Lochia: Is Postpartum Bleeding Normal?
There’s no better joy for a new mom than to welcome her baby into the world. But pregnancy and childbirth can lead to multiple changes in your body. You might think that these changes would wave off once your little one arrives. But in reality, there’s still a lot going on in your body in the postpartum period. There might be an instance where you might witness bleeding after delivery. However, there’s no need to be alarmed. It’s postpartum bleeding, which is known as lochia. It is one of those changes which are a natural part of your body’s recovering mechanism. Read on to learn more about the stages of lochia, how long bleeding after delivery can last and what you should do when you experience postpartum bleeding.
What Is Postpartum Bleeding?
Postpartum bleeding is referred to the vaginal discharge that appears after childbirth. It could appear after a vaginal delivery or even after a C-section. The discharge called lochia consists of blood, mucus and placental tissue. In this condition, your uterus sheds and replaces the lining which safeguarded your little one and kept him snug during his or her stay in your belly. At first, vaginal bleeding after delivery might look a little alarming. But remember that it’s your body trying to heal itself after giving birth. You might even experience cramps in the area of your uterus which is known as ‘after pains’. In case you suspect that your vaginal bleeding is different from lochia, you must contact your doctor immediately.
Is Postpartum Bleeding Normal?
Postpartum bleeding is normal during this period. It's also normal to see some small blood clots that are about the size of a plum during this time.
However, if you have heavy bleeding—that is, you soak through two sanitary pads in under an hour—and particularly if you also have pelvic pain, a fever, or tenderness, then contact your doctor, as the bleeding you are experiencing may be caused by something other than the normal postpartum shedding of the uterine lining.
Difference Between Postpartum Bleeding After A C-section And A Vaginal Delivery
Usually, there isn’t much difference between postpartum vaginal bleeding after a C-section and a vaginal delivery. Except you may witness that the bleeding is light in a cesarean delivery than vaginal.
What Does Lochia Look Like?
The colour and amount of lochia discharge change with time. Starting red or brownish before briefly darkening and then getting progressively lighter (and decreasing in amount) as the days and weeks go by.
Here’s what the bleeding might look like on a maternity sanitary towel during the postpartum period:
Lochia Colour Guide*:
| Time after giving birth | Colour of lochia |
|---|---|
| Day 1 | Red or brownish blood |
| Days 2-6 | Dark brown or pinkish-red |
| Days 7-10 | The same, or a lighter shade of brown or pinkish-red |
| Days 11-14 | The same or lighter as before. Could be redder if you start to be more active around now. |
| Weeks 3 and 4 | Paler, possibly creamy white (if you still have discharge) |
| Around week 6 | Occasional small patches of brownish or pinkish spotting, or creamy yellow discharge (if any) |
*The colour and quantity of postpartum bleeding can vary. This guide is not suitable for diagnosis. In case if you have any concerns, always consult your doctor.
How Long Does Postpartum Bleeding Last?
The duration of postpartum bleeding is different for every mum. Sometimes it can last a couple of weeks, sometimes a month or longer. Generally speaking, the lochia stops flowing after about two to six weeks.
How Much Bleeding Is Normal After Pregnancy?
On the first day after giving birth, you can expect to see quite heavy postpartum bleeding. It’s common to go through several soaked sanitary maternity pads in the first 24 hours.
You may also pass one or two larger (plum or tomato-sized) blood clots, or several smaller (grape-sized) ones on the first day. These are usually nothing to worry about – but tell your doctor about them to be on the safe side.
The precise quantities of postpartum bleeding can vary between mums, but after the first day, the amount of bleeding after birth should decrease as time passes.
A typical progression could look like this:
On the first day: Heavy bleeding – a soaked maternity sanitary towel every few hours
Days 2-6:
Moderate blood loss (7-12 cm stain on a sanitary towel), gradually reducing to around a 5 cm stain around the end of the first week
Days 11-14:
The amount of postpartum bleeding should keep on decreasing. Some towels will hardly be stained
Weeks 3-6:
The discharge should keep getting less, and periods of no staining at all will get longer until eventually the lochia stops altogether. If you notice fresh or bright red blood again during this time, it might be your period returning – but don’t hesitate to ask your doctor if you’re unsure about the bleeding.
Keep in mind that although the amount of bleeding goes down with time, some things can cause the amount of discharge to increase periodically before decreasing again. These include:
The time of day:
The bleeding might seem heavier in the morning or after you’ve been resting. This is because lochia can pool in your vagina overnight or while you’re lying down, then more of it comes out in one go when you stand up.
Breastfeeding:
It can boost levels of the pregnancy hormone - oxytocin, which can trigger contractions in your uterus. You may feel these contractions as ‘after pains’ – these can vary in intensity from mild, period-like cramps to feeling almost like labour contractions. Sometimes, however, you might not feel them at all. The contractions may cause the discharge to be slightly heavier – and possibly a little redder – after a feed.
Physical activity
As you regain your strength, you may also become more active, going for walks or doing more around the house. In the first two weeks, this could lead to slightly heavier postpartum bleeding. This is usually fine as long as the colour stays more or less the same (remaining brown or pinkish). Let your doctor know if you experience any bright red bleeding.
Can Postpartum Bleeding Stop and Start Again?
Although there may be times when you notice more or less discharge, lochia itself doesn't usually stop altogether only to start up again. Sometimes, the bright red discharge you had in the first few days after you gave birth may also return. The flow of vaginal discharge may increase:
In the morning after you wake up
During physical activity, like postpartum exercises
While you're breastfeeding.
Is it Normal for Postpartum Bleeding to Stop and Start Again?
Usually as time passes by, lochia tends to decrease. This means the amount of discharge starts to vary a little between each change of sanitary pad. After a couple of weeks, you might have intermittent periods of little to no discharge. Overall, it's the reduction factor that needs to be looked at.
In case you notice a fresh red discharge after postpartum bleeding has decreased or stopped, it is highly unlikely that you are witnessing lochia again. The red discharge could be your period returning. If you feed your baby exclusively or partially with formula, this could happen as soon as five to six weeks after giving birth.
If you’re breastfeeding, your period will usually (but not always) begin later than this. It is because the hormones that produce breast milk production can stop your body from producing the hormones that regulate your menstrual cycle.
If you experience fresh bleeding after your lochia has subsided, it’s best to consult your doctor, especially if you’re unsure about what might be causing it.
What Should You Do When You Have Postpartum Bleeding?
Postpartum bleeding can cause a little discomfort. Thus, when you are experiencing postpartum bleeding, try following these guidelines to stay comfortable and help prevent infections:
Use a superabsorbent maternity sanitary towel:
Maternity pads are better than the thinner pads you might normally wear during your periods. They promote faster healing of your perineum (the area between your vagina and anus), which is important if you gave birth vaginally. Using maternity pads also makes it easier to judge the amount of blood loss that you’re experiencing after birth.
Don’t use tampons just yet:
As per experts, it’s best not to use tampons for at least, your six-week postnatal check-up. This is done to avoid any kind of infection.
Practice good hand hygiene:
Make hygiene your number one priority. Make sure to wash your hands before and after using the toilet and/or changing your sanitary pad. Keep your nails short and remove all jewelry before washing hands thoroughly. When washing your hands, don’t forget to wash the nail beds, thumbs, wrists and backs of the hands, and wash for at least 20 seconds.
The Bottom Line
At first, you might experience a little discomfort while dealing with postpartum bleeding. But you need to remember that lochia is a natural part of your body’s recovering phase. Having maternity pads hands-on can prove to be helpful for you in this period.
There’s no need to worry, soon enough your vaginal bleeding will subside. It can be a little overwhelming for you to deal with so many things. But your little one’s giggles and warm hugs will make this hassle easier for you to handle.