I have brown discharge again after more than two months of giving birth.

There will be some secretions and lochia at the beginning after giving birth. This symptom is normal because the uterus needs to excrete all the impurities. Only by excreting them completely can the uterus be cleaned and allowed to recover completely. However, if some brown secretions appear two months after delivery, it should be considered as a precursor to menstruation or caused by physical weakness. It is also possible that it is related to infection and inflammation. You need to go to the hospital for timely examination and take protective measures.

Preventive Care

1. The postpartum period is a period of recovery for the reproductive organs. Due to the weakness of the vital energy, it is particularly easy for external evils to invade and form blood stasis. As the saying goes, postpartum women are often weak and have blood stasis. Because blood stasis is mostly caused by cold, you should pay attention to keeping warm after delivery, avoid being exposed to the cold and wind, avoid cold stimulation, and prevent the invasion of cold evil.

2. Encourage the mother to get out of bed and move around as soon as possible, and increase the amount of exercise day by day. This will be more conducive to the discharge of lochia and blood stasis, and promote the recovery of the uterus. If conditions permit, you can learn to do postpartum health exercises to strengthen your whole body and restore your physical strength as soon as possible.

3. Pay attention to hygiene during the postpartum period, change underwear frequently, pay attention to the cleanliness of the vulva, use disinfected toilet paper, and it is best to use sanitary napkins. Do not take a bath or have sex to prevent ascending infection.

4. Keep your emotions stable, avoid negative mental stimulation such as worry, depression and anger, and prevent qi stagnation and blood stasis from aggravating the symptoms of blood stasis.

Pathological etiology

Can be divided into uterine atony. There are 4 categories: birth canal laceration, placental factors and coagulation dysfunction.

1. After the fetus is delivered due to uterine atony, the placenta is detached from the uterine wall and expelled, and the blood sinuses of the mother's uterine wall open, causing bleeding. Under normal circumstances, due to the reduction in volume of the uterine cavity after delivery and the strengthening of muscle fiber contraction, the blood vessels in the uterine wall intertwined between the muscle fibers are compressed to stop bleeding. At the same time, the blood sinuses are closed and the bleeding stops. At the same time, because the blood of pregnant women is in a hypercoagulable state, platelets stuck to the endothelial collagen fibers of damaged blood vessels after placental detachment aggregate in large numbers to form thrombi, and fibrin is deposited on the platelet thrombi to form larger blood clots, which effectively block the uterine blood vessels and prevent bleeding when the muscle fibers relax after contraction. If uterine contractions are weak after the fetus is delivered, the uterus cannot contract and shrink normally, and bleeding will not occur if the placenta has not been detached and the blood sinuses have not opened. If the placenta is partially detached or detached and expelled, uterine contractions are weak and cannot effectively close the blood sinuses of the uterine wall at the placenta attachment site, resulting in excessive bleeding, which is the main cause of postpartum hemorrhage. Weak uterine contractions may be caused by excessive mental stress of the mother, excessive use of sedatives and anesthetics during delivery; abnormal head presentation or other obstructive dystocia, resulting in prolonged labor and maternal exhaustion; poor development of the uterine muscle fibers; excessive distension of the uterus, such as twins, macrosomia, and excessive amniotic fluid, which causes excessive stretching of the uterine muscle fibers; maternal anemia, pregnancy-induced hypertension, or pregnancy complicated by uterine fibroids, all of which can affect uterine contractions.

2. Soft birth canal laceration is another important cause of postpartum hemorrhage. If the uterus contracts too strongly, labor progresses too quickly, or the fetus is too large, the cervix and/or vagina may be lacerated before the fetus is delivered. Improper protection of the perineum and improper obstetric surgery can also cause perineal and vaginal lacerations. If the episiotomy is too small, severe perineal lacerations may easily occur when the fetus is delivered, and premature episiotomy may also cause excessive bleeding from the incision. Severe perineal and vaginal lacerations can extend upward to the vault, paravaginal space, and even deep into the pelvic wall. Severe tearing of the deep vagina near the vault can cause the hematoma to extend upward into the broad ligament. During childbirth, minor cervical lacerations are almost inevitable. Usually, the lacerations are shallow and there is no obvious bleeding, so cervical lacerations are not diagnosed. Cervical laceration with heavy bleeding occurs when the fetus passes through the cervix that has not yet fully dilated too quickly. In severe cases, it can affect the vaginal vault downward and extend upward to the lower part of the uterus, causing heavy bleeding.