Postpartum vaginal discharge, known as lochia, is a normal and necessary process as the body recovers from pregnancy and childbirth. This discharge is the body’s way of shedding the lining of the uterus that built up during the pregnancy. Many new parents express concern about the characteristics of lochia, particularly its smell. Understanding the typical flow, color, and odor of lochia can offer reassurance and help distinguish between a normal healing process and a situation that requires medical attention.
Understanding Lochia: Duration and Flow
Lochia is composed of a mix of blood, mucus, and uterine tissue, and it progresses through three distinct stages as the uterus returns to its pre-pregnancy size. The entire process typically lasts between four to six weeks, though some people may have traces of discharge for up to eight weeks. During this time, it is important to exclusively use sanitary pads, as inserting anything into the vagina, such as a tampon, can increase the risk of infection.
The initial stage, called lochia rubra, lasts for approximately three to four days after delivery. It is characterized by a heavy flow of dark or bright red discharge. This discharge often contains small blood clots, which are generally considered normal as long as they are smaller than a quarter.
Following this, lochia serosa begins around day four and lasts until about the twelfth day postpartum. Lochia serosa is thinner and more watery, transitioning in color to a pinkish-brown hue as the amount of blood decreases. The final stage is lochia alba, which starts around day 12 and continues until the discharge stops completely. This discharge is yellowish-white and has a minimal flow.
The Expected Smell of Postpartum Bleeding
The question of whether postpartum bleeding smells is common, and the answer is yes, lochia does have an odor that is considered normal. Since lochia is largely made up of blood and healing tissue, it naturally carries a scent similar to that of regular menstrual blood. Many describe the normal smell as somewhat earthy, musty, or slightly metallic.
This mild, stale scent is usually not strong or offensive and is simply a byproduct of the biological material being expelled from the body. As the discharge lightens and moves through the serosa and alba stages, the odor typically becomes less noticeable. The metallic scent in the earlier, bloodier stage is due to the presence of iron in the blood.
Maintaining good hygiene can help manage the normal odor associated with lochia, which involves frequent changing of pads. Gentle washing of the perineal area with water is recommended, but avoid douching, which can disrupt the natural balance and push bacteria into the healing uterus.
When Odor Signals a Problem
While a mild, menstrual-like smell is normal, any significant change to a foul, putrid, or fishy odor is a cause for concern. This may signal a postpartum infection, such as endometritis. This abnormal odor suggests the presence of harmful bacteria colonizing the uterus or a wound. A concerning odor is often accompanied by other symptoms that indicate the need for immediate medical evaluation.
These accompanying red flags include a fever of 100.4°F (38°C) or higher, chills, and increased uterine tenderness or severe abdominal pain. It is also a warning sign if the bleeding suddenly increases, or if the lochia reverts to bright red after it had already lightened. Soaking through more than one maxi pad in an hour, or passing blood clots larger than a golf ball, also requires urgent medical attention. A greenish color to the discharge is another symptom that indicates potential infection.