Lochia is the term for the vaginal discharge that occurs following childbirth. This discharge is a natural part of the body’s postpartum recovery. It is composed of blood, mucus, and tissue from the uterus, which must be shed as the uterus involutes back to its pre-pregnancy size. Many new parents wonder if this flow, which can be inconsistent, can genuinely stop and then restart again. Understanding the expected pattern and the common causes of temporary changes in flow can help clarify the difference between a normal fluctuation and a sign that requires medical attention.
Understanding the Typical Lochia Timeline
The postpartum discharge follows a predictable progression of color and volume, reflecting the stages of uterine healing over approximately four to six weeks. The first stage, known as lochia rubra, begins immediately after delivery and is characterized by a heavy flow of bright or dark red blood, often containing small clots. This initial phase typically lasts for about three to four days as the uterus contracts to close off the blood vessels where the placenta was attached.
The discharge then transitions into the second stage, called lochia serosa. This discharge is lighter in volume and changes color to a pinkish-brown hue, usually starting around day four or five and continuing for about a week. The color change indicates a decrease in red blood cells and an increase in serum and tissue components within the discharge.
The final stage is lochia alba, which is a whitish-yellow discharge. It contains a high concentration of white blood cells, mucus, and epithelial cells from the healing uterine lining. This final, much lighter discharge may continue intermittently until the six-week mark or sometimes a little longer.
Common Reasons for Lochia Fluctuation
While the overall trend is for the lochia to lessen over time, temporary increases in flow are common. These fluctuations are often directly related to physical activity or hormonal responses that influence uterine contraction. Increased physical exertion, such as walking for a longer duration or lifting a heavier object, can cause the discharge to temporarily become heavier or revert to a pinker or redder color.
Breastfeeding is another frequent cause of a sudden, brief gush of lochia due to the release of the hormone oxytocin. When the baby nurses, or even when the parent anticipates feeding, the body releases oxytocin, which triggers mild uterine contractions. These contractions help the uterus return to its pre-pregnancy size.
Changes in body position can also account for the apparent stop-and-start pattern, particularly upon waking up. When a person lies down to rest or sleep, the lochia can pool within the vagina and uterus. Upon standing up, gravity causes the collected discharge to release all at once, resulting in a sudden, heavy gush that may be mistaken for the flow restarting.
Signs That Require Medical Attention
Although normal fluctuations are common, certain signs indicate that the discharge is abnormal and requires immediate medical consultation. This is necessary to rule out complications like hemorrhage or infection. A primary warning sign is soaking through more than one standard-sized sanitary pad in a single hour for two or more consecutive hours.
The passage of large blood clots, specifically those larger than a golf ball or a plum, also warrants prompt medical attention. While small clots are normal, larger clots can signal that the uterus is not contracting effectively to stop the bleeding. Other concerning symptoms include a sudden return of bright red bleeding after the lochia had already lightened to pink or white.
Fever, chills, or a foul-smelling vaginal odor are symptoms that may indicate a postpartum infection, such as endometritis. Additionally, any excessive or persistent abdominal pain should be reported to a healthcare provider, especially if it is not relieved by standard pain medication.