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Lochia: All You Need To Know About Postpartum Bleeding

Blood flow after delivery is normal. In fact, it is a normal recovery process at the beginning of motherhood. This blood flow (or Lochia) is a sign that your body, especially your uterus, is returning to its pre-pregnancy state.

Are you wondering why you’re still having blood flow even after delivery? Do you want to know the cause, duration, and treatment options?

Read on to find out.

What is Lochia?

Lochia is a normal discharge of blood and mucus from the uterus after childbirth. It is also known as postpartum bleeding. The discharge begins right after childbirth and can continue for about 4 to 6 weeks after delivery.

lochia signs

In most cases, the heaviest flow is usually observed in the first two weeks after birth. Although the duration varies from woman to woman, it often ranges from two to six days.

Lochia looks a lot like menstrual blood, however, it lasts longer and is heavier than normal period bleeding. Furthermore, lochia comes in various colors; it may look pink, brown, or yellow.

What Causes Lochia?

During pregnancy, your uterus houses your baby, the placenta, excess uterine tissue, and of course, blood.

After childbirth, your uterus sheds out all these excess materials and fluids through postpartum contractions. These postpartum contractions are normal, they help to return your already enlarged uterus to its normal size.

However, if these contractions don’t occur properly, something called uterine atony can occur. This causes heavy bleeding even after childbirth

The chances of experiencing heavy lochia are increased if you have any of the following:

  • Multiple delivery (i.e. giving birth to more than one child at a time)
  • If you have given birth several times before
  • Giving birth to a child weighing more than 8 pounds
  • Induced labor with oxytocin (Pitocin)
  • Placenta problems
  • Uterine rupture
  • Prolonged labor
  • Vaginal or cervical tear during delivery
  • Given birth through a cesarean section (your chances for postpartum hemorrhage is increased with a C-section compared with a normal vaginal delivery)
  • General anesthesia (if you had a C-section)
  • Preeclampsia (high blood pressure and protein in your urine that develops during pregnancy)
  • Obesity

What Are The Contents of Lochia?

Most times, lochia contains:

  • Blood
  • White blood cells
  • Mucus
  • Pieces of the uterine lining

The Stages of Lochia

As the uterus clears out the excess blood and tissue, the appearance of lochia changes over time.

It may follow this pattern:

1. Lochia Rubra

In the early days, lochia rubra may appear dark red and very heavy. Then, after about four to ten days, the lochia will lighten up and look brownish or pinkish in appearance.

2. Lochia Serosa

At this point, lochia may look thin, brownish, or pink in color. It usually appears after ten to fourteen days and is quite similar to spotting. Most times, it contains blood cells, cervical mucus, and some microorganisms.

3. Lochia Alba

For the remaining days or weeks, the lochia will look like watery mucus and appear white or yellow in color.

In this stage, Lochia Alba is no longer tainted with blood. Furthermore, the flow of lochia may become very irregular.

Lochia alba

Treatment of lochia

Lochia is normal and should happen, just like your monthly menstrual flow.

It is a normal part of your body’s postpartum healing process.

When your uterus has returned to its normal size, you won’t be passing lochia again. But you should watch the flow of blood to be sure it is within normal range.

lochia alba treatment

Although you can’t make lochia go away any sooner, you can try the following tips to stay comfy during this phase:

  • Wear pads and not tampons after birth to avoid infection and irritation of the vagina. You can start with heavy duty pads since the flow will be quite heavy.
  • Use pain relief drugs as recommended by your doctor to reduce pain of postpartum cramping.
  • Rest as much as possible.
  • Wear loose-fitting clothes and comfortable underwear.

When to Seek Medical Help

It is normal to pass fluid after delivery. However, excessive bleeding (or postpartum hemorrhage) is not. This should be reported immediately to the doctor.

Call your doctor immediately if you experience:

  • Heavy bleeding (which causes you to change your pad more than once within the same hour)
  • Passing large clots for more than three days after childbirth
  • Fever
  • Blurred vision
  • Lightheadedness or confusion
  • Nausea
  • Pain, cramping, or swelling in the abdomen or vagina
  • Rapid heartbeat
  • Foul-smelling lochia

These signs may be indications of an infection or hemorrhage, which is potentially dangerous. You should seek medical attention immediately.

Lochia rubra cramps

Conclusion

Call your doctor if lochia remains heavy for more than two weeks after delivery, or you are still having it for more than eight weeks postpartum. You should also see your doctor if you have signs of excessive bleeding especially if your pad soaks every hour or two.

You are not alone.

REFERENCES

Cho, Seung-Hee, and Kim, Song-Baek (2013). A Study on the Duration and Character of Lochia in Women Hospitalized at Korean Medical Postpartum Care Center. The Journal of Oriental Obstetrics and Gynecology. Accessed on 7th July, 2021 from https://www.researchgate.net/publication/290467002_A_Study_on_the_Duration_and_Character_of_Lochia_in_Women_Hospitalized_at_Korean_Medical_Postpartum_Care_Center

Susan Fletcher, Chad A Grotegut and Andra H James (2012). Lochia Patterns Among Normal Women: A Systematic Review. Journal of Women’s Health. Accessed on 7th July, 2021 from https://www.researchgate.net/publication/232717497_Lochia_Patterns_Among_Normal_Women_A_Systematic_Review

Claudia Chi, Mira Bapir, Christine A. Lee and Rezan A. Kadir (2010). Puerperal loss (lochia) in women with or without inherited bleeding disorders. Research Obstetrics. https://doi.org/10.1016/j.ajog.2010.02.042

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