I keep thinking it’s time for a post with more pizzazz, but if we’re going to be honest, I’m a Women’s Health educator and much of the info isn’t so glamorous. 😉 So while the subject of Postpartum Bleeding can’t exactly be defined as fun and upbeat, it’s one with real (dare I say unique) importance to frum woman, and we’ll be breaking it down into a few posts so it’s less intimidating.
I know from personal as well as professional experience that what you read about postpartum bleeding and what you actually experience postpartum can be worlds apart. And when you’re trying to get to the mikvah, that can be so frustrating/disempowering/scary – feel free to fill in the right word for your situation!
I’m always happy to toss around official data, but some of my info here is just plain anecdotal. “How fast can you get a week of clean bedikahs?” isn’t a well researched question. All that to say that this post is going to be Real World.
Before we get to some of the most common questions and concerns, I want to make sure one thing is clear. It’s probably obvious to some, but not everyone has thought it through (and that’s ok – there are many other things to think about postpartum!).
Postpartum bleeding (lochia) is not the same as menstrual bleeding (a period). I’m not talking the length/amount here; obviously those are different. I’m talking about the source and makeup. I don’t want to get too detailed for those who are definitely NOT interested, but… When a woman has her period, she’s shedding a relatively thin layer of blood from the lining of the uterus. It’s basically a fixed amount. There’s more involved with postpartum lochia (a thicker mucous membrane, white blood cells, small fragments of placental tissue, a “scab” called eschar where the placenta was attached to the uterine wall), and the flow changes according to a variety of factors such as exercise and uterine muscle tone. We’ll get back to this.
How long is it normal to bleed for after birth?
The official response:
| Lochia Name | Lochia Description | How long it lasts |
| Rubra | red, heavy | 2-4 days postpartum |
| Serosa | pinkish brown, lighter in color and amount than rubra | Up to 10 days-2 weeks postpartum |
| Alba | white or yellowish | From 10 days to 4-6 weeks postpartum |
Pause for a second. Look at that chart again. They described basically 10 days to 2 weeks of bleeding after giving birth. That suggests most women would get to the mikvah around 3 weeks. BUT THEY DO NOT. (I mean, some women do. Which is totally cool. And need not pressure the rest of us.)
The real world response:
- From around 10 days, most bleeding that you see will be very light flow or spotting of brownish pink, mixed in with other lighter white or yellow discharge. Not red, but still considered a problematic color halachically by most rabbanim.
- Most women have to wait 4-6 weeks until they can do a hefsek and follow up with bedikahs. (Many poskim recommend skipping the Moch postpartum due to localized discomfort or sensitivity, check with your LOR).
- As a general rule, if you start too early you’ll find yourself starting and stopping, or stressing over a multitude of shaylahs. It’s generally worth waiting for a few clean days before you begin, just for your sanity.
- It’s normal to have a limited few hours of brighter red and heavier bleeding around 10 days postpartum – that’s when the scab from the placenta site comes off. (Not everyone will experience that. Kind of like losing a mucus plug; it can come out at once or break away in small pieces over time.)
- Having some bright red bleeding briefly (spotting or a light flow, not passing big clots) after a week or two of being “nearly clean” can also be ok. It doesn’t mean you’re back to stage one, it probably means you pushed your body too hard in the last day or two.
- If you are 8 weeks postpartum and still haven’t been able to get clean, it’s time to do more thorough investigation. While 8-10 weeks is still within the range of “normal”, there may be something else going on that your physician or a bodeket can help with to get you to the mikvah sooner.
What are some “Red Flags” postpartum ?
Contact your OB provider right away if you experience any of these symptoms:
- soaking through more than one pad every hour
- bleeding that’s accompanied by sudden and severe pain and/or cramping
- bleeding continuously for more than seven days
- blood clots that are bigger than a softball or grapefruit
- foul-smelling discharge
- a sudden fever
- severe headache
- trouble breathing
Keep in mind: you should see your heaviest bleeding in the first few days postpartum. Sudden significant bleeding after lochia has tapered off, especially if it is accompanied by a strong sense of weakness or feeling ill, should be reported immediately.
To be continued…
Follow up blogposts to address:
- Are you speeding up or slowing down the postpartum bleeding process?
- Getting to the mikvah postpartum
P'nima Wellness 