Bloodclots After Childbirth: What's Normal, What's Not

As practicing midwives, we routinely get all the post-childbirth questions you can think of (and those you've never thought of, too). Hands down, one of the most common concerns new mamas face is: Are my blood clots normal?

Blood clots are part of normal healing after childbirth, but it's important to monitor their size and frequency so that you can know the difference between normal ones and ones that require your care provider's attention.

So how can you tell? We're breaking it down below – read on for what you need to know about blood clots after childbirth.

What's the normal healing process after childbirth?

As a normal part of the healing process, the uterus sheds its lining after childbirth. This substance is called Lochia and is made up of blood, tissue, and mucous (similar to a menstrual period).

In very general terms, you can expect that bleeding will be heaviest for the 1-3 days immediately following childbirth. Depending on how much you are able to rest after your birth, and other factors such as whether you breastfeed and how much you exercise, you can expect to bleed for as little as 2-3 weeks or as long as 6 weeks, with the flow lessening over time.

You may notice heavier flow when you move from a prone or sitting position to standing – this is nothing concerning! It is simply the release of blood that has pooled in your vagina. It’s less important to count the days of each lochia stage (as it can vary from woman to woman), and much more important that the amount of lochia consistently diminishes and the colour changes from red to pink to creamy or white. 

The three normal phases of lochia, or bleeding after childbirth

There are 3 “normal” phases of lochia and it’s important that you recognize each stage in order to be able to tell if something is amiss. 

1) Lochia rubra — first 2 to 3 days after delivery

  • the lochia is mostly blood

  • the blood looks bright red

  • the blood flow can be heavy to moderate

  • you may see small blood clots

2) Lochia serosa — starts at approximately day 4 and lasts until day 10

  • the colour changes to pink or pinkish-brown

  • the flow is much less

  • flow is ongoing

Note: Blood clots or bright red blood during this time may be signs of a problem.

3) Lochia alba — from approximately day 10 until day 21

  • the color is light yellow to a cream color

  • the flow has almost stopped and does not smell

Note: The presence of clots, a bad smell, or bright red blood during this time may be signs of a problem.

Generally, there is a progression from lochia rubra through lochia serosa to lochia alba.  If you are overextending yourself, you may experience some red spotting that means you should stop and rest more.  

When to call your healthcare provider?

You should call your healthcare provider immediately at any time after birth if your bleeding does not decrease or if you are filling more than one menstrual pad in one hour.

“You should call your healthcare provider immediately at any time after birth if your bleeding does not decrease or if you are filling more than one menstrual pad in one hour.” QUOTE

What about blood clots?

Passing clots of blood is common during the first two weeks postpartum, and clot size can range from the size of a small pea to a golf ball – and can be quite shocking if you’re not prepared!

Blood clots form when you are sitting or laying down – remember that blood we talked about pooling in the vagina?  As it pools, the blood may clot.

Some women experience discomfort walking or using the toilet and many report that after passing a clot the discomfort goes away. Typically the rule of thumb is golf-ball sized clots are fine but baseball-sized clots require follow up with your midwife or doctor.

However, if you have prolonged red bleeding and clots after the first week postpartum and are experiencing pain in your abdomen or have any sign of fever or chills, you should contact your care provider.

To recap:

What's normal?

  • Blood clots during the first week or two postpartum

  • Blood clots ranging in size free a pea or a golf ball

  • Some discomfort, usually relieved after passing the blood clot

  • Bleeding decreases as the days pass

What's not normal?

  • Blood clots, bad smell, or bright red blood in the second to third week postpartum

  • Blood clots the size of baseballs

  • Pain in your abdomen

  • Fever or chills

If you're currently dealing with blood clots after childbirth, we recommend monitoring them to make sure they stay within the normal range. Fortify your body with well-formulated herbal teas containing red raspberry leaf, and load up on as much rest as you can with a new babe in the house!

As midwives, one of our all-time favourite ways to tone the uterus after childbirth and support overall recovery is the universal women's herb raspberry leaf tea. We recommend it consumed as a tea on its own or as part of a nourishing herb blend. Drink one to three cups daily throughout the three normal phases of lochia, the shedding of the uterus lining after childbirth.

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