Persistent Postpartum Bleeding: Causes, Diagnosis, and Treatment

Question
QUESTION: I had a premature baby (33 weeks and 4 days) almost five months ago on February 14 and had a period for about two weeks. It came back on March 31 and I bled for about two months, both heavy and light. I went to the emergency room and had various test ran and everything came back normal. I continued to bleed until I finally went to my gynecologist on June 6th and she put me on Low Ogestrel birth control and the bleeding stopped about two days later. I began to bleed again about two and a half weeks later and I am still bleeding. It is actually heavier now with HUGE blood clots and severe cramping. Is this normal after childbirth or is this something more serious?

ANSWER: Were you checked for a retained placenta?  This is one possibility that would explain your continued bleeding, and could require a D&C to fix.  You need to check with your obstetrician again and ask for more testing.  If you continue to pass large clots, you may need to head to the emergency room.  Definitely go there if you feel weak or faint, as you may be experiencing excessive blood loss.

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QUESTION: I was tested for this already and my tests came back normal. I was also given a intravaginal ultrasound and that came back normal too. Is there any other reason that I may be bleeding like this?

Answer
Have you been checked for bleeding disorders, such as thrombocytopenia or von Willebrand's disease?  Have your liver and kidney functions been tested?  I'm assuming here that your uterus and cervix were thoroughly examined and found to be free of physical abnormalities, and that your bloodwork did not indicate any problems with your reproductive hormones.  You definitely need to follow up with your doctor on this, and seek out a second opinion if necessary.  This is not normal bleeding and needs to be followed up on, not dismissed with oral contraceptives.