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Postpartum Lochia: What Is Normal Postpartum Bleeding?

Postpartum Lochia: What Is Normal Postpartum Bleeding?

One of the things first-time mothers ask their doctor about is the possibility of bleeding right after giving birth. Soon, they would learn that it’s normal for a certain level of vaginal bleeding to occur after a normal spontaneous delivery. This bleeding, which is sometimes referred to as postpartum lochia (or simply lochia), often follows a certain pattern of color, amount, and consistency. Learn more about postpartum bleeding below.

Postpartum Lochia: The Typical Pattern

Immediately after giving birth, a large amount of blood flows from the uterus until it contracts. After that, the amount of blood significantly decreases. The color and consistency of the discharge also change over the weeks. This is because lochia isn’t just composed of blood; it also contains mucus and other tissues from the uterus.

The overall duration of postpartum bleeding varies from one woman to another, but the average, according to one report, is 24 to 36 days¹.There also seems to be a “pattern” in the amount, color, and consistency of vaginal discharge.

Initially, postpartum lochia consists of a large amount of red discharge known as lochia rubra. The discharge then becomes reddish-brown, brown-pink, to brown and takes on a more watery consistency. This is called lochia serosa. After serosa, comes lochia alba, which is yellowish to whitish in color.

Of course, let’s not forget that there’s typically a progressive decrease in the amount of vaginal discharge.

What If You Deviate From The Typical Pattern?

What we described in the previous section may be the usual pattern. However, a woman may experience different patterns of consistency and color that may not be typical, but still normal.

Case in point: some women experience prolonged rubra phase and shorter serosa and alba phrases. Other women experience two rubra phases².

Another report also indicated that some women had an increase in the amount of bleeding at 7 to 14 days³.Experts likewise remind women that breastfeeding and physical activity may result in increased postpartum lochia⁴.

Since “normal” lochia has many variables to consider, doctors highly advise mothers and their loved ones to instead look for signs that something is wrong.

When To Seek Medical Help

Postpartum lochia doesn’t need treatment as it’s a normal part of healing. However, please remember that you must use sanitary pads. Never use tampons as you shouldn’t insert anything in the vagina for six weeks after giving birth.

Also, if you observe the following, contact your healthcare provider right away⁴:

  • Foul-smelling vaginal discharge; lochia typically smells musky, like one’s menstrual blood.
  • Fever and chills, especially when the temperature is higher than 38° C.
  • Bright red bleeding that persists beyond the 3rd day.
  • Large blood clots (larger than a plum).
  • An increased amount of postpartum lochia that warrants more than one sanitary pad per hour.
  • Increased swelling or bruising in the perineum or the incision site (Cesarean section).
  • Severe abdominal pain or cramping that doesn’t get better with pain medicine.
  • Pain or burning sensation during urination
  • Separation of stitches
  • Severe headache
  • Fainting
  • Blurred vision
  • Severe pain, swelling, or redness in one extremity
  • Feeling pain or warmth or seeing redness on areas of the breast
  • Difficulty breathing
  • Any signs of postpartum depression

Do Mothers Who Have Had Cesarean Section Also Experience Postpartum Lochia?

Reports say they do, and that they may have less bleeding after 24 hours than mothers who had vaginal deliveries.

Key Takeaways

Postpartum lochia is the normal vaginal discharge that follows after giving birth. In most cases, lochia follows a pattern: going from rubra, to serosa, and finally, to alba. However, the duration, color, and consistency of vaginal discharge after giving birth vary from woman to woman. Hence, mothers must watch out for signs of postpartum hemorrhage and infection.

Learn more about Postpartum Care here.

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Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

1. Lochia Patterns Among Normal Women: A Systematic Review, https://www.liebertpub.com/doi/10.1089/jwh.2012.3668, Accessed November 9, 2021

2. Characteristics of normal lochia, https://pubmed.ncbi.nlm.nih.gov/10772198/, Accessed November 9, 2021

3. Normal and Abnormal Puerperium, https://emedicine.medscape.com/article/260187-overview#a1, Accessed November 9, 2021

4. Pregnancy: Physical Changes After Delivery, https://my.clevelandclinic.org/health/articles/9682-pregnancy-physical-changes-after-delivery, Accessed November 9, 2021

5. Lochia, or Postpartum Bleeding: What Do You Need to Know?, https://obgyn.coloradowomenshealth.com/blog/lochia, Accessed November 9, 2021

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Written by Lorraine Bunag, R.N. Updated 3 weeks ago
Fact Checked by Bianchi Mendoza, R.N.