Updated 3 October 2026
At a glance
- RCOG describes primary PPH as losing 500 ml (a pint) or more of blood within the first 24 hours after birth and secondary PPH as abnormal or heavy bleeding between 24 hours and 12 weeks after birth (RCOG, Heavy bleeding after birth).
- NCT says to get medical help straight away if you suddenly lose a lot of blood from the vagina, feel faint, or have a rapid heartbeat (NCT, Bleeding after birth and postpartum hemorrhage).
- Cleveland Clinic lists dizziness, blurred vision, an increased heart rate, pale or clammy skin, and clots larger than a golf ball among signs to report (Cleveland Clinic, Postpartum hemorrhage).
- With severe signs, your local emergency number comes first; a bleeding log is a record to hand over afterward.
- Postpartum Journey is a postpartum recovery tracker that keeps bleeding trends, sleep, pain, mood, and labs in one dated history, and its insights show how recovery weeks compare.
Bleeding is expected after birth, and most of it settles. A small share becomes postpartum hemorrhage, and it can start in the hospital or weeks later at home, when sleep is short and a new parent is easy to talk out of worrying.
This guide covers signals and records only: what PPH is, how sources describe normal bleeding and warning signs, what to write down, and who to call. Treatment decisions belong to your care team, and severe signs call for your local emergency number.
What postpartum hemorrhage is and when it can happen
Postpartum hemorrhage, often shortened to PPH, is heavy bleeding after birth. The UK’s Royal College of Obstetricians and Gynecologists (RCOG) describes two types: primary PPH, when you lose 500 ml (a pint) or more of blood within the first 24 hours after the birth, and secondary PPH, which occurs when you have abnormal or heavy vaginal bleeding between 24 hours and 12 weeks after the birth (RCOG, Heavy bleeding after birth). Cleveland Clinic gives the same two windows and adds that in some cases PPH does not cause symptoms until after you have left the hospital (Cleveland Clinic, Postpartum hemorrhage).
Two facts help set the tone. RCOG says most women who have a primary PPH have no identifiable risk factors, and that the majority of women do not experience a hemorrhage after giving birth. The WHO lists severe bleeding, mostly bleeding after childbirth, among the major complications that account for around 75% of all maternal deaths (WHO, Maternal mortality fact sheet). Both support the same habit: know the signs, and do not wait on a feeling that it might settle.
| Type | When it happens | Where you might be |
|---|---|---|
| Primary | Within the first 24 hours after birth | Usually still with the care team |
| Secondary | Between 24 hours and 12 weeks after birth | Often at home, which is why you and your support person need to know the signs |
Source: Postpartum Journey, from RCOG
This guide covers signs and records only. Treatment belongs to the care team, and the one instruction it repeats is to get help straight away when the signs below appear.
In Postpartum Journey, the Daily check-in holds sleep fragments, pain, mood, and feeding-night load together with any bleeding change noted that day. Each entry carries its date, so days since birth can be read from the history. Learn offers short topics on recovery bleeding, fourth-trimester sleep, mood, and visit prep that connect to your own logged weeks. Together they show whether what you are seeing fits the pattern the topic describes.
Normal bleeding compared with signs that need a call
Some bleeding after birth is expected. RCOG says it is normal to bleed after you have a baby, that bleeding is usually heaviest just after birth and gradually becomes less over the next few hours and days, that the color should change from bright red to brown over a few weeks, and that the bleeding, called lochia, will usually have stopped by the time the baby is 12 weeks old (RCOG, Heavy bleeding after birth). The signs below are the ones sources single out as reasons to reach the care team.
| Sign | What sources say | Who to reach |
|---|---|---|
| Sudden loss of a lot of blood from the vagina, feeling faint, or a rapid heartbeat | NCT: get medical help straight away; these could be signs of PPH (NCT, Bleeding after birth and postpartum hemorrhage) | Your local emergency number |
| Dizziness, blurred vision, pale or clammy skin, shortness of breath | Cleveland Clinic lists these among signs of PPH (Cleveland Clinic, Postpartum hemorrhage) | Your local emergency number if they come with heavy bleeding; otherwise your provider right away |
| Bleeding getting heavier, an offensive smell, or feeling unwell | RCOG: contact your midwife or GP (RCOG, Heavy bleeding after birth) | Your midwife or doctor the same day |
| Clots larger than a golf ball or larger than a 50p piece (a UK coin) | Cleveland Clinic: larger than a golf ball may be a sign of a problem; NCT: tell your midwife | Your midwife or doctor |
| High temperature or a sore and tender tummy | NCT: get immediate medical help | Your provider immediately |
Source: Postpartum Journey, from NCT and RCOG
If your care team gave you its own thresholds or phone numbers, those come first. If the first call goes unanswered while the signs are present, call your local emergency number.
The Flare Tracker in Postpartum Journey lets you flag a day that stands out, such as a pain spike or a crash after cluster feeds. A flag gives a rough day its own dated marker. The Daily Journal takes typed or voice notes, including fear around bleeding or pain. Read afterward, the pattern shows whether a worrying day was a one-off or the start of a trend.
Track the bleeding pattern: pads, clots, color, and trend
Cleveland Clinic suggests wearing a sanitary pad and watching how long it takes to fill, noting that bleeding should gradually decrease over several weeks and that your provider should be contacted if it does not (Cleveland Clinic, Postpartum hemorrhage). NCT adds that very absorbent pads should be changed regularly, and that the number used helps the midwife understand how much bleeding has happened (NCT, Bleeding after birth and postpartum hemorrhage). That makes a pad log the simplest record there is.
Fields for each bleeding entry
Postpartum Journey (part of Health Journey Labs) uses these fields for each bleeding entry:
| Field | How to write it |
|---|---|
| Days since birth | Day number, counted from the birth date |
| Pad changes | Times changed and how full each pad was when changed |
| Clots | Size compared with a coin or golf ball, and how many |
| Color and smell | Bright red, darker, brown; any strong smell |
| Trend | Lighter, the same, or heavier than yesterday |
| With it | Dizziness on standing, racing heartbeat, fever, belly tenderness |
Source: Postpartum Journey
NCT notes that bleeding is redder and heavier just after breastfeeding or expressing milk, because breastfeeding makes the womb contract, while the overall amount of blood is the same whether or not you breastfeed. Writing “after feeding” on the entry for a heavier pad avoids mistaking that pattern for a change. The log is for reporting. When the signs in the table above appear, call first and write later.
The Period Tracker in Postpartum Journey records when bleeding starts and stops, the flow, and how heavy or light it felt. Those dated lines give days since birth a bleeding trend. The Daily check-in adds sleep, pain, and mood on the same dates. Over a few weeks, the pattern shows whether bleeding is easing and which days stand out.
Body signs that travel with heavy bleeding
Heavy bleeding rarely shows up alone. Cleveland Clinic lists dizziness, blurred vision, feeling faint, an increased heart rate, pale or clammy skin, and pain and swelling in the vaginal or perineal area among signs of PPH, and says shortness of breath is another (Cleveland Clinic, Postpartum hemorrhage). RCOG notes that with a primary PPH you may feel dizzy, light-headed, faint or nauseous (RCOG, Heavy bleeding after birth). NCT lists a high temperature and a sore, tender tummy as reasons to get immediate medical help (NCT, Bleeding after birth and postpartum hemorrhage).
Body signs to note with bleeding
Postpartum Journey notes these body signs on the same entry:
- Dizziness or blurred vision on standing, with the time it happened
- A heartbeat that feels fast or pounding at rest
- Shortness of breath that is new
- Fever, chills, or a tender belly
- Pain or swelling in the vaginal or perineal area
Write down what you notice with its time, but treat these as reasons to call, with the log as a note to hand over afterward. For sudden heavy bleeding with faintness, a racing heartbeat, or trouble breathing, call your local emergency number. A support person can make the call while you stay where you are (Postpartum Journey checklist).
The Daily check-in in Postpartum Journey covers physical symptoms, emotional state, nutrition, sleep, exercise, meds, and external factors, so dizziness or a fast heartbeat sits in the same entry as sleep and pain. That puts each sign in context. The Daily Journal holds the line about what a night cost or what you feared. Looking back, the pattern shows whether body signs came with the days that bled more.
After heavy bleeding: tiredness, iron, and follow-up blood tests
Heavy bleeding can leave a lasting mark. RCOG says that if you lose a lot of blood it can make you anemic and worsen the normal tiredness of having a baby, that you may still be tired and anemic when you go home and may need treatment with iron, and that your GP may offer a blood test in 6 to 8 weeks to check your blood count (RCOG, Heavy bleeding after birth). Choices about iron and other treatment come from your clinician.
Tiredness after birth has many causes, including broken sleep and feeding nights, so a record helps separate them. Note the energy rating each day, whether tiredness is worse on standing or climbing stairs, and when any blood test was done. Bring the dates and results to the next appointment. For blood tests, see How to track postpartum labs with sleep and mood weeks.
My Labs in Postpartum Journey files result dates for blood counts, iron studies, and other tests, to be read with symptoms and function. Seeing a result date beside the tiredness ratings of the same weeks makes it easier to discuss. My Meds records medicine names, timing, and dose, including iron or pain medicine used as advised. With both in the history, you can separate a tiredness change that followed a test or a medicine from one that did not.
Make a plan before you need it: who to call and what to say
Signs are easier to act on when the plan already exists. Write a short card and keep it where you and your support person can find it. Fill in the numbers from your own care team and region.
Lines on the plan card
Postpartum Journey keeps these lines on the card:
- Your local emergency number, written in large type
- Your maternity unit, midwife, or provider line for same-day concerns
- The name of the person who will make the call if you feel faint
- The signs from the table above, in a short list
- The address or directions a responder would need
When you call, a few facts help: days since birth, how much and how fast the bleeding is, any clots, dizziness or racing heartbeat, and any known risk factors. RCOG lists risk factors such as a previous PPH, anemia, twins, pre-eclampsia, cesarean delivery, and a long labor, and stresses that most women with these risk factors will not experience a hemorrhage (RCOG, Heavy bleeding after birth). From Postpartum Journey, we recommend sharing the card and the signs with your partner or support person before a hard night, so they are not learning it in the middle of one.
The AI companions in Postpartum Journey include Clara for general chat and specialist companions, and they can help word a calm partner script or listen after a hard night. They already see your logged history. Weekly Goals holds one small aim, such as sharing the card with a support person this week, and records whether it held. Across a few weeks the habit shows whether the plan is in place.
After a bleeding scare: sleep, mood, and follow-up
A frightening bleed can echo. RCOG notes that you and your birth partner may have found the experience distressing, that it is often helpful to talk through the events, and that if you continue to feel upset or develop anxiety or depression after you go home you should talk to your midwife, health visitor or GP (RCOG, Heavy bleeding after birth). Cleveland Clinic adds that excessive bleeding can be traumatic and that it is OK if it takes time to heal emotionally (Cleveland Clinic, Postpartum hemorrhage).
Keep a few lines on sleep, mood, and the thoughts that come back, such as replaying the day or dreading the next night. If feelings are heavy, fast-changing, or hard to manage, tell your provider. If you think about harming yourself or your baby, call your local emergency number. Asking for a debrief of what happened at the birth is a reasonable request, and written notes make it easier.
My Assessments in Postpartum Journey holds structured check-ins that reach past the daily scores, and onboarding questions add life and social context. They add a steadier view of mood than a single bad day does. The Daily Journal takes voice notes when typing is too much. Together the history helps separate a rough week from a pattern worth raising with a provider.
Visit preparation: what to bring to a clinician after heavy bleeding
A postpartum visit is short, and bleeding questions can get lost. Bring the bleeding log for the days since birth, the dates of any flagged days or calls, the symptoms that came with them, and a list of questions. Ask for the facts of the birth too, since you may not have heard them clearly.
Questions for the bleeding visit
Postpartum Journey lists five questions to ask:
- What was recorded about my blood loss, and what treatment was given?
- Do I need a blood count or iron follow-up, and when?
- Which signs should make me call right away, and which number should I use?
- Does anything in my history raise the chance of heavy bleeding in a future birth?
- Who can I talk to about how the birth felt?
For the wider recovery routine and what to log in these weeks, see How to Start Tracking Postpartum Recovery in the Fourth Trimester and How to Get Through a Hard Postpartum Recovery Day Without Losing Notes.
The Doctor Report in Postpartum Journey turns the logged history into a one-page summary of dates, sleep and mood context, bleeding or pain, and how you functioned. Handing over a copy before the visit shows the bleeding trend without a long retelling. My Care Team keeps clinician names and short visit notes, which helps when visits tend to ask only about the baby and skip your sleep debt. Those notes show whether your own questions got answered.
How Postpartum Journey can help
A notebook by the bed can hold a pad log. The harder part is reading bleeding, sleep, pain, mood, and blood test dates together across weeks. A tool that dates each line makes the weeks comparable, and our roundup Best Postpartum Apps 2026 compares the choices.
Postpartum Journey is a personal postpartum tracker from Health Journey Labs on the App Store and Google Play. It keeps bleeding notes, clots, sleep, pain, mood, medicines, and lab dates in one place, each stamped with its day. That lets the history show how bleeding is trending, which days stood out, and what to bring to your care team. Below is what you can use and how each part helps.
- Daily check-in — A short guided daily form covers the body, mood, nutrition, sleep, movement, medicines, and outside factors, and leaves room for sleep fragments, pain, mood, and feeding-night load.
- Daily Journal — Spoken or typed notes on what the night cost, handoffs with a partner, visit debriefs, guilt after canceling, and fear around bleeding or pain.
- Period Tracker — Records when bleeding starts and stops, the flow, and how heavy or light it felt, read with sleep, energy, mood, and the rest of the log.
- Flare Tracker — Flags a day that stands out, such as a pain spike, a crash after cluster feeds, or a hard mood day, so a one-off differs from a pattern.
- My Meds — Gives each medicine an entry for name, timing, and dose, whether pain medicine, iron, stool softener, thyroid tablets, or another option used as advised.
- My Labs — Files result dates for blood counts, iron studies, and other tests, lined up against symptoms and function.
- Weekly Goals — Pairs a single small weekly aim with a check on whether it was met.
- My Care Team — Stores clinician names and short notes around each visit, including visits that asked only about the baby.
- Doctor Report — Condenses the history into a single page of dates, sleep and mood context, bleeding or pain, and function.
- My Assessments — Structured check-ins reach beyond daily scores, and onboarding questions cover life and social context.
- Learn — Short topics and prompts on fourth-trimester sleep, recovery bleeding, mood, and visit prep, linked to your own logged weeks.
- AI companions — Clara handles general chat and specialist companions cover knowledge, fitness, nutrition, and relationships. They read the logged history, so a visit, a calm talk with a partner, or a soft rain check gets worded with them, and a hard night gets a listener.
- Food Tracker — Meal or drink lines, caffeine and alcohol included, read with sleep, mood, and energy.
- Weight Tracker — Scale numbers or body notes alongside recovery weeks, energy, and sleep.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Postpartum Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- RCOG — Heavy bleeding after birth (postpartum hemorrhage)
- Cleveland Clinic — Postpartum Hemorrhage (PPH)
- NCT — Bleeding after birth and postpartum hemorrhage (PPH)
- WHO — Maternal mortality fact sheet
FAQ
What counts as heavy bleeding after birth?
RCOG defines primary PPH as losing 500 ml (a pint) or more of blood within 24 hours of the birth, and Cleveland Clinic describes persistent, excessive bleeding as the most common symptom. At home, measures are less exact, so the signs matter: clots, dizziness, a fast heartbeat.
Postpartum Journey keeps the pad changes, clot sizes, and trend you note, so you can describe the pattern to a clinician. When the signs are present, call first and let the log catch up later.
How long is postpartum bleeding normal?
RCOG says bleeding is usually heaviest just after birth, reduces over the next hours and days, changes from bright red to brown over a few weeks, and will usually have stopped by the time the baby is 12 weeks old.
The Period Tracker in Postpartum Journey records start and stop dates, flow, and how heavy or light bleeding felt, so the history shows whether bleeding is easing on the usual curve.
Can hemorrhage happen after I go home?
Yes. RCOG describes secondary PPH as abnormal or heavy bleeding between 24 hours and 12 weeks after the birth, and Cleveland Clinic says PPH may not cause symptoms until after you have left the hospital.
Daily entries in Postpartum Journey carry the date, so days since birth are visible when you describe a change. The Daily Journal can hold a quick voice note if typing is too much.
Which signs mean I should get help right away?
NCT says to get medical help straight away if you suddenly lose a lot of blood from the vagina, feel faint, or have a rapid heartbeat, and to seek immediate help for a high temperature or a sore, tender tummy. Call your local emergency number when they appear.
Postpartum Journey is for the record afterward. The Flare Tracker marks the day with a dated flag, and the history shows the team when things changed and what came with it.
When should I call my midwife or doctor the same day?
RCOG says to contact your midwife or GP if bleeding is getting heavier, if the lochia has an offensive smell, or if you feel unwell. Cleveland Clinic and NCT also point to larger clots as something to report to your care team.
In Postpartum Journey, the Daily check-in and the bleeding notes show the trend over several days, which gives the midwife or doctor more than a single snapshot of one bad afternoon.
Why does bleeding look heavier after breastfeeding?
NCT explains that bleeding is redder and heavier just after breastfeeding or expressing milk because breastfeeding makes the womb contract, while the overall amount of blood is the same whether or not you breastfeed.
Writing “after feeding” on a pad entry in Postpartum Journey keeps that pattern from being read as a change, and the history shows the difference between a feeding effect and a true change over days.
What should I log about bleeding?
Write days since birth, pad changes with how full each pad was, clot size compared with a coin or golf ball, color, smell, the trend since yesterday, and any dizziness, heartbeat, fever, or belly tenderness.
The Period Tracker and Daily check-in in Postpartum Journey hold those lines in one dated history, which gives a clinician a clear window into the weeks since birth and the days that stood out.
Should I log first or call first?
Call first when the signs in this guide appear. A log is a record to hand over afterward and does not replace help in the moment. If signs are severe, call your local emergency number first.
Postpartum Journey keeps notes you add later, so nothing is lost by calling first, and entries can be dated to the time of the event, even if a support person writes them.
What if I feel dizzy when I stand?
Dizziness is on the Cleveland Clinic list of signs of PPH, and RCOG says you may feel dizzy, light-headed, faint or nauseous with a primary PPH. Treat dizziness with heavy bleeding as urgent and report it to your provider; call your local emergency number if you feel faint.
The Daily check-in in Postpartum Journey lets you note dizziness with the time and what you were doing, which helps a clinician judge whether it follows bleeding, feeding, or poor sleep.
Can heavy bleeding explain why I am so tired?
It can contribute. RCOG says a large blood loss can make you anemic and worsen the normal tiredness of having a baby. Broken sleep also matters, so a record helps separate the causes.
My Labs in Postpartum Journey files result dates for blood counts and iron studies, and the Daily check-in holds energy ratings, so the history shows how tiredness moved around any test.
What blood tests might follow heavy bleeding?
RCOG notes that your GP may offer a blood test in 6 to 8 weeks to check your blood count. Your own team decides which tests apply to you and when.
Postpartum Journey lets you file the date of each result in My Labs, so you can bring the dates to the next visit with the symptoms from the same weeks.
Does having a risk factor mean I will hemorrhage?
No. RCOG says most women with risk factors will not experience a hemorrhage, and most women who have a primary PPH have no identifiable risk factors. Share your history with the care team so they can plan.
The Doctor Report in Postpartum Journey summarizes dates, bleeding or pain, and how you functioned, so the care team sees the recovery picture together with your history and can answer from facts.
How do I get my partner ready to recognize the signs?
Share the list of signs and the plan card before a hard night: who calls, which number, and what to say. Practice reading the card aloud once so it is familiar.
The AI companions in Postpartum Journey can help word a calm partner script, and they already see your logged history, so the script can reflect your recovery so far and the nights that have been hardest.
How can I cope emotionally after a bleeding scare?
RCOG says it is often helpful to talk through the events and that you should talk to your midwife, health visitor or GP if you keep feeling upset or develop anxiety or depression. Cleveland Clinic says it is OK if emotional healing takes time.
The Daily Journal and My Assessments in Postpartum Journey hold mood notes and structured check-ins over time, so a provider can see more than one bad day and respond to the whole stretch.
Why does privacy matter for your health records?
Health notes are personal — symptoms, medications, mood, and what you canceled. Treat any digital log as sensitive; on paper, keep the notebook somewhere only you control.
Entries you add to Postpartum Journey are your own health notes. Check the app's privacy policy for how data is stored and handled. Nothing in this article is medical advice.