Key takeaways
- Some signs and symptoms of internal bleeding after a C-section may include soaking through a pad every hour for over 2 hours or experiencing dizziness and a fast heart rate.
- Normal postpartum bleeding (lochia) typically lasts about 5 weeks and reduces over time. However, late postpartum hemorrhage, which involves very heavy bleeding, can occur up to 12 weeks after delivery. It requires immediate medical attention.
- Various factors, including uterine atony, retained placental tissue, and certain medical conditions like preeclampsia, can increase the risk of internal bleeding after a C-section.
According to the Centers for Disease Control and Prevention (CDC), almost
C-section is considered a safe surgery, and most people recover with minimal to no issues.
However, though commonplace, a C-section is still a major surgery. In some cases, people may experience complications, such as internal bleeding, infections, blood clots, and bladder damage.
Understanding what’s considered typical bleeding during the recovery period and when to seek help can help reduce your risk of complications.
Post-partum bleeding and discharge are known as lochia. Lochia is normal after giving birth by C-section. However, excess or heavy bleeding may be a sign of a complication that needs medical treatment.
In general, it takes around
Even though you can’t see internal bleeding, there are other signs that it might be occurring early on in the recovery period. Be mindful if you notice any of the
- tachycardia, or a heart rate that’s more than 100 beats per minute
- shortness of breath or gasping
- abdominal bruising, bloating, or tenderness
- feeling dizzy, faint, or light-headed
- blurry vision
- shock
- low blood pressure (hypotension)
- swelling in the lower extremities, such as legs or ankles
- hands or feet are cold or clammy
- heavy vaginal bleeding that requires changing pads every hour, or passing large clots bigger than a plum
- reduced urination
When should I be concerned about bleeding after a C-section?
Light bleeding and discharge after delivery — regardless of whether you delivered vaginally or by C-section — is normal. Bleeding for roughly 5 weeks is also normal.
However, it’s important to get immediate medical attention if you’re soaking through a pad every hour for more than 2 hours, passing blood clots larger than a plum, or exhibiting symptoms like dizziness, confusion, and a fast heart rate.
Some bleeding after giving birth is normal. It may last around 5 weeks during the postpartum recovery period.
Normal bleeding refers to lochia, which includes the blood, mucus, and uterine tissue that’s released after birth. Mild cramping can also accompany this process as the muscles work to return the uterus to its original size.
The heaviest lochia typically occurs during the first few days after giving birth. Initially, the lochia is primarily blood. As you recover, bleeding should reduce and shift primarily to vaginal discharge — although this differs from person to person.
C-section recovery usually doesn’t have as much bleeding as those who delivered vaginally.
For those who opt not to nurse, your menstrual cycle should return to normal shortly after these 6 weeks. But if you opt to fully breastfeed or chestfeed, your period may take as long as 6 months past the 6-week recovery period to return.
Late postpartum hemorrhage signs and symptoms
Late postpartum hemorrhage (PPH) refers to very heavy bleeding that may last up to
PPH may cause similar symptoms to internal bleeding, such as dizziness, shock, fast heartbeat, and clammy feet and hands. It may also be accompanied by fever or uterine tenderness because of a potential infection.
In most cases, late PPH stems from uterine infections or placental tissue that wasn’t completely removed after giving birth.
Additionally, those with a history of PPH have a higher risk of experiencing it with subsequent pregnancies.
There are four common causes of internal bleeding and late PPH after a C-section. These
- Uterine atony: This occurs when the uterine muscle isn’t constricting the many blood vessels that were formed during the pregnancy.
- Trauma: Bleeding may occur if the uterine or the C-section lacerations or stitches rupture.
- Placenta: Blood clots or heavy bleeding may occur if the placental tissue was not completely removed.
- Thrombin: Having a deficiency in blood coagulation factors can make it harder for your blood to clot.
Several other factors may increase your risk of experiencing internal bleeding after delivery, including:
- personal or familial history of postpartum hemorrhage
- preeclampsia
- high blood pressure (hypertension)
- multiple birth pregnancy or large babies
- prolonged labor
- gestational diabetes
- obesity
- excess amniotic fluid buildup (polyhydramnios)
If left untreated or if interventions are taken too late, internal bleeding may lead to severe, life threatening complications. But taking a proactive approach to internal bleeding can lead to better outcomes.
The first step is accurately determining the source of the internal bleeding. This can include blood tests, ultrasounds, and physical examinations.
The next step can include a wide range of treatment methods depending on the severity or cause of bleeding, including:
- medications to contract the uterine muscle
- manual uterine massages to help your muscles contract
- repairing any cuts or tears in the vagina, cervix, or uterus
- uterine artery embolization
- blood transfusion
- placing an intrauterine balloon to help stop the bleeding
A healthcare professional can help develop the best treatment plan for you.
Lochia will typically be bright red for roughly 1 week after having a C-section. After this time, it should change to dark red, brownish, or even pinkish.
Eventually, the lochia should consist mostly of discharge, with minimal blood, as you progress through your postpartum recovery.
Bleeding should lighten as your postpartum period continues, but it’s not unusual for it to increase slightly occasionally if you’re engaged in more physical activity.
You may notice more bleeding when you resume your previous activities, but the bleeding should not return to the levels it was at immediately following your C-section.
If you need to replace more than a pad an hour for 2 hours, contact a doctor immediately.
Initial light bleeding and discharge during the days immediately following delivery are normal. But if the incision begins to change color, bleeds, swells, or becomes extremely painful long after your C-section, you should contact your doctor.
It may take up to 6 weeks for the scar to fully heal, but each person’s recovery timeline will be different.
Most internal bleeding tends to develop within 1 day of giving birth, but you may be at risk for up to 6 weeks after delivery. But this would be especially rare. If your bleeding increases rather than decreases during your recovery, contact your doctor.
Some researchers estimate that just over 8% of people who have a C-section birth experience PPH.
Most people who have a C-section will go through their postpartum recovery period without experiencing any severe complications or risks.
However, some people may be at a higher risk of internal bleeding or postpartum hemorrhage.
It’s important to get immediate medical attention if you’re experiencing heavy bleeding, blood clots, and symptoms like dizziness, a fast heart rate, and clammy skin. A doctor can assess your symptoms and develop an appropriate treatment plan tailored to your individual needs.