women experience postpartum. However, it is crucial to monitor your symptoms and seek medical advice if you have concerns about the volume or nature of your menstrual flow. Your healthcare provider can offer personalized guidance based on your medical history and current health status.

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