Lochia, or Postpartum Bleeding: What Do You Need to Know?

It’s normal to have vaginal bleeding in the days after having a baby, but you should know the symptoms indicating it’s abnormal & requires medical attention.

A woman holding her baby thinking about lochia | CU OB-GYN | Denver & Aurora, COThe time after childbirth is an exciting one, but it’s also a period of adjustment and healing for mothers. Immediately after giving birth to a baby, a woman’s body goes through the natural process in which the placenta, the organ for nourishing the fetus, is shed. Through this entire postpartum process, there will be bleeding – but it’s important to know how much bleeding after delivery is normal, how long it goes on for and how to handle this part of the birth experience.

So, let’s have a look at some facts to help distinguish normal postpartum bleeding from abnormal. This can help new mothers avoid unnecessary stress and anxiety or, in more serious situations, let them know if they need to plan to visit their OB-GYN.

How do I know if my lochia (postpartum bleeding) is normal?

Lochia is the menstrual period-like discharge women experience after giving birth. It’s made up of the mucous membrane lining the uterus during pregnancy, as well as red and white blood cells being shed. Women will experience bleeding after a vaginal birth as well as after a cesarean delivery.

Duration. The normal bleeding process lasts about six weeks after the delivery. During this time, the uterus that carried the baby during pregnancy will undergo changes that return it to its normal state. During this time, women should wear pads, not tampons or menstrual cups, as these can introduce bacteria into the still-recovering genital tract and uterus.

Consistency & color. This is one of the factors that can be a little tricky to judge and can vary. For example, getting small blood clots during postpartum bleeding can be normal. Also, in the first few days after delivery, women may get a reddish-brown lochia, which is normal as well.

The next stage of vaginal bleeding comes when the reddish-brown bleeding with possible small clots turns into a watery one that is either brownish or pinkish in color. This stage lasts for about 2 to 3 weeks.

After this time, the color will move to a whitish, pale shade. This is because by around the end of the 3rd week, most of the red blood cells have been passed through the bleeding. This discharge can stay until the 6th week after the delivery. In some situations, this discharge may persist until the 8th week after delivery, which can be normal.

Amount. Bleeding in the first two weeks after delivery is considerably heavy as tissues from the pregnancy are being shed. This gradually decreases as the material gets sloughed off with time. Light bleeding or spotting after delivery can continue for up to six weeks after delivery, although it varies from person to person. Some women also notice increased lochia when physically active, first thing in the morning, or while breastfeeding.

Related reading: Pregnancy, Labor & Delivery Blog

How do I know my lochia requires a doctor’s attention?

Women experiencing the signs and symptoms below should schedule an appointment with one of our OB-GYNs.

  • Excessive bleeding (saturating a pad in less than an hour).
  • Getting abnormally large, golf ball sized clots.
  • Foul-smelling bleeding or discharge.
  • Severe cramping.
  • Feeling nausea and dizziness.
  • Blurred vision.
  • Chills or fever (temperature more than 100.4° Fahrenheit).
  • Feeling faint or weak.
  • Increased heart rate.

Do I need to worry about postpartum hemorrhage?

Postpartum hemorrhage is excessive bleeding after the birth of a baby, most commonly as a result of the uterus’ inability to contract down (uterine atony). Excessive bleeding can also occur from lacerations, retained placenta, an abnormally adherent placenta or other rare reasons.

Most cases of postpartum hemorrhage occur at delivery or soon after, but in rare cases women may bleed heavily after returning home in a delayed postpartum hemorrhage. Some causes for delayed postpartum hemorrhage are retained placenta, bleeding disorders, infection or placental problems.

Your midwife or OB-GYN should discuss risks such as postpartum hemorrhage as part of your pregnancy care. For example, women who have a C-section are slightly more at risk of a postpartum hemorrhage, as are women with twin pregnancies or preeclampsia.

Conclusion on bleeding after birth

Having a baby changes everything. If you are a woman who is in the midst of the postpartum period, be sure to celebrate these milestones and be mindful of how your body and baby are responding.

While focusing care and attention on your new baby, it’s also essential to care for your own health – do not forget yourself.

If you notice any of the abnormal signs mentioned above, seeking medical help is important. With timely attention and caution, you can save yourself from undue stress while also ensuring your health.

When in doubt, ask us – we are here for you. At CU, we enjoy helping women understand their bodies and be mindful of their health throughout their lifespan.

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