What Sort of Bleeding or Discharge is there After Birth?

Annie Evett & Jodi Cleghorn

What is lochia?
Why do women bleed after birth?
Healthy vagina, healthy discharge
Vaginal bacteria and infections
Common vaginal infections
Conclusion
References

What is lochia?

Immediately following birth women experience a discharge medically termed lochia. It is first mixed with blood, much like a period, that begins as a heavy flow and becomes lighter and brownish over time, ending as a yellowish white discharge. Medical texts state that the initial ‘heavy period’ stage lasts for around ten days, and continuing for around six weeks similar to a normal period.  Before it ceases  there may be an odour, which is strong but not offensive.  

Why do women bleed after birth?

Midwifery wisdom reminds women that the bleeding after birth is directly related to the detatchment of the placenta. Some midwives actually term say that the 'womb is weeping' - mourning the end of pregnancy. The seperation of the placenta from the utuerus causes  a wound and like any other wound on our body, it bleeds in an attempt to create a protective covering to allow the tissues beneath to heal. 

Personal experience changes from individual to individual. Some women experience very heavy bleeding for over two weeks while others have no discharge at all after two weeks. Some women have reported bleeding for months .

Rest allows for that natural process of healing to happen.  If women do not rest, then it is like knocking a healing wound, the protective scab loses intergrity and the wound  bleeds again.  Bright red blood is the body's way of saying SLOW DOWN, REST. There is very strong anecdotal evidence that the more rest a woman after birth is directly related to the length of time she will bleed - that is:

little or no rest     =     more bleeding and for longer
lots of rest            =     less bleeding and for a short time

Women often find that they will begin to bleed bright red when they become active after a period of rest, or if they have a particularly busy day in those early week.

There also seems to be evidence that the more rest had in the first four to six weeks after birth the healthier, more energetic and better able to cope mothers are in the first year of their baby's lives.

Healthy Vagina, Healthy Discharge

Normally, vaginal discharge is clear or white ( and is normally about 4 tsp within a day). It consists of:  

• water
• albumin - the most abundant protein in the body
• a few stray white blood cells
• mucin - the oily substance that gives the vagina and cervix their slippery sheen
  

It may become stretchy and slippery during ovulation, about two weeks after the first day of your menstrual period and for a short space of time during your lunar period of fertility.  Vaginal discharge is neither dirty nor a toxic waste product such as urine or faeces. A healthy discharge smells sweet and any change in the color, amount of discharge, consistency or smell, along with other symptoms such as pain or itching, may indicate that you have an infection.

White discharge
Thick, white discharge is common at the beginning and end of your cycle. It is known as 'hostile mucuous" meaning sperm cannot live in it. Normal white discharge is not accompanied by itching, nor resemble cottage cheese. If itching is present, thick white discharge can indicate a yeast infection.

Clear and stretchy discharge
This is "fertile" mucous and means you are ovulating and fertile. It resembles egg white and can be stretched between your fingers. This is something worth learning to observe and note - especially as ovulation occurs before you experience your first period after you have had a child and many women are caught out, falling pregnant soon after the birth of their first child - especially if they are not exclusively breastfeeding.  See here for more information on breastfeeding and contraception.

Clear and watery
This occurs at different times of your cycle and can be particularly heavy after exercising.

Brown
May happen right after periods, and is just "cleaning out" the last traces of your menstrual blood from your vagina. Old blood looks brown.

Spotting Blood/Brown Discharge
This may occur when you are ovulating/mid-cycle. Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a pregnancy test.

Yellow or Green
May indicate an infection, especially if thick or clumpy like cottage cheese or has a foul odour.

Vaginal Bacteria and Infections

The vaginal ecosystem is created through a mutually advantageous relationship between the vagina itself and the micro-organisms that inhabit it. The vagina is normally colonised by healthy bacteria called lactobacillius - the same bacteria found in yoghurt. Not suprisingly, and rather challenging for most women, Dr Hillier from the Maggee Women's hospital in Pittsburg states:

"A healthy vagina is as clean and pure as a tub of yoghurt." 

These lactobacilli help to maintain the vagina at a pH level of 3.4-4.5. These good bacteria exist to protect the reproductive organs from bad bacteria that may cause infections.

Bacterial growth is controlled and affected by many different factors, such as acid level in the vagina and changes in hormone levels. Anything that upsets this balance and makes the vagina less acidic may increase your risk of infection or overgrowth of less helpful bacteria or  yeast, such as candida.  It's interesting to note that 75% of women will have suffered from a yeast infection at some time in their lives

Possible triggers to upset the vagina eocsystem:

• Antibiotic use
• Birth control pills
• Douching
• Use of spermicides (very alkaline)
  
• Diabetes
• Pregnancy
• Stress
• Tight or synthetic undergarments
• Using tampons
• Consuming food and drink high in sugar or yeast
  

It's important to note that the pH level in the vagina changes after birth, due to fluctuations in hormones, becoming less acidic making it a more hospitable environment for candida and increasing the possiblities for developing thrush.

Common vaginal infections

Signs of yeast infections (candida or thrush)

• White, cottage cheese-like discharge
• Swelling and pain around the vulva
• Intense itching

Signs of bacterial vaginosis (smelly vagina)

• A white, gray or yellowish vaginal discharge
• A fishy odor that is strongest after sex or after washing with soap
• Itching or burning
• Slight redness and swelling of the vagina or vulva
• Caused when good lactobacillius baceteria are overgrown by bad bacteria, such as gardnerella vaginalis
  

Signs of trichomoniasis (a common sexually transmitted disease)

• A watery, yellowish or greenish bubbly discharge
• An unpleasant odor
• Pain and itching when urinating
• Most apparent after your period

 
Keep in mind that once the flora of your body's bacteria goes out of balance, candida yeast will overpower. I'd suggest that you try and find an anti candida regime. Do avoid eating any sugar, drink lots of pure water and support your system with a probiotic, good nutrition and additional supplements. Pharmaceuticals tend to only bandaid  any problem rather then getting to the root of what it is causing it. If it becomes a reoccurring issue find a good anti candida pill to get your body back on track and seek assistance from a health professional for the long term support of your body.  

Also consider changing from synthetic sanitary products (both tampons and pads) and consider changing to reusable cloth pads or devices such as The Keeper.  Tampons can leave tiny microscopic fibres in the vagina and many brands of sanitary pads contain perfumes and other aborption agents that are toxic. Anecdotal evidence from women who have swapped to these toxic free alternatives has shown that they no longer suffer from thrush, especially women who had a long and persistent history of thrush.

Conclusion

In conclusion the amount of rest directly relates to the amount of bleeding after birth ... the more rest, the less bleeding, the faster your body will heal and the healthier your will be in the short, medium and long term. Vaginal discharge is a normal healthy part of being a woman. If you have a discharge that is painful or itchy, offensive in odour or you are concerned about consult a trusted medical practioner or alternate health professional. Consider toxic free, environmentally friendly sanitary products such as reusable cloth pads and The Keeper, that support healthy vaginal ecosystems.

If you found this article helpful, considering purchasing our eBook "Reclaim Sex After Birth."

References

Healthy Vaginas viewed at Menstruation.com.au 

Woman: an intimate Geography by Natalie Angier (Anchor:2000)

Vaginal Infections viewed at eMedicineHealth

Common vaginal infections view at BUPA