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Continuously on and off bleeding after delivery. What should I do to stop this?

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Practicing since : 2007
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I would like to start off by saying I am a 23 year old female and have two children. I have been having a post-partum issue for the last 3 months. My baby is 3 months and 2 days old today and I have yet to stop my post-partum bleeding completely. I have seen a specialist, having been referred by my general practitioner, but I would like a second opinion.
Basically the story goes like this... I had my baby and everything seemed normal except that I bled consistently for about 9 weeks and then on and off for the remaining 3-4 weeks and am still bleeding lightly on and off. During this time my doctor sent me for two ultrasounds, both of which showed several pea size masses which she said could be either left over blood, clots or placental tissue. I had an episode of heavier bleeding for 4-5 days around week 7 or so that the doctor thought might have been a period but I am doubtful because it hasn't returned and I am breastfeeding exclusively. During the period of heavier bleeding there was some minimal tissue pieces being expelled along with the blood, not large at all but I thought maybe worth mentioning. This happened after the first ultrasound but before the second and both ultrasounds showed these small masses.
After all of this I finally went to see the specialist and he told me that I could opt for a D&C but that may interfere with breastfeeding and my daughter as of now is refusing to take a bottle and it is an invasive procedure. He said that if it were him he would wait because the pieces are so small and that they might be expelled with my next period. At the time I opted not to get the D&C but now I am wondering if I made the right decision.
I am constantly sore in the pelvic region, nothing debilitating, and some days worse than others. It is a bit tender and achy, sometimes upon sitting and standing and sometimes just generally achy etc. just enough to remind me that something doesn't seem right. I am worried that I will get an infection. If he was right and the contents might be expelled during my next period, because I am exclusively breastfeeding, I may not get a period for 3 more months, maybe up to a year, it can't be good for my body to have this bacteria just sitting around for so long, can it? I feel like I am just waiting to develop an infection and it is going to happen sooner or later.
So I am wondering if whoever is reading this feels that I should opt for the D&C or if you agree with the specialist and think that the pieces are so small it won't make a difference anyway. Also is there a way, possibly something oral I could take that would encourage my body to have a period and that way I can see if my body will expel whatever it is in there naturally so I don't have to wait months until I might develop a serious infection. This is really weighing on my mind and I would appreciate any answer you feel you can give me.
I really would like to avoid having to stop breastfeeding for any length of time if that is a possibility, I am just really uncomfortable with this situation and it is making me really depressed, thank you in advance for your insight. I apologize that this post is so long-winded I just wanted to be thorough so that you had all the necessary information.

Posted Sat, 11 May 2013 in Women's Health
Answered by Dr. Rishma Lakhani 36 minutes later

I read your history, seems a bit complicated.

I wanted to know whether the delivery was normal or a Cesarean delivery; and since you are bleeding on and off continuously since last 3 months, I think you should go for D&C even if the bits are small as they are bothering you and as you mentioned there are chances of infection if not removed.

Oral medications can be tried, oral methergin tablets but I am not sure whether they would work now or not as it is already past 3 months, they could have worked immediately in a month or so if the bleeding was controlled at that time, with oral medications.

Any ways I think at this time better option would be to go for D&C and it can be done under local anesthesia on a day care basis, it won’t affect the breast feeding of the baby probably.
XXXXXXX your Gynecologist and decide about the further management.
Don't worry, Take care.

Dr.Rishma Lakhani
Above answer was peer-reviewed by
Follow-up: Continuously on and off bleeding after delivery. What should I do to stop this? 5 hours later
It was a normal delivery, as in it was not a c-section and neither was my first pregnancy. The specialist I went to see didn't seem too concerned about an infection and said it was just as likely that I would get an infection from the D&C as I would if the bits remained inside.

I am confused as to why he would think this though, he seemed against the D&C for some reason. I will follow up and ask my doctor about the methergin or if it would be possible for a D&C under local anesthesia... although he specifically said general anesthesia. If local was possible there would be no question though; I would get it done. If I began to take birth control pills, such as the XXXXXXX pill, would this start my periods again or would they still stay at bay because of the breastfeeding?
Answered by Dr. Rishma Lakhani 7 hours later

Yes, I would appreciate if you XXXXXXX your gynecologist and discuss out about the options of methergin and D&C under local anesthesia.
Secondly, chances of infection after D&C would be less than the bits inside if proper sterile techniques used.

If you start with the XXXXXXX pill, then your menses will resume even if you are breast-feeding the baby as the bleeding is by hormone withdrawal.

Do not worry; Take care.

Dr. Rishma Lakhani
Above answer was peer-reviewed by
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