Bleeding after birth is normal, it is called lochia, and it carries on for a few weeks. What matters is the direction. It should get lighter and browner as the weeks pass, and it should never suddenly get heavier.
The hard part is knowing where the line sits, and a lot of people are discharged without ever being told the number.
The discharge folder nobody reads
You leave hospital with a bag, a baby, and a folder of leaflets. Somewhere in that folder there is probably a page about what to expect. Nobody reads it in the first week, because the first week is not a reading week.
So the information arrives the other way round. Something happens at 2am, and only then does anybody go looking, and by then you are searching from inside the worry rather than ahead of it.
This is the page to read before you need it. Ten minutes now is worth an hour later.
What normal looks like
ACOG says bleeding may start bright red, and within a few days it should become lighter and more pink. The NHS describes the same arc from the other end: it gradually turns brownish and decreases until it stops.
It is heavy at the beginning. The NHS says you will need super absorbent period pads and should change them regularly, washing your hands before and after.
That hand washing line reads like fussiness and is not. There is an open wound inside the uterus where the placenta detached, and it does not feel like a wound, which is exactly the problem. Nothing about the experience signals “you are healing from an injury” the way a visible one would.
The trend matters more than any single day. Lighter and browner is what you want. Heavier than yesterday is what you watch for.
Why it gets redder during a feed
If the bleeding looks redder and heavier while feeding, that is expected. The NHS explains that breastfeeding makes the womb contract, which is also why period like cramps turn up mid feed.
Nobody mentions this one in advance, and it is a genuinely alarming thing to discover on your own. If your evenings have turned into one long feed, our post on cluster feeding covers that pattern.
How long, and why nobody gives you a number
You will see four to six weeks quoted everywhere. Neither ACOG nor the NHS publishes a fixed end date. The NHS says it carries on for a few weeks and leaves it there.
That is frustrating when you want to know whether you are normal, and it is honest. The one concrete marker either body offers is indirect: the NHS says no tampons until after the six week postnatal check, because that wound has not healed.
So the useful question is not how many weeks you are at. It is whether it is still tapering.
The numbers that mean call now
This is the part to memorise, and it is also where two respected bodies publish different thresholds.
| Sign | Who publishes it |
|---|---|
| Soaking through one or more pads in an hour | CDC, Urgent Maternal Warning Signs |
| Soaking through two pads an hour for more than 1 to 2 hours | ACOG, definition of postpartum hemorrhage |
| Clots bigger than an egg, or passing tissue | CDC |
| Losing blood in large clots | NHS |
| Sudden or very heavy loss with feeling faint or a racing heart | NHS |
| Discharge that smells bad | CDC |
When two thresholds disagree, act on the lower one. The CDC line of one pad in an hour is the earlier alarm and it is the one to use. Calling and being told it is fine costs an hour. Waiting costs something else.
Note also that the NHS lists feeling faint and a racing heart together with the heavy bleeding, and names the cause outright: postpartum haemorrhage. Feeling faint is not a milder separate symptom. It is part of the same picture, and it is the part most likely to get explained away as tiredness, because at that point everything is explained away as tiredness.
Say the number out loud to someone
This is the practical bit that turns the table above into something that works.
The person bleeding is exhausted, is often the last person to want to make a fuss, and is being handed a baby every two hours. Whoever else is in the house should know the number too. One pad an hour. Clots bigger than an egg.
Partners tend to hover with no idea what they are watching for, which converts into either constant low grade anxiety or missing the actual thing. A specific number solves both. It is much easier to be useful with a threshold than with a vague instruction to keep an eye on things.
The risk does not end at discharge
ACOG is direct: postpartum hemorrhage usually happens within 24 hours of delivery, but it can occur up to 12 weeks later.
The most common cause is uterine atony, where the uterine muscles do not contract normally, so the blood vessels do not tighten after delivery. ACOG also lists retained pieces of placenta, clotting disorders, and tears in the uterus, cervix or vagina.
The CDC goes wider. Its urgent maternal warning signs apply during pregnancy and in the year after delivery. Being past the six week mark is not a reason to talk yourself out of calling, and it is a very common reason people do.
The other things in these same weeks
- Fever of 100.4°F (38°C) or higher. On the CDC list. Paired with a sore, tender tummy, the NHS flags possible infection.
- Uterine infection. ACOG describes endometritis, usually 2 to 10 days after delivery, though some women develop it up to 6 weeks after. Untreated it can cause sepsis.
- High blood pressure. Postpartum preeclampsia most often happens within days but can occur up to 6 weeks later, including in women whose blood pressure was normal throughout pregnancy. ACOG says call right away for a systolic reading of 140 mm Hg or higher, or diastolic of 90 or higher.
- Pain or swelling in one calf. CDC flags this up to 6 weeks after birth. The NHS notes redness can be harder to see on brown and black skin.
- Thoughts of harming yourself or your baby. On the CDC’s urgent list, in the same tier as haemorrhage. Our post on baby blues and postpartum depression covers that separately.
No tampons yet
The NHS is specific. Not until after the six week check. Internal period products including menstrual cups raise the infection risk before that wound has healed. Maternity or period pads until then.
The six week check is not the only appointment
Most people assume postpartum care is one visit at six weeks. ACOG changed that in 2018 and reaffirmed it in 2025.
Rather than an arbitrary six week check, ACOG recommends contact with a maternal care provider within the first 3 weeks, then ongoing care as needed, concluding with a comprehensive visit no later than 12 weeks. For anyone who had a hypertensive disorder in pregnancy, it recommends a blood pressure check no later than 7 to 10 days postpartum.
ACOG’s own reasoning is worth repeating: postpartum care should be an ongoing process rather than a single encounter. If you have only been booked for one appointment at six weeks, asking for earlier contact is not being difficult. It is asking for what the guidance already says you should have, and it is much easier to ask when you have the sentence ready.
Your period, and getting pregnant again
The NHS says if you bottle feed, or combine bottle and breast, your first period could start as soon as 5 to 6 weeks after birth. If you fully breastfeed including at night, it may not return until you reduce breastfeeding.
The one that surprises people: you can get pregnant again just 3 weeks after birth, even while breastfeeding and even with no period. The NHS advises starting contraception within 21 days.
Three weeks. Read that again, because at three weeks postpartum the idea is so far from anybody’s mind that it functions as genuinely new information.
The short version
- A few weeks of bleeding is normal. Red to pink to brown, tapering.
- One or more pads soaked in an hour is the CDC threshold for calling. Use that one.
- Clots bigger than an egg, passing tissue, or a bad smell all mean call.
- Feeling faint or a racing heart alongside heavy bleeding is part of the emergency, not separate.
- Haemorrhage can happen up to 12 weeks out. CDC warning signs run a full year.
- No tampons until after the six week check.
- ACOG says contact a provider within 3 weeks, not just one visit at six.
- Tell whoever else is in the house the numbers.
Sources
- American College of Obstetricians and Gynecologists, “3 Conditions to Watch for After Childbirth”
- American College of Obstetricians and Gynecologists, Committee Opinion No. 736, “Optimizing Postpartum Care”, May 2018, reaffirmed 2025
- Centers for Disease Control and Prevention, HEAR HER Campaign, “Urgent Maternal Warning Signs and Symptoms”, 15 May 2024. List developed by the Alliance for Innovation on Maternal Health
- NHS, “Your body after the birth”, last reviewed 25 April 2024
A note on this post. Written and edited by the NewBloom editorial team. NewBloom is not written by doctors, nurses or midwives, and nothing here is medical advice. We read the current guidance from bodies like ACOG, the CDC and the NHS and write down what it says, with every claim traced to its source and named in the sentence where it appears. General guidance is not the same as an answer about your own body. Your doctor, midwife or health visitor can examine you and we cannot, so anything here that raises a question about your own recovery is a reason to ask them. If something is wrong right now, contact your doctor or your local emergency number. More about how we write these posts.