Postpartum bleeding (lochia discharge)
Reviewed by Dr. Jennifer Lincoln
After months of experiencing significant changes to your body and mind, you are probably looking forward to starting to feel some semblance of your old self. You'll shed some 15 or so pounds, along with a slew of pregnancy hormones, on the day that you give birth. But your postpartum journey, which includes weeks of vaginal bleeding, is just beginning.
3-6 WEEKS POSTPARTUM
Lochia
In the days and weeks after birth, you can expect to experience a lot of vaginal discharge and bleeding, regardless of whether you’ve had a vaginal or cesarean birth. This discharge, called lochia, is a mix of mucus, blood, and the uterine lining.
Rubra
First 3 to 4 days
Small dark-red blood clots Saturating a pad with rubra in two to three hours is normal. If you're consistently saturating more than one pad per hour with rubra, you should contact your doctor.
Serosa
Begins around day 4
Watery pinkish-brown discharge Serosa varies in volume, but it typically saturates a few pads per day, for 7 to 14 days.
Alba
Begins around day 10
Creamy whitish-yellow discharge Alba typically saturates two to three pantiliners per day and lasts 10 to 28 days. If you're exclusively breastfeeding, alba may subside after two to three weeks postpartum.
Note: If you're still discharging any lochia after 6 weeks, you should contact your doctor.
What it is
Whether you deliver your baby vaginally or via C-section, excreting a dark-red vaginal discharge (also known as lochia) for up to six weeks postpartum is perfectly normal. While we refer to lochia as blood, it’s actually a combination of blood, mucus, and tissue that has been contained in your uterus to help sustain the pregnancy.
Blood clots, which may accompany lochia, are also a normal part of the postpartum package. These masses of blood congeal together, as the protein, cells, and platelets that lined your uterus leave your body. If they are larger than a quarter, reach out to your health care provider to rule out anything serious, such as a postpartum hemorrhage. Your provider may recommend that you come in for a physical exam, ultrasound, and possibly bloodwork. Medical guidance may include limiting your physical activity until any clots reabsorb.
When it happens
The color and flow of lochia will change in the weeks after delivery. Here is what you can expect:
- First few days after delivery: rubra—red to brownish-red blood, with a heavy flow, including clots, that soaks a maternity pad every few hours.
- Up to three weeks after delivery: serosa—pinkish-brown blood that becomes increasingly watery over time. Flow will lighten as well.
- Weeks 3 to 4: alba—yellowish-white discharge, with a lighter flow.
- Week 5 and beyond: brown, red, or yellow spotting can last for weeks.
You may notice an increase in your lochia discharge while breastfeeding, when being more physically active, right after standing for longer periods, or in the morning. Lochia tends to pool in the vagina overnight.
Who’s most likely to experience it
Anyone who gives birth, vaginally or via C-section, will experience some form of postpartum bleeding. However, those who give birth vaginally tend to bleed more heavily and for longer.
What to do about it
Postpartum bleeding doesn’t last quite as long as many other postpartum symptoms, and there are some tried-and-true remedies that can help alleviate some of the discomfort.
EXPLORE POSTPARTUM BLEEDING
Use sanitary pads
You should expect bleeding for up to six weeks postpartum. Shelve your tampons, and use pads exclusively. Change your pad at least every four hours.
Wear something comfortable that won’t aggravate your skin. Loose-fitting, full-coverage underwear is ideal for healing. (Thongs can create a better environment for bacteria to grow.)
Bleeding should taper off around the second week but can last for up to six weeks postpartum, at which point it may temporarily stop and start up again.
- Change sanitary pads frequently, and add an ice pack or witch hazel pads to help reduce swelling and discomfort.
- Mesh underwear, often supplied by hospitals, can hold high-absorbency maxi pads in place while saving your nicer underwear from stains.
When to get help
Most new moms bleed for up to six weeks postpartum. Check in with your doctor if:
- the flow of postpartum blood (lochia) increases over time
- you’re changing your sanitary pad more than once every hour
- you’re discharging blood clots larger than a stone fruit (peach or plum)
- you feel dizzy, faint, or your heart is racing
- you have a fever that’s worsening
- you’re experiencing flu-like symptoms or notice a foul-smelling vaginal discharge
Additional resources
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