Lochia, often referred to as postpartum bleeding, is a natural vaginal discharge occurring after childbirth. It expels excess tissue and blood that supported the pregnancy, aiding the body’s recovery. This discharge is a combination of blood, mucus, and uterine tissue, mainly originating from the site where the placenta was attached to the uterine wall. This process indicates the uterus is returning to its pre-pregnancy state.
Understanding Lochia
Lochia progresses through three distinct stages, with changes in color, consistency, and flow. The first stage, lochia rubra, begins immediately after delivery and typically lasts for three to four days. During this period, the discharge is bright or dark red, heavy in flow, and may contain small blood clots, usually no larger than a plum. This initial phase is similar to a heavy menstrual period, reflecting the body’s shedding of the uterine lining and placental remnants.
Following lochia rubra, the discharge transitions to lochia serosa, from day four to day twelve postpartum. It becomes lighter (pinkish or brownish), thinner, and more watery. The flow during lochia serosa is moderate, and blood clots usually diminish or cease. This shift indicates a gradual reduction in bleeding as the uterus continues to heal.
The final stage is lochia alba, beginning around day twelve and persisting for several weeks. This discharge is yellowish-white, very light in flow, and contains little to no blood, consisting primarily of white blood cells and uterine cells. This progression signifies the uterus contracting and repairing itself after childbirth.
How Long Lochia Typically Lasts
The duration of lochia ranges from four to six weeks, though it can vary among individuals, sometimes lasting up to eight weeks. The initial heaviest bleeding typically subsides within the first three to ten days following delivery. Several factors can influence both the duration and characteristics of lochia.
The mode of delivery can affect lochia; individuals who have a cesarean section may experience slightly less initial bleeding compared to those who have a vaginal delivery. Lochia still occurs after a C-section as the placental site heals. Breastfeeding also plays a role, as the release of oxytocin during nursing stimulates uterine contractions. These contractions can lead to a heavier initial flow and a quicker resolution of lochia.
Physical activity can also impact lochia flow. Increased exertion can sometimes cause a temporary increase in discharge or a return to a redder color, indicating that the body may need more rest. It is common for the flow to fluctuate, with occasional gushes, especially after resting or during breastfeeding.
Recognizing When Lochia is Abnormal
While lochia is a normal part of postpartum recovery, certain signs indicate a problem requiring medical attention. Excessively heavy bleeding is a cause for concern, such as soaking more than one sanitary pad per hour or passing blood clots larger than a golf ball. These can be indicators of complications like postpartum hemorrhage.
A foul odor from the lochia, distinct from the typical metallic or earthy smell of menstrual blood, suggests infection. Other signs of infection include a fever or chills. If the lochia, after having lightened, suddenly returns to bright red bleeding, especially if accompanied by other symptoms, warrants medical evaluation.
Severe abdominal pain or uterine tenderness that does not subside or worsens can also signal a complication. Lochia that continues beyond six to eight weeks, especially if it remains red or heavy, should be discussed with a healthcare provider. Contacting a healthcare professional immediately upon experiencing any of these signs is important for assessment and care.