How many days of postpartum bleeding are normal?

Written by Du Rui Xia
Obstetrics
Updated on March 11, 2025
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Postpartum hemorrhage typically stops around three weeks. Lochia can be classified into bloody lochia, serous lochia, and white lochia. Another type is abnormal bleeding, which is pathological bleeding. It occurs postpartum, for instance, due to soft birth canal injuries, cervical lacerations, uterine atony, or pre-existing blood disorders, which may extend the bleeding duration even beyond a month. This abnormal condition requires prompt medical attention. Normal lochia during the initial three to four days is bloody. As the bleeding from the uterus gradually decreases, it transitions to serous lochia, which can last about ten days. Finally, it becomes white lochia, which clears up after about three weeks.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Causes of postpartum hemorrhage

The causes of postpartum hemorrhage can be summarized into four main reasons: First is related to the placenta; second is lacerations in the soft birth canal; third is coagulation dysfunction; fourth is uterine atony, among which uterine atony is the most common cause. So, how can one determine if postpartum hemorrhage is caused by uterine atony? Clinically, after the placenta is delivered, examination of the soft birth canal is conducted. Upon examining the uterus, if it is found that the outline of the uterus is unclear and pressing on it results in a lot of blood and blood clots flowing out from the uterine cavity, then the uterus becomes firm when pressed and softens when not pressed. This situation indicates uterine atony. Other injuries, such as lacerations in the soft birth canal, are generally detected during an examination. There are also factors related to the placenta and coagulation dysfunction, which are the four main causes of postpartum hemorrhage.

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Written by Zhao Li Li
Obstetrics
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What are the causes of postpartum hemorrhage?

Under normal circumstances, postpartum hemorrhage is one of the most severe complications that can occur during childbirth. Postpartum hemorrhage can be caused by several reasons: The first is mainly due to uterine atony leading to bleeding, which is relatively common and generally requires the administration of potent oxytocics to promote uterine contraction; The second is mainly due to local tears in the vagina or cervix leading to bleeding; The third is primarily caused by issues such as placental adhesion or implantation; The fourth is due to disorders in the body's coagulation function, leading to uncontrolled bleeding.

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Written by Du Rui Xia
Obstetrics
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Postpartum constipation and bleeding from the anus what's going on?

When constipation occurs after childbirth and there is anal bleeding, it may be due to fissures caused by constipation or hemorrhoids causing blood vessel rupture and bleeding. Postpartum, due to the reduced activity of the mother and the consumption of too refined foods, waste cannot be smoothly expelled, leading to difficulty in defecation due to fecal impaction. During straining, this might cause rupture of the anus or fissures, or lead to hemorrhoids by disrupting local blood circulation. It is advisable to go to the hospital for a check-up to see if it is serious, and if necessary, treatment to stop the bleeding may be required.

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Written by Zhang Lu
Obstetrics
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Should the uterus be removed due to severe postpartum hemorrhage?

Whether postpartum hemorrhage requires hysterectomy primarily depends on the severity of the hemorrhage and the specific causes of the postpartum hemorrhage. First, if the amount of postpartum hemorrhage is very substantial, leading to conditions like DIC in the pregnant woman, and if not removing the uterus may cause ongoing bleeding, it is essential to remove the uterus quickly to reduce vaginal bleeding. Second, if the postpartum hemorrhage is caused by issues like amniotic fluid embolism or poor contraction of the uterus, and conservative treatments are ineffective, it is also necessary to make a prompt decision to remove the uterus.

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Written by Zhang Yin Xing
Obstetrics
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Does postpartum breastfeeding cause bleeding?

Bleeding caused by postpartum breastfeeding generally occurs within 42 days after delivery, during which the mother has lochia secretion. Breastfeeding promotes the secretion of oxytocin, which acts on the uterus and causes it to contract, facilitating the expulsion of lochia and aiding in the recovery of the uterus. Typically, by 42 days postpartum, the uterus has returned to its non-pregnant size and the expulsion of lochia is essentially complete. Subsequent breastfeeding is not directly related to vaginal bleeding. Another situation is due to the increase in prolactin during lactation; menstrual periods may not have fully resumed in women who are breastfeeding, and abnormal uterine bleeding may occur. As long as the amount and duration of bleeding do not exceed normal menstrual flow, no special treatment is needed.