Postpartum Bleeding: Understanding and When to Seek Medical Advice

Question
Hi Brenda,

I bled for 6 weeks after delivery; it finally tapered off and got yellow, then clear during that last week, but it had been bright red up until that point. It stopped entirely for two weeks, then I went for my post-delivery checkup. I had some spotting that night, which I know is normal after a pap smear, but every day since then, the blood has gotten heavier and bright red again. So now it's been 5 days and I'm going through a Maxi pad every two hours. I called the OB, who said that it was unrelated to the pap and just a normal part of childbirth. However, most of what I've read says it's NOT normal to still have bright red blood past 8 weeks.

I don't believe it's my period... I'm nursing, and my periods are normally excruciatingly painful. I have no pain with this, just a slowly increasing amount of blood ever since that pap smear.

I developed hemmorhoids during childbirth (which also seem to be getting worse instead of better), and had two hemotomas (sp?). I also had a large fibroid. Otherwise, it was a normal pregnancy and delivery.

So I'm wondering if I need to get a second opinion or if I should trust the OB and just wait it out. What do you think?

Answer
Dear Jen,

If you had two hematomas and a fibroid, the exam and Pap smear may have stimulated some bleeding. It sounds like the bleeding post-delivery went through its normal course and was appropriate. I would suspect that this should also taper off, however it is the amount that is significant to me more than the fact that your are bleeding again. This may very well be that first period - especially if you are supplementing at all to your breastfeeding. A Maxi pad every two hours for 5 days is some significant bleeding. Even though you normally have cramping, the first period after delivery is often not the "normal" period for any woman. It may have started as spotting from the Pap, but then your period may have been prompted to begin.

My suggestion would be to give this a few more days. If it hasn't tapered off or ended after 8 days of bleeding, I would call back and let them know that you went through your normal course of post-delivery bleeding and had stopped prior to the Pap and exam. And now this bleeding has become significant (give them the amount, like you did me) over the last "X" number of days. If you don't get a satisfactory answer and still feel there may be something not right, there is nothing wrong with getting a 2nd opinion.

I hope this has helped you and answered your question. I wish you well.

Brenda