See Postpartum Bleeding: Real World Expectations for Part 1 on this topic.
Can I make this process speed up? Is something I’m doing slowing it down?
To some extent, how long you bleed for is just built in – the same way there are women with healthy cycles who have 3 day periods, and there are women with healthy cycles who have 7 day periods. (It’s some multifactorial situation involving clotting factors, prostaglandin production, and the constriction of arterioles. And now we’re getting too techinical even for me!)
That being said, the Number 1 thing you can do is REST. Remember when I said postpartum bleeding is not the same as period bleeding? The way you can see this most clearly is that postpartum bleeding will increase after exertion. Your uterus needs to tighten up and seal off the blood supply that was feeding your baby. This is very different physiologically from shedding a lining built up to support the implantation of a new pregnancy (period bleeding).
So…when you’re making a Shabbos bris and someone offers to push you in a wheelchair to shul? Say yes. Please. It’s not weak, it’s not embarassing. It’s taking care of your body, your shalom bayis, and your baby. You’re one month postpartum, still haven’t made it to the mikvah, and you want to get back to running? Just wait a few more weeks. Let your uterus finish up the process of growing a baby, birthing a baby, and “getting back in shape” in a way that you can’t see.
It’s possible that taking Vit C with Bioflavanoids will help some women get clean faster postpartum, though that recommendation is most commonly used for women with long periods. Drinking a lot of water is never a bad idea. And I’m sure there are many other solutions people suggest that I’ve just never heard of, as they’re not based on scientific evidence. (Something about lemon juice is popular here in Israel? Feel free to comment below if you know more.) But honestly, being patient and laying low has the most to offer (and yes, may be the hardest to actually follow through with).
Other Considerations:
- After a C section, some women will experience less bleeding in the first few days postpartum than those who had a vaginal birth because of how the uterus is “cleaned up” after delivery. On the flip side, the light bleeding may go on longer for some women because it’s a bit harder for the uterus to contract tightly after surgery.
- There is an additional complication that can happen after a c section called a surgical “niche,” where blood collects in a small pocket next to the scar. Usually bleeding from a niche will be a darker brower, and spotting/light bleeding can occur after periods as well, later on. Your OB provider should be able to assess for this with ultrasound. (Post cesarean surgical niche has recently become a popular topic in medical literature – if your provider is less up to date, s/he may not recognize the term immedately.)
- If a woman has had many children (what we’d called medically a “grand multipara” – cool title, no?), her uterus may just take longer to tighten up. It’s been stretched out many times and the tone of the muscle is looser, which can slow things down.
Plus, keep in mind that bright red bleeding after 6 weeks postpartum is more likely to be a period than postpartum bleeding (assuming no serious complications with additional symptoms like fever, discharge with a strong bad odor, severe pain, etc.). The first postpartum period is often heavier than usual and can include small clots (for women who resume mensturating within the first few months after birth).
A brief note on when to expect postpartum periods, while we’re side tracked that way anyhow:
- When a woman is not breastfeeding, she can expect to ovulate within 1-3 months of giving birth and have a period 2 weeks later.
- Women who breastfeed generally have a delayed “return to fertility” due to a few different hormonal factors. That’s a topic for another post, but for a woman who is exclusively breastfeeding, the average time to ovulation is 5-6 months.
- Remember, “average” means that some women will have their periods right away. And for some they won’t return for a year or more!
- It seems you can expect a woman to be pretty consistent with her own history, assuming each baby nurses well.
- When periods resume, they can remain irregular for a while, especially while breastfeeding.
- If a woman has a veset kavuah before becoming pregnant, she should speak to her Rav about when to resume tracking her onot that way. For 24 months postpartum a woman has the halachic status of a meineket whether she is breastfeeding or not. One cannot estabish a veset kavuah during that time. There are those who say the veset kavuah is suspended the entire 24 months, and there are those who say the veset kavuah is reinstated when a woman stops nursing, even before 24 months. (The veset kavuah is always reinstated at 24 months, even if a woman is still breastfeeding.)
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