It's not so easy for mums to tell the difference between a blocked period and just a few hours of reduced flow. If you have the impression that you have too little menstrual flow, you should not be afraid to look at the pads for a whole day. This is because it is important that you have enough flow throughout the day. There may be slightly less flow in between. This can happen when you are sleeping or lying on the sofa. When you start moving around more, your flow should resume. You can recognise a real congestion of your period by the fact that movement does not change anything. It then remains small and there is too little in the pads you used during the 24 hours for the time after the birth.
A genuine blockage of the lochia must be treated. It can lead to serious complications.
In this article, our midwife Katharina explains what you can do to prevent a blockage, when you need to see a doctor and what measures you can take to support medical treatment.
For many mums, the flow stops for a few hours. If the congestion lasts longer, it can lead to serious complications in the postpartum period. This is because the blocked blood is a good breeding ground for germs, which cannot be transported out of the uterus during a blockage. This is why puerperal haemorrhage can lead to puerperal fever. Puerperal fever is a serious complication in the puerperium. It often results from congestion during labour. It is therefore important to recognise it and treat it quickly. In this article, our midwife Katharina explains how you can recognise congestion, how your doctor will treat you and what you can do yourself to support the treatment.
In the case of lochia (Lochial congestion, lochiometra) is a congestion of the lochia. This means that the remains of pregnancy and labour can no longer flow out of the uterus. If left untreated, this can lead to puerperal fever and other serious inflammations in the body.
What are the symptoms of a blocked menstrual flow?
The most obvious sign is a sudden absence or premature cessation of menstrual flow. It may also be that there is suddenly an unusually low flow of lochia. Other signs are
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- - foul-smelling menstrual flow (distinctly different odour to the smell of your period)
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- - Very soft and pressure-sensitive uterus
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- - Enlarged uterus
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- - Mild to severe abdominal pain
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- - Pulling to stabbing headaches (especially at the temples)
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- - Earache
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- - Fever
Postpartum fever (also known as puerperal fever) is a common consequence of untreated postpartum haemorrhage. You should see a doctor at the first sign and have your menstrual flow checked if you don't have a midwife who comes to your postnatal visits. If you have a high temperature and severe uterine pain, you need to act quickly: please see a doctor immediately.
How does lochia develop?
There are various reasons why you may experience congestion during labour. One possibility is cramping of the cervix, which leads to premature closure of the inner cervix. This can lead to the fact that the lochia can no longer flow through the cervix.
Too much clotted blood or residue from the egg membrane can also block the cervix, which ultimately leads to a blockage of the lochia. A uterus that is very strongly tilted forwards or backwards also triggers congestion of the lochia. This leads to the cervix being kinked and the lochia not being able to drain.
If remnants of the placenta remain in the uterus after the birth, they can hinder the uterus from involuting.
If the uterus does not contract enough, i.e. the contractions are too weak, the lochia may not be expelled from the uterus. The lochia then accumulate in the uterus.
It is therefore important to know what the cause of the menstrual flow blockage is.
Here's what you can do to prevent a blocked menstrual flow
A blockage of menstrual flow occurs because the involution of your uterus is not proceeding or cannot proceed properly.
The best preventative measure you can take is therefore to support the involution of your uterus.
These measures give your uterus strength and the right position for involution:
Frequent breastfeeding: The stimulation of the nipples ensures that your uterus also receives the hormone oxytocin. This provides your uterus with natural support for the removal of your menstrual flow.
Lying on your stomachLying on your stomach while sleeping or after breastfeeding promotes the involution of the uterus. It is best to try to lie on your stomach for a few minutes as early as possible or even to sleep like this. If the breast hurts when lying on your stomach due to the milk coming in, lying on your stomach is often only possible for a short time and with good breast support.
Empty the bladder frequently: After the birth, the feeling of constantly having to go to the toilet to pee has disappeared for most mums. And the baby needs so much attention that going to the toilet is often secondary. However, this is not good for the involution of the uterus. A full bladder leads to congestion during labour. Make sure you take the time to empty your bladder regularly. If you go to the toilet before every breastfeeding session, a full bladder will not prevent involution.
How is lochia diagnosed?
The midwife can feel the size of your uterus and its firmness. If it is too large or very soft in relation to the day of labour, then its involution is impaired. This may be due to the fact that there is postpartum discharge in the uterus. She will then support the involution with massages and give you tips on what you can do yourself to clear the congestion.
In midwife Katharina's workshop, learn why it is crucial for new mums to recover properly after giving birth. She will share insights on what happens to your baby after birth, what decisions you will have to make and, above all, how you can enjoy the upcoming postpartum period to the full. This phase is of great importance to build a close bond with your baby.
Can I clear my lochia myself?
Your own measures must be successful after a few hours. You can then try them if you feel healthy overall. As soon as you experience symptoms such as headaches, fever, pain or a foul odour from your discharge, you must see a doctor immediately.
You can support your doctor's treatment. Postpartum haemorrhage is a serious postnatal complication that you should never treat on your own. Once your doctor has made a diagnosis and suggested a treatment, there are a few things you can do to help you recover more quickly:
Gentle abdominal massageRegular abdominal massages with gentle clockwise pressure around the navel can help to relieve congestion.
Heat helpsIf you have the go-ahead from your doctor or midwife, you can take a lukewarm sitz bath. A handful of dead sea salt stimulates the bleeding. However, the sitz bath should only reach up to the belly button.
Cold helps: A cool pack on the abdomen helps your uterus to contract and thus promotes the menstrual flow. However, you should make sure that the cold is applied to the upper edge of the uterus and that the treatment is not too extensive. You should not cool down.
Postnatal teaOur midwife Katharina recommends a postnatal tea that stimulates the uterus. The postnatal tea is made from equal parts of the herbs lemon balm, lady's mantle and shepherd's purse. Add one teaspoon to a cup of water and leave to infuse for ten minutes. You can drink up to three cups a day.
If these measures do not help, you need to see a doctor with this problem.
The doctor can immediately recognise with an ultrasound whether fluid has accumulated in your uterus. There are now two treatment options:
The doctor tries to reactivate the uterus. It should contract again and thus stimulate the labour flow. Treatment is then carried out with a drug that stimulates labour. This can be done with the synthetically produced hormone preparation oxytocin, but also with a prostaglandin preparation. The medication is often Cyclotec given. This medication is suspected of having sometimes life-threatening side effects during labour. These concerns do not apply to the treatment of postpartum haemorrhage. We have written an article on its use for inducing labour:
Cyclotec: Contraceptive with fatal consequences
If the cause of the congestion is a cramp in your cervix, a different form of treatment will be necessary. The congestion is caused by the Administration of antispasmodicöSend medication dissolved. These are intended to relax the cervix and are only available on prescription. Sometimes, however, it is sufficient for the doctor to mechanically dilate the cervix slightly so that the accumulated fluid can drain out.
You can still support the medical therapy with the measures described above.
