If your postpartum bleeding returns to bright red...

[Sasharna]

...does it really mean you have to slow down and take it easy? I've read this is so, but I've never seen the reasons behind it explained. What happens if you don't listen?

I'm 4.5 weeks PP now and I feel pretty good. I get more bright red blood whenever I exert myself a little though (maybe a couple teaspoons over several hours--not much). I don't want to take it easy anymore. I feel fine and want to go on long walks, do a lot of housework, etc.

[wombatclay]

Well, the way it was explained to me is that the newly post partum uterus is essentially a "wound" similar to a skinned knee. The surface is a bit leaky and needs some time to heal, and like a knee it is a "moving" surface so to speak. Bright red blood is "fresh" blood and suggests that you're putting more stress on the healing tissue than it can really take.

You probably wont have any "drastic" complications as a result of overdoing it (especially at 4.5 weeks pp), but you could become anemic/worsen existing anemia or become mildly dehydrated (both of which could impact your energy levels and breastfeeding) and it may take longer for the postpartum flow to end. I'd probably do whatever felt good, keep an eye on the flow, and if you felt crummy after doing whatever then...well... give it another week.

And congrats on the babe! :

[Sasharna]

Thank you! The baby is wonderful.

And thank you so much for the advice! This makes a lot of sense to me. Just visualizing it that way helps, too. I feel so much better knowing why things happen.