This is one of the hardest things to deal with, how much is too much and how do you know it. First, you want to make sure the fundus is firm. There are times when you massage, yes the fundus is firm, but does it get firmer when you massage. This will usually decrease the "trickle" you may easily see. We would do pad counts and we kept the same one under the patient until it is about soaked if the patient has heavy bleeding or if we are concerned about the amount of blood loss. You will be able to tell the difference just by how heavy the pad is. When in doubt and a more experience nurse isn't available right away, keep the pads laid out on a chuck in the recovery room area, or in the tub if you are in the patients room. Let the nurse in charge know what's going on. Keep a watch on the patients bladder. A full bladder will not let a uterus contract as needed. If the fundus is firm, and the bladder empty, then you are usually looking for lacerations or possible retained placenta. The doctors I've worked with would have standing orders about catherizations and pitocin. If this doesn't correct the situation, call the Dr. It's normal that when the patient first gets up, the pooled blood in the vagina will pass and be a large amount, but it doesn't continue. Keep a check on the vital signs, but moms can lose a good bit of blood before vitals will change. We had a doctor that collected cord blood after deliveries, heparinized it, and then used it in an inservice. Measured out in ML.s what 50ml, 100ml, 200ml, and 250 ml would look like on a pad. If you have baby scales available, you can weigh the pads also when you are concerned. You can also describe the amount in sizes of softball, cantaloupe, basketball....especially when it's "congealed" and you don't have individual clots. I hope this helps.