Postpartum Lochia: What to Expect With Normal Bleeding After Birth
If there’s a perk of pregnancy (you know, besides the arrival of baby), it’s the absence of a monthly period for nine+ months. But as soon as baby is born, you’ll experience what’s called postpartum lochia. Basically, it’s the normal bleeding that lasts for a few weeks after delivery.
Bleeding after birth is the last thing you want to deal with while juggling sleepless nights, establishing a feeding schedule and handling endless diaper changes. But postpartum lochia is actually beneficial; it’s your body’s way of clearing out any placental material that’s left after baby is born. Ready to get the lowdown on lochia? From lochia stages to color and odor, here’s everything you need to know about this completely normal part of the postpartum process.
Lochia is the medical term for postpartum bleeding, says Heather Lopez, MD, an ob-gyn with BJC Medical Group at Missouri Baptist Medical Center. While this is a good basic explanation, your body is actually shedding more than just blood. “Lochia is fluid made up of blood, remaining placental cells, sloughing of the endometrial lining as well as mucus,” Lopez says. “Lochia mainly comes from the site at which the placenta detached from the uterine wall during birth.”
You can expect lochia to be a bit heavier than your normal period; it’ll probably last longer too. “I always tell my patients that lochia is nature’s way of getting you back after not having had a period during the 40 weeks while you were pregnant,” says Heather Bartos, MD, an ob-gyn and medical director at Be. Women’s Health and Wellness in Frisco, Texas. And the good news is that any lochia you’re experiencing will gradually become lighter, both in flow and color. This is a normal progression that indicates you’re moving through the different lochia stages.
Lochia is par for the postpartum course—and while it’s not an ideal addition to the fourth-trimester experience, any heavy-duty bleeding usually subsides after a few days. Here are the three lochia stages to know about:
Immediately following baby’s birth, you can expect to experience heavy, dark red or bright red bleeding that may contain small clots. This is the first lochia stage, called lochia rubra (rubra meaning red). Those pads provided by the hospital may seem huge and hefty, but you’ll be grateful for them during this early stage of lochia. It’s also normal to experience significant uterine cramping during these first few days. Lochia rubra typically lasts for the first three to four days after birth, says Lopez, and then you’ll enter the second stage: lochia serosa.
During the second stage of lochia, you’ll still be bleeding, but it’ll probably feel much more manageable. Suffice to say, the lochia serosa stage is significantly less aggressive. “Bleeding usually becomes lighter during this time, and you’ll notice the color of your bleeding can change from a light red to a watery pink-brownish color,” says Lopez. For most new moms, lochia serosa sticks around a bit longer than lochia rubra; you can expect this stage from about day four to day 10 postpartum.
Finally, the lighter bleeding of the lochia serosa stage will fade into discharge; the lochia color will now be more yellowish but can sometimes be mixed with a bit of spotting. This is the final lochia stage, called lochia alba, and it may last for up to six weeks after delivery.
Of course, you’re probably eager to move on and enjoy the early days with baby without the inconvenience of postpartum lochia—so exactly how long does bleeding last after birth? Like just about everything related to the pregnancy, delivery and postpartum experience, lochia after birth will vary from person to person. And you can experience it regardless of how you deliver: there’s lochia after vaginal birth and lochia after c-section too. “Bleeding after both a vaginal delivery and a cesarean can last sometimes up to five or six weeks. If you’re still bleeding after six weeks, you should discuss this with your physician,” Lopez says. Rest assured that, for the most part, lochia should taper off significantly by that six-week mark.
Lochia after vaginal birth
Lochia after a vaginal birth will likely be heavier than bleeding after a c-section. If you tore during childbirth or had an episiotomy, you could be bleeding from that site as well, adding insult to injury.
Lochia after c-section
If you have a c-section, you might be surprised to learn that you’ll still experience lochia and postpartum discharge. The upside is that the bleeding might be a bit less heavy for you than it is for those moms who’ve had vaginal births. Still, the placenta has been separated from the uterus, exposing open blood vessels—so, yes, some bleeding will happen.
By the sixth week, the bleeding will likely subside—but it’s not abnormal for lochia to stop, turn red and then fade back again, especially during the early stages. Often, this is simply a side-effect of trying to do too much, too soon after delivery. Breastfeeding moms may also notice an increase in lochia during nursing sessions, according to the Cleveland Clinic; a spike in the hormone oxytocin causes contractions which can lead to more uterine shedding.
There is a rare postpartum bleeding complication to be aware of called subinvolution. This is characterized by intense vaginal bleeding about two to three weeks after delivery, when you think your lochia has just about ended. “In this case, the scab located in the spot where the placenta was attached to the uterine wall falls off prematurely, and you now have an open kind of bleeding,” says Bartos. If you suddenly start bleeding very heavily again, call your doctor or midwife right away. “You might be admitted to the hospital for Pitocin or other medicine to help clamp down the uterus,” explains Bartos. “It helps squeeze the site where the scab fell off to help compress the bleeding.”
By now, you know that lochia can be slightly different for every new mom. Of course, you may still be wondering what situations might be cause for concern when it comes to postpartum bleeding. Signs of abnormal lochia discharge can include:
- Foul-smelling lochia. There is a normal lochia smell; it takes on a bit of a musty odor, similar to that of menstrual blood. But if lochia smells foul, it can indicate an infection. It can be difficult to distinguish one odor from another, but if you notice a sudden change in the way your discharge smells, it warrants a call to your doctor, says Bartos.
- Lochia with fever and/or tenderness. Any fever that occurs following baby’s birth should be discussed with your doctor, as it can indicate the start of an infection, says Bartos.
- Lochia that suddenly becomes very heavy. As previously mentioned, a sudden change in the flow of your bleeding after birth typically just means you’ve been too active too soon. Try to rest (easier said than done, we know). Either way, it’s wise to keep an eye on the sudden onset of heavy bleeding, since it can also be a sign of subinvolution or a dangerous hemorrhage; if you’re soaking a pad every hour or two or pass large clots, you should seek help right away.
Bleeding after birth may not be pleasant, but it’s completely normal. And before you know it, those first few physically tumultuous postpartum weeks will pass, and you’ll begin to feel more like yourself again. In the meantime, being prepared to keep yourself as comfortable as possible can help you deal with lochia. “Make sure you have plenty of pads at your disposal; try the overnight size pads, and be sure to have some throwaway underwear like granny panties at home ready to go,” Bartos says. You should be able to downgrade to light or mini pads within a few days. Just don’t use tampons for lochia; nothing should go in your vagina for at least six weeks after birth, according to the Cleveland Clinic.
The best thing you can do is try to take it easy. Yes, you now have a tiny, helpless human being to care for (and that can inhibit your ability to put your feet up), but you need to prioritize your recovery too. Labor and delivery is hard on your body. Accept help (better yet, proactively ask for it!) so that you can rest and relax as needed. Postpartum lochia is inevitable, but allowing yourself to slow down can help give you some relief.
About the experts:
Heather Bartos, MD, is an ob-gyn and the medical director of Be. Women’s Health and Wellness in Frisco, Texas. A navy veteran, she spent 12 years serving the women and spouses of the armed forces, and was an associate professor at the Uniformed Services University of Health Sciences in Bethesda, Maryland. She completed her residency at Baylor College of Medicine, and earned her medical degree at The University of Texas.
Heather Lopez, MD, is an ob-gyn with BJC Medical Group at Missouri Baptist Medical Center. She earned her medical degree from Florida State University College of Medicine in Tallahassee.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.