Patient :I gave birth vaginally 5 weeks and 2 days ago. I had to go back to work a little less than 2 weeks after giving birth, and my job as a manager at a fast food joint does require a lot of physical activity for up to 12 hours a day. My bleeding has suddenly turned bright red and has increased within the past couple weeks, enough to get me pretty concerned. The problem is, I can't afford to quit working or work less hours. Is this just the effect of doing too much too soon, and if so how should I handle it if I can't stop working?
Red lochia generally lasts for only the first few days after delivery. What you are experiencing now could be late or secondary postpartum hemorrhage. This term is used to describe moderate to severe bleeding that occurs between 24 hours and 12 weeks after childbirth, though late postpartum hemorrhages typically occur one to two weeks postpartum.This is mostly a result of uterus not contracting completely as a result of retained placental bits or amniotic membranes. It could also be because of pelvic/ uterine infections.
If the bleeding is heavy (more than one pad an hour) or if you develop additional symptoms such as fever, foul smelling lochia etc. I would suggest that you contact your doctor or his clinic immediately regarding the same. This kind of bleeding can sometimes become life-threatening, and you might even be hospitalized for the same.
Your doctor will examine you and may start an IV to give you fluid, medication to help your uterus contract, and possibly antibiotics. An ultrasound examination also might be needed to see if any placental tissue remains in your uterus. Depending on the cause of the bleeding, the treatment will vary from medical methods such as IV antibiotics, uterotonic agents to surgical methods such as a dilatation and curettage to remove the remnant tissues.
In any case, this is not something you should neglect and I suggest that you see your doctor immediately.
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