Hesperian Health Guides
In the Weeks After Birth
Bleeding
Bleeding normally continues for a few weeks. At first it is about the same amount as a heavy menstrual period and then it lessens, becomes more watery, and stops after 2 or 3 weeks. Filling a thick pad or rag with blood in 1 hour (or faster) is too much.
If bleeding increases in the days after birth, the mother may just need help with her chores and care for her other children so she can rest more. But sometimes bleeding is caused by something left inside the womb, and sometimes it is caused by infection.
To help stop bleeding, first help the mother breastfeed. This makes the womb contract. Also remind her to urinate often. Show the mother how to massage her womb to make it firm. If none of that works, give oxytocin or misoprostol and look for signs of infection.
Infection
A woman’s temperature often goes up about 3 days after the birth when her milk comes in. A lasting fever or fever of 38° C or higher is a sign of infection.
It is normal for vaginal discharge to have a strong smell for several days after birth. But a foul or fishy smell after birth is a sign of infection inside the womb. Other signs include chills, fast pulse, or pain or tenderness around the womb.
Treat any sign of womb infection with ampicillin, gentamicin, and metronidazole. If possible, use injectable antibiotics at least for the first 2 days. If you do not have antibiotics, or if the woman does not start to get better in 24 hours, get help.