Lochia is a normal vaginal discharge that occurs after childbirth, serving as a natural part of the body’s recovery process. Understanding its characteristics, including when changes might signal a problem, is important for new mothers.
What is Lochia?
Lochia is the vaginal discharge experienced after giving birth, regardless of whether the delivery was vaginal or via C-section. It consists of blood, mucus, and tissue shed from the uterine lining that supported the pregnancy. This discharge helps the uterus return to its pre-pregnancy state. Lochia typically lasts for four to six weeks, though the duration can vary.
Normal Lochia Characteristics
Normal lochia progresses through distinct stages. Initially, for three to four days after delivery, lochia rubra appears as bright or dark red discharge, similar to a heavy menstrual period. Small blood clots, generally no larger than a plum or raisin, may also be present during this phase.
Following lochia rubra, lochia serosa appears pinkish-brown and has a thinner, more watery consistency. This stage typically lasts from four to ten days postpartum. The final stage, lochia alba, is a whitish-yellow discharge with a lighter flow, which can continue for up to six weeks or sometimes longer.
Normal lochia has a distinctive, earthy, or musty odor, often similar to regular menstrual blood. It may also have a metallic or stale scent. This smell is normal and is not foul or unpleasant.
Signs of Infected Lochia
Infected lochia often presents with a distinctly foul, strong, or unpleasant odor, which is an indicator of potential infection. This smell can be fishy, putrid, or rotten, differentiating it clearly from normal lochia. A change in the odor of lochia warrants prompt medical attention.
Beyond a foul smell, other lochia changes can signal infection. Persistent bright red bleeding beyond the expected timeframe for lochia rubra, or a return to bright red bleeding after it had lightened, can be concerning. The consistency of the discharge might also change, becoming pus-like or thick and discolored. An increase in lochia amount, particularly if it saturates more than one sanitary pad per hour, is another red flag.
Postpartum infections are accompanied by other systemic symptoms. A fever of 100.4°F (38°C) or higher is a common sign of infection, especially if it occurs within the first week after delivery. Other symptoms include chills, severe abdominal pain or tenderness, and general malaise. An increased heart rate can also be a symptom.
When to Seek Medical Attention
Contact a healthcare professional immediately if any signs of infected lochia or other concerning symptoms appear. This includes foul-smelling vaginal discharge, a significant infection indicator. Do not hesitate to reach out if you notice a fever of 100.4°F (38°C) or higher, chills, or severe abdominal pain or tenderness.
Seek medical evaluation if soaking through more than one sanitary pad in an hour, experiencing large blood clots (golf-ball sized or larger), or if bleeding becomes heavier after it had previously slowed. Early detection and treatment of postpartum infections prevent more serious complications. While some variations in lochia are normal, any symptom that causes concern should prompt a medical consultation.