The objective of this paper is to determine the characteristics of each phase of lochia and how these may be influenced by a number of obstetric variables. Thirty-nine healthy women who had spontaneous vaginal delivery following uncomplicated pregnancy volunteered to complete a diary sheet immediately postpartum. The women were instructed to assess the color of their lochia by a color slide with differential gradation from dark red to white. The color was labeled as rubra (red, red-brown), serosa (brown-pink, brown), or alba (yellow, white). The overall duration of lochia was 36.0 +/- 7.5 days (range 17 to 51 days, median 37 days). Three types of lochia color patterns were identified: type 1--rubra-->serosa-->alba sequence (n = 20); type 2-rubra-->serosa-->alba sequence with prolonged rubra phase and short serosa and alba phases (n = 11); and type 3-with two rubra phases (rubra-->serosa/alba-->rubra-->serosa/alba sequence with near-equal duration of each phase) (n = 8). The rubra phase lasts 12.1 +/- 6.7 days in type 1, 24.8 +/- 5.0 days in type 2, and 5.5 +/- 2.5 days (the first rubra) in type 3 pattern (p < 0.05). There was a higher proportion of lactating women among women with type 1 pattern as compared with type 2 (11/20 and 2/11, p < 0.05, respectively). Women with type 2 pattern were of higher parity (2.8 +/- 1.3) as compared with those with type 1 (1.8 +/- 0.8) (p < 0.05). There were no significant differences in infants' birth weight between the various color types (3,276.0 +/- 379.8 g, 3,564.4 +/- 737.9 g, and 3,080.0 +/- 180.0 g for type 1, type 2, and type 3, respectively. There were no significant differences in overall duration of lochia or gestational age at delivery between the various color types. The results confirm the clinical impression that lochia persists longer than classically reported and is of diverse patterns. Three unique types of color patterns were identified. Type 1 is the most prevalent and is associated with prolonged breast feeding and thus can be considered as the classic type. Type 2 is associated with short or no breast feeding and higher parity. Type 3 may be a variant of type 2. We suggest that traditional teaching on lochia characteristics needs reappraisal. Show
You’ve welcomed a beautiful bundle of joy into the world—congrats! Having a baby comes with a lot of physical changes to your body. Some of them can be quite surprising, like heavy vaginal bleeding after giving birth. Bleeding after delivery is perfectly normal. In fact, there’s even a name for post-pregnancy bleeding. It’s called lochia. Use this guide to understand what lochia is, what causes postpartum bleeding, and what to expect with normal (or not normal) blood loss the weeks after childbirth. What is Lochia?Lochia, also known as postpartum bleeding, is vaginal bleeding after giving birth that includes bloody fluid made up of blood, placental tissue, sloughed off endometrial lining and mucous. Normal postpartum bleeding continues for 3 to 6 weeks as your uterus heals and returns to its usual shape and size. What Causes Lochia and Postpartum Bleeding?Postpartum bleeding is your body’s way of getting rid of the extra blood and tissue in your uterus that helped your baby grow. The blood in lochia comes mostly from the area where the placenta detached itself from the uterine wall during birth, leaving a wound that needs to heal. The endometrial lining, which thickens during pregnancy, also sloughs off, similar to when you have your period. Postpartum Bleeding Stages: Rubra, Serosa and AlbaHow long does postpartum bleeding last? How much blood loss is normal and what does the color of blood mean? You’ll go through three postpartum bleeding stages: lochia rubra, lochia serosa and lochia alba. Learn about the different stages below, including how long you can expect to bleed and what to expect during each stage. How long it lasts: 3-4 days postpartum What color: Bright or dark red The first stage of postpartum bleeding is rubra and can last up to four days postpartum. Postpartum bleeding is heaviest the first few days after baby is born. Blood will be a dark or bright red and will be very heavy. It is normal to see clots in your lochia during this stage. Normal blood clots are smaller than a quarter or a small plum. You may feel cramping and uterine contractions as your uterus returns to its usual size. If you have large clots—larger than a quarter—you should consult your doctor. Stage 2: Lochia SerosaHow long it lasts: 4-10 days postpartum What color: Pinkish brown The second stage of postpartum bleeding is serosa and can last about two weeks after delivery. Your blood flow will lighten. Its color will change from light red to a watery pink or pinkish brown. Your placenta will likely still be bleeding, but it will be significantly lighter than the initial few days after you give birth. You can still see blood clots during this stage, though clots should be smaller. Stage 3: Lochia AlbaHow long it lasts: 10-28 days postpartum What color: Whitish yellow The third stage of postpartum bleeding is called alba and can last two to six weeks after giving birth. Lochia changes from pink to a light brown to yellowish white color. You may still experience occasional spotting of blood. This stage of postpartum bleeding is mostly white blood cells leaving the body after they helped heal your uterus after birth. Amazing what a woman’s body can do, right? How Much Bleeding is Too Much Postpartum and When Should You Call Your Doctor?Bleeding is heavy for the first few days after delivery. However, if you experience heavier blood loss after that, call your doctor. In some cases, heavy bleeding after childbirth is a sign of postpartum hemorrhage. While it is most likely to happen in the first 24 hours after delivery, postpartum hemorrhage can take place anytime during the first 12 weeks after delivery. Postpartum hemorrhaging is very serious and needs immediate attention. It can make your blood pressure drop so much that your organs don’t get enough blood. This can cause death if left untreated. If you think you have postpartum hemorrhage, contact your doctor or head to the emergency room right away. Signs of Postpartum Hemorrhage:
Protection to Manage Bleeding After BirthBleeding after delivering a baby can leave a new mom in quite a quandary. While changing diapers and caring for your little one, you may be wondering how to provide protection and comfort for yourself as well. Regular menstrual pads just don’t cut it. You may even find yourself soaking through one every three hours or so. Definitely do not use tampons. This can be very dangerous after giving birth. Instead, a product like Always Discreet underwear are great for postpartum bleeding, especially during the first stage when blood flow is heaviest. Postpartum underwear can come in different sizes with different levels of absorbency—use this guide for choosing which postpartum underwear is best for you. Always Discreet postpartum underwear are super thin and flexible, which means they are super comfortable. They use special gel technology that locks in moisture and fluid, keeping your skin dry. You may even forget you have one on.
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. Verywell / Theresa Chiechi 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:
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.
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 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. 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:
There are three stages, or "types," of lochia. The duration of each stage can vary from person to person. Characteristics of lochia rubra include:
Characteristics of lochia alba include:
Characteristics of lochia serosa include:
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:
Unless there are complications like infection, lochia does not require treatment. To help manage lochia, try:
To help prevent irritation and infection:
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:
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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