Yes, you’ll still need to wear a postpartum diaper after a C-section
Postpartum bleeding, or lochia, happens no matter how you gave birth.
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Postpartum bleeding (also called lochia) is probably far from any woman’s favorite postpartum symptom, but it’s very much a normal part of postpartum recovery—no matter how you gave birth. That fact may surprise you—as Chrissy Teigen recently lamented after the birth of her fourth baby this year, whom she delivered via C-section.
“She’s here! Esti Maxine Stephens—the house is bustling and our family could not be happier,” Teigen captioned a photo announcing the new baby’s arrival. “Daddy sheds nightly tears of joy seeing Luna and Miles so full of love, and I am learning you still need diapers with a c section!? We are in bliss. Thank you for all the love and well wishes—we feel it all!”
During pregnancy, your body went through myriad changes to grow your baby. Now that the baby is here, it makes sense that your body needs to heal. Your body’s natural healing process after birth will involve some vaginal bleeding or spotting—how much postpartum bleeding you experience will depend on your individual body and your birth experience. It’s also normal for postpartum bleeding to be especially heavy or noticeable in the days right after birth.
But just because it’s “normal” doesn’t mean we automatically know what to do about it. So let’s explore postpartum bleeding—why it happens and what to do about it.
Why postpartum bleeding happens
Postpartum bleeding, called lochia, happens whether you have a vaginal or Cesarean birth. Bleeding may last up to six weeks or longer after labor and delivery.
The bleeding and discharge occur for a few reasons. The blood remaining in your uterus from birth and remnants of the pregnancy need to be expelled after the baby is born. Your uterus is also healing the site where your placenta was attached. It’s much like a wound that needs time to get better.
If you are at all concerned about how much you are bleeding, let your birth team know right away.
Related: 3 tips on childbirth recovery tips from a postpartum doula
How much postpartum bleeding is normal
Lochia changes as time passes.
For the first three to five days, postpartum bleeding will feel (and look) like a moderately to heavy period. The blood will be red or dark red with a moderate flow (called lochia rubra.) You may see a few small pieces of the amniotic sac, vernix (the white waxy substance that covered your baby in the womb) or lanugo (your baby’s downy body hair) in those first days.
You may also have some blood clots, which can be normal. Blood clots form when blood is stagnant, or not moving. So, if you sleep for a period of time and then stand up, you may see or feel a clot or two come out. You may also have a gush of blood when you stand up because the blood has been pooling in your vagina while you were lying down.
Related: 9 postpartum undies that make the fourth trimester a little easier
By the end of the first week, the lochia rubra will transition into lochia serosa, which consists of a lighter flow and lighter color. It’s usually light red or brownish-red instead of deep red. Lochia serosa lasts about two weeks, though this can vary—for some women this type of postpartum bleeding will last for just 10 days, while others may experience it for up to four weeks.
After lochia serosa comes lochia alba. This is more like vaginal discharge than bleeding. It is yellowish-white in color and may last until around week six postpartum.
Will I have postpartum bleeding after a C-section?
Many women are surprised to learn that they will still have vaginal bleeding after a C-section, even if they did not experience any contractions. To put it plainly, yes, you’ll still need to wear a postpartum diaper after a C-section birth. The blood comes from your uterus, which is healing the place where the placenta detached, as well as recovering from surgery and healing from all those months of pregnancy.
Though other aspects of C-section recovery may differ from vaginal birth recovery, the postpartum bleeding after a C-section will be much like the bleeding after a vaginal birth.
Can I use a tampon for postpartum bleeding?
For the first months of postpartum, either pads or disposable or washable absorbent underwear are the best ways to manage postpartum bleeding. Tampons are not recommended. If you had a vaginal birth, your vagina is sensitive and healing, and tampons will impact that process. With either type of delivery, tampons can increase the risk of toxic shock syndrome.
Our top picks to help manage postpartum bleeding
When should I call my doctor or midwife about postpartum bleeding?
It is possible to bleed too much—this is called a postpartum hemorrhage, and it requires immediate medical treatment. While most postpartum hemorrhages happen right after birth, they can happen days or even weeks later, so it is important to pay close attention to how much you are bleeding.
Signs of too much postpartum bleeding include:
- A sudden increase in bleeding or sudden return to bright-red bleeding when it’s been brown or pink
- Filling a pad with blood within one to two hours
- Multiple blood clots, or one clot that is the size of a golf ball or larger
Other concerning signs to report right away include:
- Foul-smelling vaginal discharge
- Blurred vision
- Dizziness, light-headedness or weakness
- Fast heartbeat or rapid breathing
- Clammy skin
- Nausea or vomiting
- Swelling in the vaginal area
Our intention is to never worry you too much, mama, but when it comes to postpartum bleeding, we drop our guard on that a bit. It is essential to be aware of the risk if you have a problem because it’s likely that you are going to be the one to identify it first, not your medical team. This is a vital area to practice your self-advocacy.
If you have any concerns, call your provider, go to the emergency room or call 911 right away.
How to optimize postpartum healing and recovery
Over the course of six to eight weeks, you will start to feel a lot better—though full recovery from birth takes about a year.
Here are a few tips to help you feel better and heal after birth:
- Sitz bath: This is a plastic basin that goes on your toilet. It is filled with water and acts like a whirlpool for your bottom. Several times per day for about 20 minutes, sit with your bottom immersed in the sitz bath. Use room temperature or warm water (not hot). You can also mix in two tablespoons of witch hazel and a few drops of lavender essential oil. If you decide to use your bathtub, make sure that it is cleaned and disinfected so your perineum doesn’t become infected.
- Padsicles: Take a regular menstrual pad and line it with witch hazel (either poured from a bottle or presoaked towelettes). You can then add a tablespoon of aloe vera and a few drops of lavender essential oils if that’s your preference. Place the pad in your underwear, or if you don’t need it right away, wrap it up and put it in the freezer until you do.
- Pee frequently: When your bladder is full, it can push the uterus off to one side, which impacts the uterus’s ability to heal and shrink. Stay hydrated and empty your bladder about every two hours while awake to prevent this from happening.
- Rinse, don’t wipe: When you go to the bathroom, avoid wiping yourself clean when you can. We love products like the Frida Peri Bottle to rinse away urine and blood.
Mama, you just went through the Herculean tasks of pregnancy and birth—be patient with your body. It will take time for you to get used to the changes your body goes through after delivery.
By giving yourself a chance to adjust, you are allowing your body to heal properly. If you still don’t feel comfortable after some time, whether physically or emotionally, reach out to your doctor for advice on how to navigate it.
A portion of this story was excerpted from The Motherly Guide to Becoming Mama. A version of this story was originally published on June 24, 2021. It has been updated.