Blood
Clotting Postpartum: Risks of Large, Heavy Blood Clots
Aug
Some postpartum bleeding and blood clots are normal in the days and weeks after giving birth. As you recover from childbirth, the uterus is shrinking back to its normal size and shedding any extra blood and tissue.
But any heavy, excessive bleeding or blood clots that are bigger than roughly the size of a plum should be reported to a healthcare provider as soon as possible, as this could signal a more serious issue.
This article provides an overview of normal postpartum bleeding and blood clots, offering tips on the various warning signs you shouldn’t ignore.
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Postpartum Clot Size: What’s Too Big?
Postpartum bleeding (lochia) is common and often includes passing smaller blood clots that may have formed in the uterus.
To minimize the risk of complications, starting immediately after birth, your healthcare team will want to evaluate just how much blood you may be losing and the size of blood clots you may be passing.
Any blood clots should be smaller than a golf ball for a couple of weeks following birth. If you’re passing blood clots larger than an egg—or passing lots of blood clots with tissue—report this to your healthcare provider. They can determine whether it’s a sign of something more serious.
Risk Factors
Some people may be at a greater risk for dangerous heavy bleeding and clots after birth, known as postpartum hemorrhage (PPH). This is more likely if you’ve experienced certain conditions affecting the uterus, placenta, or blood clotting, including:
- Prolonged labor
- Having obesity
- Preeclampsia (high blood pressure during pregnancy)
- A prior pregnancy
PPH still happens in people with no known risk factors.
How Much Postpartum Clotting Is Normal?
Some postpartum bleeding and clots is expected, but this should gradually decrease over the course of several weeks. Here’s a rough timeline for what you might expect:
- First day after birth: A heavy flow of blood, with a small blood clot or two the size of a quarter up to a golf ball
- First week after birth: Moderate bleeding, with some small blood clots the size of a quarter
- Second week after birth: A lighter blood flow, with any blood clots measuring smaller than a quarter
- Two to six weeks after birth: A gradual reduction in blood flow that even stop for periods of time, with few to no blood clots
- Sixth week after birth: Some spotting as the menstrual period potentially prepares to return (at this point, any heavy bleeding or blood clots should be reported to a healthcare provider right away)
Managing Bleeding
Experts don’t advise using tampons to manage postpartum bleeding until you’re cleared to do so by your healthcare provider. Instead, try pads, sanitary towels, or period underwear as options to help contain the blood flow. Be sure to change them regularly. Wash your hands before and after to keep the area clean while your body heals.
Risks of Heavy Bleeding and Clots Postpartum
Passing lots of larger blood clots and losing a significant amount of blood after birth are symptoms of PPH.
Postpartum Hemmorrhage (PPH)
Risks of PPH include:
- Losing lots of blood quickly, which can cause a dangerous drop in blood pressure
- Shock
- Death, if not treated
Cases of PPH usually happen within the first 24 hours after giving birth. But this condition can also develop days or weeks after delivery. It’s typically caused by the uterus not contracting properly after the baby is born, which leads to heavy bleeding.
At the Hospital With Postpartum Clotting: Treatment
If it’s determined that you’re having excessive postpartum bleeding or blood clots, your healthcare provider will recommend treatment at the hospital or other medical facility.
Depending on your particular situation, this might involve:
- Checking to ensure all of the placenta has been delivered and removing any pieces that may remain
- Helping your uterus to contract via medication or hands-on abdominal massage
- A blood transfusion to replace lost blood, if necessary
- Intravenous (IV) fluids for hydration, if needed
- Surgery to locate the cause of the bleeding and clots and stop it
- In rare, life-threatening cases, surgery to remove the uterus (hysterectomy) to stop the bleeding
Consequences of PPH
Postpartum hemorrhage is treatable if your medical team can find the cause and stop the bleeding quickly enough. It is serious, though, and can lead to shock and, in rare cases, death due to a drop in blood pressure.
It’s estimated that roughly 1 to 5 out of 100 people giving birth will experience PPH, which is a leading cause of maternal mortality.
If You’re Worried or Unsure, Call for Help
The main signs that a bleeding or blood-clotting problem is at play include heavy, excessive bleeding from the vagina and passing large blood clots. Other signs that you’ll need to seek immediate medical attention are:
- Fever
- Low blood pressure
- Chills
- Blood soaking through two pads an hour
- Blurry vision
- Dizziness or weakness
- Rapid heart rate
- Shortness of breath
- Confusion
- Severe headache
Postpartum Care
Having a baby is a big change physically, mentally, and emotionally—and the postpartum period (12 weeks following childbirth) can be challenging. As you recover from giving birth, know that you can ask for help when you need it for yourself or your baby.
Attending postpartum checkups will ensure that your postpartum care team can assist or provide referrals for necessary follow-up care.
When Do Postpartum Blood Clots Stop?
Most people can expect to have postpartum bleeding and blood clots that gradually reduce to light spotting for up to six weeks. Over this time, you should not notice any new or large blood clots or a heavier blood flow.
Around six weeks, bleeding and blood clots should typically have resolved or stopped. At this time, it’s also possible that your menstrual period may start to return.
Summary
After childbirth, it’s normal to experience several weeks of vaginal bleeding and blood clots. This happens as blood and tissue are shed from the uterus while it contracts to normal post-pregnancy size.
Bleeding and blood clots no larger than a golf ball can develop over the first couple of weeks postpartum. The blood flow gradually becomes lighter, and the blood clots become smaller until they stop around six weeks postpartum.
Any heavy bleeding or large blood clots bigger than a golf ball should be reported to a healthcare provider immediately. This may indicate a dangerous and sometimes deadly complication known as postpartum hemorrhage.
