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Vaginal delivery - discharge

Definition

You are going home after a vaginal birth. You may need help caring for yourself and your newborn. Talk to your partner, parents, in-laws, or friends.

Alternative Names

Pregnancy - discharge after vaginal delivery

What to Expect at Home

You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become less red, then pink, and then you will have more of a yellow or white discharge. The pink discharge is called lochia.

In most cases, bleeding decreases the most during the first week. It may not stop completely for several weeks. It is not uncommon to have an increase in red bleeding around 7 to 14 days, when the scab forms over the spot where your placenta was shed.

Your menstrual period is likely to return in:

  • 4 to 9 weeks after your delivery if you're not breastfeeding
  • 3 to 12 months if you are breastfeeding, and perhaps not for several weeks after you completely stop breastfeeding

You may lose up to 20 pounds (9 kilograms) over the first 2 weeks after having your baby. After that, weight loss of around one half pound (250 grams) per week is best. Your health care provider can explain more about losing weight after pregnancy.

Your uterus will be hard and round, and can most often be felt around the navel. You may feel contractions for a few days. They are most often mild, but can be stronger if you have already had several babies. Sometimes, they can feel like labor contractions.

If you are not breastfeeding, breast engorgement may continue for a few days.

  • Wear a supportive bra 24 hours a day for the first 1 to 2 weeks.
  • Avoid any nipple stimulation.
  • Use ice packs to help with the discomfort.
  • Take ibuprofen to decrease pain and inflammation.

You will need a checkup with your provider in 4 to 6 weeks.

Take tub baths or showers, using only plain water. Avoid bubble baths or oils.

Episiotomy Care

Most women heal without problems, although it may take several weeks. Your stitches do not need to be removed. Your body will absorb them.

You can return to normal activities, such as light office work or house cleaning, and walking, when you feel ready. Wait 6 weeks before you:

  • Use tampons
  • Have sex
  • Do impact exercises, such as jogging, dancing, or lifting weights

To avoid constipation (hard stools):

  • Eat a high-fiber diet with plenty of fruits and vegetables
  • Drink 8 cups (2 liters) of water a day to prevent constipation and bladder infections
  • Use a stool softener (not enemas or laxatives)

Ask your provider what you can do to relieve the discomfort and speed the healing of your episiotomy.

Other Self-care

Try eating smaller meals than normal and have healthy snacks in between.

Any hemorrhoids you develop should slowly decrease in size. Some may go away. Methods that may help your symptoms include:

  • Warm tub baths
  • Cold compresses over the area
  • Over-the-counter pain relievers
  • Over-the-counter hemorrhoid ointments or suppositories (ALWAYS talk to your provider before using any suppositories)

Exercise can help your muscles and improve your energy level, but DO NOT start until you feel ready. Increase the amount of exercise slowly. Get plenty of rest.

You can start sexual activity around 6 weeks after delivery, if the discharge or lochia has stopped.

Women who breastfeed may have a lower sex drive than normal, along with vaginal dryness and pain with intercourse. This is because breastfeeding lowers hormone levels. The same drop in hormones most often prevents your menstrual period from returning for many months.

During this time, use a lubricant and practice gentle sex. If sex is still difficult, talk with your provider. Your provider may recommend a hormone cream that can reduce your symptoms. These changes in your body are temporary. After you are done breastfeeding and your menstrual cycle returns, your sex drive and function should return to normal.

Talk with your provider about contraception after pregnancy. You may be able to get pregnant as soon as 4 weeks after having a baby. It is important to use effective contraception during this time.

In the days or even months after delivery, some moms feel sad, disappointed, tired, or withdrawn. Many of these feelings are normal, and they often will go away.

  • Try talking with your partner, family, or friends about your feelings.
  • If these feelings do not go away or become worse, seek help from your provider.

Pee often and drink plenty of fluids to avoid bladder infections.

When to Call the Doctor

Call your provider if you have vaginal bleeding that is:

  • Heavier than 1 pad per hour or you have clots that are bigger than a golf ball
  • Still heavy (like your menstrual period flow) after more than 4 days, except for the expected increase around 7 to 14 days for a day or so
  • Either spotting or bleeding and returns after going away for more than a few days

Also call your provider if you have:

  • Swelling or pain in one of your legs (it will be slightly redder and warmer than the other leg)
  • Fever
  • Increased pain in your belly
  • Increased pain over your episiotomy or in that area
  • Discharge from your vagina that becomes heavier or develops a foul odor
  • Sadness, depression, withdrawn feeling, feelings of harming yourself or your baby, or inability to care for yourself or your baby
  • A tender, reddened, or warm area on one breast. This may be a sign of infection

References

Isley MM, Katz VL. Postpartum care and long-term health considerations. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Patterson DA, Matus CD, Curtis J. Vaginal delivery. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 177.

Review Date:11/11/2016
Reviewed By:Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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