5.1.4  Check for heavy bleeding (haemorrhage)

After the birth, it is normal for a woman to bleed the same amount as a heavy monthly period. The blood should also look like monthly blood — old and dark, or pinkish. At first, the blood comes out in little spurts or gushes when the uterus contracts, or when the mother coughs, moves, or stands up, but the flow should reduce over the next two to three days and become the more watery reddish discharge known as lochia (Study Session 2).

Very heavy bleeding is dangerous. To check for heavy bleeding in the first six hours after birth check the mother’s pads often — 500 ml (about two cups) of blood loss is too much. If she soaks one pad per hour, it is considered heavy bleeding. If the mother is bleeding heavily, and you cannot stop it, take her to the hospital. Watch for signs of shock. Remember that postpartum haemorrhage is a major cause of maternal mortality and it can happen at any time in the postnatal period – though it is most common in the first seven days.