Q: Good morning doc. Please I gave birth 3 months ago. Few days before six weeks doc’s appointment, I had spotting that lasted for days. I complained to my doctor and he said it’s menstruation. Now last week the spotting started again. What could be the cause? Thanks.

A: ‘Bleeding’ after having a baby is normal. The reason is because as the placenta separates from the uterus when the baby is born, the blood vessels where the placenta was attached start to bleed…understandably, because they are open They bleed into the uterus (womb). As the womb starts to contract, it seals up the blood vessels such that bleeding stops significantly.

So, the ‘bleeding’ after having a baby is a mixture of blood, bacteria and tissue that has sloughed off/peeled off the uterus. This discharge is called lochia. In the first few days, there’s more blood in lochia giving it a bright red colour which eventually becomes more watery and pinkish and eventually becomes yellowish/whitish. This whole process may last 2 to 4 weeks or may come and go, as in the case described above. So, it’s not really a problem

Be sure to check the level of bleeding though and if you feel uncomfortable, please see your doctor. General rules of thumb that suggest there may be a problem are:

• If you’re bleeding heavily…perhaps you’re using a sanitary towel every hour for at least 2 hours or are passing out big clots.

• If your lochia has a bad smell and you start having fever and chills

• If your lochia is still bright red after 4 days of delivery.

Where in doubt, please err on the side of caution and see your doctor.