The process of childbirth results in postpartum bleeding, medically termed lochia. This discharge is a natural part of the body’s recovery as the uterus sheds its lining and other materials that supported the pregnancy. Lochia is a mixture of blood, mucus, and uterine tissue that must be expelled as the reproductive organs return to their pre-pregnancy state. This discharge requires the use of specialized absorbent products, similar in function to those used for heavy menstruation, for several weeks following delivery.
Postpartum Absorbent Products
The heavy nature of the initial flow means standard menstrual pads are often insufficient, leading many to seek out more robust options. The products women use are frequently large, highly absorbent, disposable underwear, which are colloquially referred to as “diapers” due to their design and capacity. These disposable garments provide full coverage and a secure fit, which is especially helpful when managing a high volume of fluid.
Hospitals typically provide a combination of large, thick maternity pads and stretchy, open-weave mesh underwear. This mesh underwear is soft and breathable, designed to comfortably hold the bulky pads and any necessary perineal cold packs or soothing treatments. They are also disposable, which simplifies hygiene during the initial days of recovery. Many women transition from the hospital-provided mesh underwear and pads to high-absorbency, disposable postpartum underwear once they return home.
These specialized disposable garments often have a high waist, which is beneficial for women who have had a Cesarean section, as they avoid irritating the incision site. It is important that women avoid using tampons or menstrual cups during the entire lochia period. Inserting anything into the vagina can introduce bacteria, significantly increasing the risk of infection, and it may also impede the natural healing of the uterine lining.
The Stages of Postpartum Bleeding
Postpartum discharge follows a predictable progression of color and volume as the uterus heals, a process that can last between four and six weeks. This discharge is divided into three distinct phases. The first stage, known as Lochia Rubra, begins immediately after delivery and lasts approximately three to four days.
Lochia Rubra is characterized by a bright or dark red color and a heavy flow, similar to a very heavy menstrual period. During this time, it is normal to experience small blood clots, which are expelled as the uterus contracts to close off the blood vessels where the placenta was attached. The second stage, Lochia Serosa, generally begins around day four and lasts for about a week to ten days.
The discharge in the Serosa phase becomes much lighter in color, typically appearing pinkish-brown and having a thinner, more watery consistency. The flow decreases noticeably as the amount of red blood cells lessens, and the discharge contains more white blood cells and wound exudate. The final stage is Lochia Alba, which begins around ten to fourteen days postpartum and can continue for several weeks until the discharge stops completely.
Lochia Alba is minimal in volume and changes to a creamy, yellowish-white color. This final phase consists mostly of white blood cells, mucus, and tissue debris from the healing uterine wall. Monitoring the color and volume progression is an important way to track the body’s healing process.
Practical Tips for Postpartum Hygiene
Maintaining meticulous hygiene is important for preventing infection and promoting comfort during the postpartum recovery period. Products like the mesh underwear and heavy pads must be changed frequently, ideally every few hours, regardless of how full they seem. Changing the absorbent product often helps to keep the perineal area dry and clean, which is especially helpful if there are stitches from tearing or an episiotomy.
Cleaning the genital area after using the toilet is best accomplished with a peri bottle, which is a small squeeze bottle used to gently rinse the area with warm water. Direct wiping, particularly in the initial days, can cause pain and irritation to tender tissues. Many healthcare providers advise against taking baths or swimming for several weeks to prevent water from entering the vagina and introducing potential sources of infection to the still-healing uterus.
It is necessary to monitor the discharge for specific warning signs that could indicate a complication like a postpartum hemorrhage or infection.
Warning signs warranting immediate contact with a healthcare provider include:
- Soaking through one or more maxi pads in an hour.
- Passing blood clots larger than a golf ball or egg.
- Foul-smelling vaginal discharge, which may signal a uterine infection.
- A fever higher than 100.4 degrees Fahrenheit.
- Any sudden increase in pain, dizziness, or a rapid heart rate.