What causes prolonged spotting after delivery?

Bleeding after delivery — lochia — is normal and typically lasts four to six weeks, changing from red to pink to brown and then a pale discharge as the uterus heals. Breastfeeding can prolong light spotting, and a temporary increase after activity is common. See your doctor if bleeding continues beyond six to eight weeks, becomes heavier again after settling, develops an offensive smell, or comes with fever or abdominal tenderness. Causes of prolonged bleeding include retained placental tissue, the uterus not contracting down properly, infection, or a return of normal periods — which can happen from around six weeks if you are not exclusively breastfeeding. Seek care the same day for soaking a pad in under an hour, passing clots larger than a golf ball, feeling faint, or fever with abdominal pain. Postpartum haemorrhage can occur weeks after delivery, and it is frequently underestimated. One more thing: if you are not breastfeeding, ovulation can resume before your first period, so contraception is worth discussing sooner than people expect.