Postpartum bleeding

I just had a baby six weeks ago. During my six week checkup I had a pap smear done. I am bleeding a bit again and was wondering if this is normal.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I think we've all been misled regarding postpartum bleeding because we expect it to go away by 6 weeks when in fact it can last up to 3 months and still be perfectly normal. If:

    • the uterus has returned to normal size,
    • you are not running a temperature,
    • you are not passing clots or tissue or feeling exceptionally fatigued,
    • and there is no foul odor associated with the bleeding, then all is probably fine.

 

In addition, newer techiniques of pap smear collection often cause the cervix to bleed for a short time. Contractions of the uterus are initiated during a pelvic exam as well as during exercise, intercourse, and breast feeding which can cause a bit of bleeding as well. Post partum spotting can also be initiated by contraceptive methods such as oral contraceptive and depot provera.

I would recommend that if it continues, especially if it is heavy, you should try to get more rest. You didn't mention if you had a C-birth, but if you did, it takes longer for the uterus to return to normal size and the bleeding will last a bit longer.

It is even remotely possible that you have begun to have periods again, especially if you're not breastfeeding. Also, I tell my community clinic patients that bleeding in between periods can be a sign of chlamydia.

The safest thing, of course, is to consult your own provider but I hope this has been helpful.

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