Blood clots after birth: Symptoms, treatment, and when to see a doctor

Those first days and weeks after birth are a whirlwind of diapers, feedings, and trying to remember the last time you drank water.
Somewhere in the middle of all that, you might notice something that makes your heart stop for a second: blood clots after birth.

The good news? Passing some clots in the postpartum period is usually normal. The not-so-good news? Sometimes clots can signal
serious complications that need fast medical care. The tricky part is knowing which is which.

In this guide, we’ll walk through what’s normal, what’s not, how doctors treat postpartum blood clots, and
when to see a doctor or call emergency services. This is general education, not a substitute for personalized medical advice
but it can help you feel more confident about what your body is doing.

Normal postpartum bleeding and blood clots (lochia 101)

What is lochia?

After delivery, your uterus sheds leftover blood, tissue, and mucus. This discharge is called lochia, and it happens after vaginal
birth and cesarean birth. It’s like your body’s cleanup crew after nine months of pregnancy and childbirth. Lochia changes over time and
can include small blood clots, especially in the first days.

• Days 1–4 (Lochia rubra): Bright or dark red, heavy, with small clots. Similar to a very heavy period.
• Days 4–10 (Lochia serosa): Pinkish or brown, lighter flow, fewer or no clots.
• Days 10–14 and beyond (Lochia alba): Yellowish or whitish discharge, light spotting or staining.

For many people, bleeding gradually tapers over 4–6 weeks, although a sudden increase can happen if you’ve been very active
or skipped some rest.

What do “normal” blood clots after birth look like?

It’s common to pass small clots, especially in the first few days after delivery when bleeding is heaviest. Normal postpartum clots are often:

• Smaller than a golf ball (many providers use “smaller than a quarter” or “smaller than a plum” as a rough guide).
• Occasional, not constant, especially as days go by.
• Associated with gradually decreasing bleeding overall.

A clot forms when blood pools in the uterus or vagina for a bit (for example, after you’ve been lying down), then exits when you stand or go
to the bathroom. That can look dramatic, but may still be within the range of normal.

When blood clots after birth may be a warning sign

While clots themselves aren’t automatically dangerous, certain patterns can signal a problem like postpartum hemorrhage
(heavy bleeding), infection, or retained placenta.

Clots and bleeding that need immediate medical attention

Call your doctor, midwife, or maternity unit right away (or follow your provider’s specific instructions) if you notice:

• Very large clots bigger than a golf ball, especially more than once.
• Sudden gushes of bright red blood that soak through a pad in less than an hour, or you’re doubling pads.
• Bleeding that gets heavier again after it had already started to slow down.
• Bleeding with foul-smelling discharge (strong, rotten, or unusual odor).
• Severe cramps or pelvic pain that’s not improving with normal pain medicine.
• Fever, chills, or feeling very unwell overall.

Very heavy bleeding with big clots can be a sign of postpartum hemorrhage, which is a medical emergency and one of the leading
causes of severe postpartum complications worldwide.

Lochia vs. dangerous venous blood clots

It’s helpful to separate two different issues:

1. Uterine/vaginal clots (what you see in your pad or the toilet) – part of lochia or heavy bleeding.
2. Venous blood clots – clots forming inside veins, usually in the legs or pelvis, which can travel to the lungs.

Lochia clots are visible and usually come out with bleeding. Venous blood clots (like deep vein thrombosis, or DVT, and
pulmonary embolism, or PE) are hidden but potentially life-threatening. Pregnancy and the postpartum period significantly
increase the risk of DVT and PE for about 6–12 weeks after delivery.

Symptoms of dangerous blood clots after birth

Signs of a blood clot in the leg or pelvis (deep vein thrombosis)

A DVT often forms in the deep veins of the leg or pelvis. After birth, watch for:

• Swelling in one leg (or arm), especially if the other side looks normal.
• Pain or tenderness in the calf, thigh, or groin that isn’t explained by an injury.
• Skin that feels warm to the touch over the painful area.
• Redness or darker discoloration of the skin.

These symptoms may develop gradually or relatively quickly. They don’t always scream “emergency” at first, which is why they can be easy
to brush off as “I probably just pulled a muscle.” If you suspect DVT, call your provider promptlydon’t wait “to see what happens tomorrow.”

Signs of a blood clot in the lungs (pulmonary embolism)

A clot that breaks loose and travels to the lungs is called a pulmonary embolism (PE), and this is a life-threatening emergency.
Call 911 (or your local emergency number) or go to the nearest emergency department if you have:

• Sudden shortness of breath or trouble breathing.
• Chest pain, especially sharp or burning, that gets worse with deep breaths or coughing.
• Rapid heartbeat or feeling like your heart is racing or pounding.
• Feeling lightheaded, faint, or like you might pass out.
• Coughing up blood.
• A sense that “something is very wrong” or severe, unexplained anxiety or doom along with these symptoms.

Postpartum PE is rare, but it’s one of the leading causes of maternal death. Quick emergency care saves lives.

Who is at higher risk for postpartum blood clots?

Anyone who has been pregnant and given birth has a higher risk of venous clots for a while. But some factors push that risk even higher.
Risk factors include:

• Previous history of DVT, PE, or a known clotting disorder (thrombophilia).
• Cesarean delivery, especially emergency C-section.
• Long labor, severe bleeding, or need for blood transfusion.
• Prolonged bed rest, limited mobility, or long travel soon after birth.
• Obesity (higher BMI).
• Age over 35.
• Smoking.
• High blood pressure disorders of pregnancy (like preeclampsia).

If you have several of these risk factors, your healthcare provider may talk with you about preventive measures, such as blood thinners
or compression devices, especially around the time of delivery.

How doctors evaluate blood clots after birth

For heavy bleeding and uterine clots

If you come in with heavy bleeding or large clots, the team will typically:

• Ask about how often you’re changing pads and the size and number of clots.
• Do a physical and pelvic exam to check your uterus size and firmness.
• Sometimes order an ultrasound to look for retained placenta or other causes of ongoing bleeding.
• Run blood tests to check your blood count and how well your blood is clotting.

For suspected DVT or PE

If a venous clot is suspected, testing may include:

• Compression ultrasound of the leg to look for DVT.
• CT scan or ventilation–perfusion (V/Q) scan of the lungs for suspected PE.
• Blood tests and monitoring of oxygen levels and heart rate.

Imaging choices depend on your symptoms, how recently you gave birth, whether you’re breastfeeding, and how stable you are.
The goal is to confirm or rule out a dangerous clot as quickly and safely as possible.

Treatment options for blood clots after birth

Managing normal postpartum clots and bleeding

For most people, small, occasional clots with a gradually lightening flow require only basic care:

• Using maternity pads (no tampons) and changing them regularly.
• Resting, especially if bleeding increases after activity.
• Feeding your baby often, which stimulates uterine contractions and helps reduce bleeding.
• Following up with your 1–2 week and 6-week postpartum visits.

Your provider may ask you to track how often you change pads and to call if bleeding increases or you pass larger clots.

Treating postpartum hemorrhage and large uterine clots

When bleeding is very heavy or clots are large, treatment may include:

• Medications to help the uterus contract (like oxytocin).
• Manual removal of clots or retained tissue from the uterus, often done in the hospital.
• IV fluids and possibly blood transfusions if you’ve lost a lot of blood.
• In rare cases, procedures or surgery to control bleeding.

Postpartum hemorrhage is an emergency, but with quick treatment, many people recover fully and go on to do well in future pregnancies too.

Treating DVT and PE after birth

Venous clots are usually treated with anticoagulant medications (blood thinners). Depending on the situation, your doctor may recommend:

• Injectable low molecular weight heparin (LMWH) – often used right after birth and compatible with breastfeeding.
• Oral anticoagulants such as warfarin, or in some cases other newer blood thinners, depending on your individual situation.
• Hospital monitoring, especially for PE or severe DVT.

Treatment duration often lasts several months and may be longer if you have an underlying clotting disorder or multiple risk factors.
Your provider will also discuss lifestyle steps and follow-up care to reduce your risk of future clots.

How to lower your risk of dangerous blood clots after birth

You can’t control every risk factor (sadly, there’s no “undo pregnancy” button), but there are practical steps you can take:

• Move early and often, as soon as your medical team says it’s safeshort walks around the room or hallway help blood circulate.
• Avoid long periods of sitting or lying still; change positions regularly.
• Drink plenty of water unless you’ve been given a fluid restriction.
• Wear compression stockings if your provider recommends them.
• Keep follow-up appointments and mention any leg pain, swelling, or breathing issues.
• Talk with your provider during pregnancy about your personal risk and whether you need preventive medications around delivery.

Most importantly, trust your instincts. If you feel something is wrong, say soloudly if needed.

When to call your doctor vs. when to call 911

Call your doctor, midwife, or maternity unit the same day if:

• You pass a clot larger than a golf ball (especially more than once).
• Your bleeding suddenly becomes heavier after it had slowed down.
• You notice a foul-smelling discharge or clots.
• You have a new, persistent pain or swelling in one leg.
• You feel dizzy, weak, or just generally “off,” even if you’re not sure why.

Call 911 (or go to the emergency department) right away if you:

• Soak through one or more pads in an hour and it continues.
• Have large continuous clots plus heavy bleeding.
• Have sudden shortness of breath, chest pain, or trouble breathing.
• Feel like you might pass out, or do faint.
• Have seizures or severe headache with vision changes.
• Have thoughts of harming yourself or your baby.

You never need to “tough it out” or worry you’re being dramatic. Healthcare teams would rather see you and reassure you than miss a serious problem.

Real-life postpartum blood clot experiences: what they can teach you

Every postpartum journey is different, but hearing what others have gone through can help you recognize warning signs and
feel less alone. The stories below are composites based on common experiences people reportnot any one specific personbut
they reflect real patterns doctors see.

1. “I thought the clots meant something was terribly wrong” – Normal lochia clots

In the first 48 hours after a vaginal birth, a new mom notices she’s passing clotssome the size of grapes, one about the size of a
large marble. Every time she gets up after feeding the baby, a small gush of blood and a clot appears. She panics, imagining worst-case
scenarios, but decides to mention it to her nurse.

The nurse asks how often she’s changing pads (about every few hours), checks that her uterus is firm and shrinking, and confirms that the clots
are still smaller than a golf ball and becoming less frequent. The nurse explains that clots are common when blood pools a bit while she’s lying
down and then comes out when she stands up. Over the next several days, the flow lightens, and the clots disappear.

Takeaway: Small, occasional clotsespecially in the first days with otherwise stable bleedingare often just a sign that your uterus is
healing and clearing out. It’s always okay to ask for a pad check or reassurance.

2. “The clots kept coming, and I started feeling dizzy” – Postpartum hemorrhage

Another new parent is home on day three postpartum. Bleeding had been like a heavy period, but suddenly she passes two very large clots,
each bigger than a golf ball. The pad she just changed is soaked in less than an hour, and she feels lightheaded when she stands up. Her partner
notices she looks pale and keeps needing to sit down.

They call the on-call nurse, who tells them to go straight to the emergency department. At the hospital, the team confirms her uterus isn’t
contracting well and she’s lost more blood than expected. She receives uterine contraction medications, IV fluids, and close monitoring. After
treatment, the bleeding slows, her blood count stabilizes, and she’s able to go home with a plan for follow-up.

Takeaway: Big clots plus heavy, ongoing bleeding and dizziness are red-flag symptoms. This is not “normal” postpartum bleeding. Getting help quickly
can prevent more serious complications and often means a shorter hospital stay.

3. “I just thought my leg hurt from carrying the baby” – Deep vein thrombosis

A first-time mom with a C-section delivery notices that one of her calves is sore and a bit swollen about two weeks after birth. She assumes
it’s from walking awkwardly with the baby or sleeping in a strange position. Over the next day, the pain worsens, and that leg looks a little
bigger than the other and feels warm.

During her phone check-in, she decides to mention italmost apologeticallyexpecting to be told it’s nothing. Instead, her provider asks her
to come in immediately. An ultrasound shows a deep vein thrombosis. She’s started on blood thinners and monitored closely. Because the clot
was caught early, it didn’t travel to her lungs, and she completes treatment at home while continuing to care for her baby.

Takeaway: If one leg is more swollen, red, warm, or painful than the other, don’t ignore it. DVT is treatable, but catching it early
greatly reduces the risk of a life-threatening pulmonary embolism.

4. “I couldn’t catch my breath walking across the room” – Pulmonary embolism

A few weeks after birth, a parent notices sudden shortness of breath climbing the stairs. At first, they blame being “out of shape,” but
the next day they feel sharp chest pain when breathing in and can’t walk from the bedroom to the kitchen without feeling like they ran a race.
They also feel a pounding heartbeat and a wave of panic.

They decide not to wait and go straight to the emergency department. Tests show a pulmonary embolism. They receive blood thinners, oxygen, and
monitoring in the hospital. It’s scary, but they recover and later say that listening to that “something is really wrong” feeling may have saved their life.

Takeaway: Shortness of breath and chest pain after birth are never symptoms to ignore. Even if the final diagnosis isn’t a PE, you are not
overreacting by getting checked out.

The bottom line

Blood clots after birth can be completely normalor a sign that you need urgent medical care. You don’t need to memorize every detail, but
remember these basic rules:

• Small, occasional clots with gradually decreasing bleeding are often part of normal postpartum lochia.
• Very large clots, heavy bleeding, foul odor, or feeling faint or unwell need prompt medical attention.
• Leg swelling, pain, warmth, and rednessespecially on one sidecan signal a deep vein thrombosis.
• Sudden shortness of breath, chest pain, or coughing up blood are emergency signs of a possible pulmonary embolism.

When in doubt, call. There’s no award for ignoring symptoms, but there’s a lot to gain from speaking up earlylike being there, healthy and
strong, for all the future first smiles, first steps, and first “why is the baby so quiet?” moments.

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