What Is Lochia?

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Also known as postpartum bleeding, lochia is a normal part of healing after giving birth in which blood and mucus are discharged vaginally. It is usually no cause for concern, but there are things to look for to make sure the process is happening as expected.

This article discusses the stages of lochia, along with how to cope with it.

A person taking out a sanitary pad from a bag.

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Defining Lochia

After a baby is born, the placenta detaches from the uterine wall and is expelled along with other tissues needed to sustain the pregnancy.

Lochia is the name of the collective discharge that leaves the uterus via the vagina in the days and weeks following childbirth.

Lochia discharge consists of:

  • The mucous membrane that lines the uterus during pregnancy
  • Red blood cells
  • White blood cells
  • Amniotic fluid
  • Tissue from the pregnancy

Lochia lasts for about six weeks, starting with heavier bleeding that may contain clots, and gradually turning to a whitish or yellowish discharge.

For about 10% of people, lochia lasts longer than six weeks.

Lochia typically smells similar to a menstrual period and may smell slightly metallic, stale, or musty. It shouldn't smell foul.

Does Lochia Smell?

Lochia should not smell bad. Foul-smelling lochia may be a sign of infection and warrants a visit to a healthcare provider.

It is normal for the bleeding to stop and start, and to experience period-like cramping as the uterus shrinks back to its normal size.

Lochia vs. Menstruation

Lochia is not a menstrual period. While the uterine lining is being shed, it is not the result of a menstrual cycle.

A genuine menstrual period can occur shortly after lochia finishes, usually within six to 12 weeks after delivery, or sometimes longer if you are exclusively breastfeeding.

It is important to be aware that pregnancy can occur before your period returns, so it is necessary to use a form of birth control to prevent unplanned pregnancy as soon as sexual intercourse that can result in pregnancy is resumed.

Contraceptive options are usually discussed at the six-week postpartum checkup. If you have intercourse before that, use condoms.

Lochia vs. Hemorrhage

While postpartum bleeding is normal, postpartum hemorrhage is not.

Excessive bleeding after childbirth can be a result of the uterus’s inability to contract down (uterine atony), from lacerations, retained placenta, an abnormally adherent placenta, or other rare reasons.

Postpartum hemorrhage is most likely to occur shortly after birth, but it can occur later on when a person is at home, so it is important to watch for signs.

See your healthcare provider, or seek emergency medical attention, if you:

  • Have heavy bleeding from the vagina that doesn’t slow or stop
  • Experience blurred vision
  • Have chills
  • Feel weak or like you’re going to faint

Stages of Lochia

There are three stages, or "types," of lochia. The duration of each stage can vary from person to person.

Lochia Rubra

Characteristics of lochia rubra include:

  • Occurs on days two to five after delivery
  • The time when bleeding is heaviest
  • Blood is dark red or reddish-brown
  • May pass clots, but they should not be larger than a golf ball
  • Can feel a gush when getting up from sitting or lying down, but it should settle down shortly after

Lochia Alba

Characteristics of lochia alba include:

  • Starts around day four
  • Lasts about two weeks
  • A mixture of blood and discharge
  • More watery
  • Pinkish to brownish in color

Lochia Serosa

Characteristics of lochia serosa include:

  • Starts around week two
  • Lasts until about six weeks after birth
  • Pink to yellow/white in color
  • Occasional spot of blood
  • Made up mainly of white blood cells

Causes

Lochia can present differently in different people, and its duration, heaviness, and other characteristics can be affected by a number of factors or activities.

People who have a cesarean delivery may have less lochia after 24 hours than those who have vaginal deliveries.

You may notice a temporary increase in lochia:

  • While breastfeeding
  • When you get up in the morning
  • When you are physically active

Coping

Unless there are complications like infection, lochia does not require treatment.

To help manage lochia, try:

  • Using sanitary pads: Do not use tampons; nothing should be inserted into the vagina for at least six weeks to lower the risk of infection.
  • Using adult pads or disposable underwear meant for incontinence for the first few days: These offer lots of coverage and absorbency for lochia and can be easier to manage than the large pads and mesh underwear supplied by the hospital.
  • Wearing comfortable clothes: In the first few days, make sure to wear ones you don't mind getting stained just in case.
  • Taking it easy: When the placenta detaches, it leaves a large wound that needs to heal.

To help prevent irritation and infection:

  • Change the pad at least every four hours.
  • Avoid penetrative sex.

When to See a Healthcare Provider

Lochia usually clears up on its own without incident, but there is a risk of infection or hemorrhage (too much blood loss).

Contact your healthcare provider if any of the following occurs:

  • Very large clots (bigger than a golf ball)
  • Very heavy bleeding (soaking through a pad every hour)
  • Lochia that has a foul smell (a fishy or unpleasant smell)
  • A greenish-colored vaginal discharge
  • Faintness
  • Breathlessness
  • Dizziness
  • Racing heart
  • Nausea or vomiting
  • Swelling and pain around the vagina or perineum (the area in between the vagina and rectum)
  • Fever of more than 100.4° Fahrenheit
  • Chills
  • Severe cramping
  • Blurred vision
  • Bloody discharge that continues beyond four to six weeks
  • The blood flow increases over time, rather than decreases
  • Pelvic pain

A Word From Verywell

Lochia is a normal part of postpartum healing in which the uterus sheds blood and tissue no longer needed to sustain the pregnancy.

While no treatment is usually needed for lochia, it is important to remember that this bleeding is partially because of the wound left behind when the placenta detaches at birth and begins to scab over and heal.

Take it easy and take your time working back up to physical activities. Rest—as much as you can with a newborn—and give your body a chance to heal.

For most people, lochia will gradually resolve on its own without any adverse effects. If you notice signs of infection such as a foul odor or fever, or signs of abnormal bleeding such as an increase in blood or large clots, seek medical attention, as this may require treatment.

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Article Sources
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  1. Colorado Women's Health. Lochia, or postpartum bleeding: what do you need to know? Updated October 2020.

  2. Goodto. Lochia: What you need to know about postpartum bleeding. Updated April 2021.

  3. Cleveland Clinic. Physical changes after child birth. Updated January 1, 2018.

  4. March of Dimes. Postpartum hemorrhage. Updated March, 2020.

  5. University of Michigan. Postpartum bleeding. Updated October, 2020.