You have just had a vaginal delivery and are set to go home with your bundle of joy. It is worth noting that the vagina following delivery is prone to so many ills which you need to be aware of and keep abreast of so your joy remains undisturbed by these ills. One of these ills is a vaginal discharge.
The discharge that comes from your vagina following delivery is in various forms and ranges from the normal to the abnormal and you need to be able to distinguish the abnormal discharge from the normal discharge so that problems are treated early without leading to complications. The type of vaginal discharge that you have following your delivery can be used to gauge the overall health of a postpartum mother.
The Vaginal Discharge
Having a vaginal discharge is a natural flow of events on account of the presence of a vagina as a body organ. The cells on the vaginal wall produce some secretions that help to keep the vagina wet and maintain the health of the vagina as a vagina that is always dry is not healthy or is entering into the climacteric or menopausal phase.
The type, color, consistency, quantity and smell of the vaginal discharge is what is important in determining if the discharge is a healthy one or not.
Normal Discharge
Lochia
The classical presentation in a woman following delivery is for the initial vaginal discharge to be bloody and then it gradually changes to a pinkish color then to a yellowish and finally to a clear discharge. This is called the lochia and occurs as the uterus involutes and sheds the extra tissues and cells formed during pregnancy as the uterus enlarges to accommodate the growing fetus. The lochia flow usually lasts for between 2 to 6 weeks ranging from lochia rubra to lochia serosa to lochia alba
Menstruation
Menses usually returns following a delivery in 4 to 8 weeks depending on if you are breastfeeding your baby or not, menstrual flow returns very early if you choose not to breastfeed your baby but amenorrhea can last for up to 3 to 12 months before menses returns if you choose to breastfeed your baby.
This classical presentation may not hold true in some situations for some women, returning much earlier and then becoming a source of worry for a new mom as the bleeding of this early menstruation becomes confusing and presenting as if it is a complication following childbirth.
The secret here is to observe the flow and if it extends beyond seven days you should consult your doctor especially if it is heavy but if it is limited to below 7 days and the flow is normal like normal menses, then there should be no cause for serious concern as early menstrual flows following delivery may sometimes be different from the prepregnancy pattern of flow.
Abnormal Discharge
Abnormal postpartum vaginal discharge is that discharge that deviates from what you have always perceived as normal vaginal discharge for you, normal pattern of lochia flow from rubra to serosa to alba and normal menstrual flow that is expected within the postpartum period. It arises as a result of several factors
Causes
Bleeding
Primary or more commonly secondary postpartum hemorrhage is a not so common cause of abnormal vaginal discharge. It is bloody and comes in clots and requires you to visit the doctor for proper diagnosis and treatment.
Infection
A lot of things can get infected in the vagina following delivery as all the tears, episiotomies, urethral injuries and perineal tears and traumas can all get infected and present with signs and symptoms of infection in the area leading to different types, colors, odors and consistencies of vaginal discharges that present in various forms in the pueperium.
Subinvolution
Following delivery of the baby, the uterus contracts down and from thence it begins the process of involution which is essentially a process the uterus undergoes to go back to its prepregnant shape and size. The uterus typically completes the process of involution by the 6-week postnatal visit at which point you will not be able to palpate the uterine mass abdominally anymore.
When this process is derailed and does not occur as expected, the uterus is said to undergo sub involution and this is associated with prolonged vaginal discharge as the uterus continues to shed cells and tissues in a prolonged process of involution with associated waist pain and discomfort in the supra pubic region. It is commonly associated with endometritis.
Symptoms and Signs
The signs of an abnormal vaginal discharge includes
- Changes in consistency and color of the normally colorless discharge which can range from greenish to yellowish to brownish or creamy white.
- Burning sensation especially while urinating or after urination
- Itching and development of rashes in the vulva and vagina
- Foul odor
- Bloody discharge occuring outside and out of tune with your menstrual flow
6 Common Postpartum Vaginal Discharges
Bacterial Vaginosis –
This is an infection of the vagina caused by bacteria organism like Gardnerella. The discharge is heavier than normal vaginal discharge, it is watery and grayish white with a foul fishy odor marking it out as a distinct discharge type.
Yeast Infection –
Yeast infection is caused by the fungal organism Candida albicans and the discharge is creamy white to yellow, thick and clumped with associated itching and burning sensation.
Trichomoniasis –
This is a parasitic infection that is sexually transmitted. It is commonly called “Trich” and presents with irritation and burning sensation of the vagina, vulva and surrounding areas, a frothy malodorous vaginal discharge and pain during intercourse and while urinating
Sexually Transmitted Diseases –
Sexually transmitted infections (STIs) like gonorrhea is a common cause of vaginal discharge. In fact gonorrhea and chlamydia are the commonest STIs and though they may not presents with any symptoms in the early stages in a woman, leading to the spread of the infection to others, the classical vaginal discharge is milky greenish in color from light green that is practically looking off-white to deep green and also has a characteristic odor. It also presents with other symptoms.
Douching –
Douching is the act of washing the vagina in the mistaken belief that it is an essential part of correct personal hygiene. Nothing can be as misleading as this as the vagina is a self-cleaning organ. Douching disrupts the normal pH of the vagina altering the bacterial flora of the vagina and introducing external organisms into the vagina while expelling the normal resident commensal bacterial flora of the vagina that confers protection against invasion.
The discharge can vary widely depending on the individual and the douching agent used. It can be thin or thick with the color ranging from shades of yellow, green, or brown and the discharge has a characteristic unpleasant odor associated.
Foreign Bodies –
This is another uncommon cause of postpartum vaginal discharge. When a foreign body like tampon or a delivery pad is forgotten in the vagina following delivery it leads to infection of the vagina and a very pussy discharge and offensive odor as the lochia is prevented from draining causing infection of the tract.
Treatment
Treatment of abnormal vaginal discharge will depend on the cause of the discharge. There will be need to adjust your hygiene practices if it is the cause of your vaginal discharge. You should consult your doctor for appropriate treatment once you judge the discharge you are having not be normal.
Final words
It is imperative that you study your body to determine what a normal vaginal discharge looks like so that you can determine what is abnormal when it occurs.
This is especially important postpartum when the vagina is easily prone to get infected with the persistent lochia flow, the episiotomy and other vaginal and perineal injuries as well as a uterus that is returning back to normal following delivery, so effective postpartum vaginal care is essential in this period.
Dr Mawa
To your postnatal health and freedom
mypostnatalmanagement.com
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