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Vaginal delivery - discharge

Pregnancy - discharge after vaginal delivery

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.

Presentation

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 after your delivery if you are breastfeeding, and perhaps not for several weeks after you completely stop breastfeeding.
• If you choose to use a contraceptive, ask your provider the effect of the contraceptive on the return of your period.

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 near the navel shortly after birth. It will get smaller very quickly, and after a week will be difficult to feel abdominally. 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 from an episiotomy or lacerations 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 or bulk laxative (not enemas or stimulating laxatives)

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

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. It can help you sleep better and relieve stress. It may help prevent postpartum depression. In general, it's safe to start gentle exercises a few days after a normal vaginal delivery -- or when you feel ready. Aim for 20 to 30 minutes a day at first, Even 10 minutes a day can help. If you feel any pain, stop exercising.

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 before you leave the hospital. 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 (if it is slightly redder and warmer than the other leg).
• Fever more than 100°F (37.8°C) that persists (swollen breasts may cause a mild elevation of temperature).
• Increased pain in your belly.
• Increased pain over your episiotomy/laceration 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.

Postpartum preeclampsia, while rare, can occur after delivery, even if you did not have preeclampsia during your pregnancy. Call your provider right away if you:

• Have swelling in your hands, face, or eyes (edema).
• Suddenly gain weight over 1 or 2 days, or you gain more than 2 pounds (1 kilogram) in a week.
• Have a headache that does not go away or becomes worse.
• Have vision changes, such as you cannot see for a short time, see flashing lights or spots, are sensitive to light, or have blurry vision.
• Body pain and achiness (similar to body pain that occurs with a high fever).

References

American College of Obstetricians and Gynecologists website. Exercise after pregnancy. www.acog.org/womens-health/faqs/exercise-after-pregnancy?utm_source=redirect&utm_medium=web&utm_campaign=otn. Updated August 2022. Accessed January 2, 2023.

American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on hypertension in pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. PMID: 24150027 pubmed.ncbi.nlm.nih.gov/24150027/.

Isley MM. Postpartum care and long-term health considerations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.

Sibai BM. Preeclampsia and hypertensive disorders.In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 38.

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Review Date: 11/21/2022  

Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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