What lochia is and why it happens
Lochia is the discharge from the womb after childbirth. It contains blood, wound secretions and tissue remnants as the womb contracts and the site where the placenta was heals.
Many people first think of bleeding. In practice lochia is more of a process: it changes, usually becomes less and shifts in colour. The aim is not to monitor every minor variation but to recognise patterns and warning signs.
A clear explanation of why lochia happens and how it can change is also available from the NHS. NHS: Body after birth
How long lochia lasts: a realistic timeframe
How long lochia lasts varies between individuals. It is often heaviest in the first days and then gradually reduces. For some people there is very little by two to three weeks, while for others it takes longer.
More important than the exact week is the trend. If it is overall decreasing and the colour shifts towards brown and then paler shades, that is more consistent with normal healing. If, after clear improvement, it becomes noticeably heavier again, that is a sign to look more closely.
What can influence the course
- How active you are and whether you stand or lift a lot
- Breastfeeding, because the womb contracts more strongly
- Whether small amounts of tissue remain in the womb, which is uncommon but can be relevant
- Infections, which are more likely to show through smell, fever and increasing pain than by colour alone
Understanding colours: from bright red to pale
Colour is often the first thing noticed, but it is only part of the puzzle. The combination of colour, amount, smell and how you feel is what matters.
Bright red
Bright red lochia is common in the first days. It can flare up briefly later, for example after increased activity or returning to activity after rest. If bright red bleeding becomes heavier again, continues for a long time or is accompanied by clots, dizziness or weakness, it is sensible to get it checked.
Brown, reddish-brown, yellowish, pale
Many people see more brown or reddish-brown shades after a few days. Later the discharge can become more yellowish or pale. This often fits with wound healing as long as smell and general condition are unremarkable.
What colour alone does not reliably indicate
A lighter or darker shade does not automatically tell you whether everything is fine. Warning signs more often appear in the overall course and accompanying symptoms than from a single colour.
Lochia smell: what can be normal and what is not
Lochia usually has its own smell. Many people describe it as metallic, slightly sweet, or similar to menstrual blood. That can be unpleasant but is not automatically a problem.
It becomes more concerning if the lochia has a clearly foul, rotten or pungent smell, especially if this is combined with fever, shivering, increasing lower abdominal pain or a noticeably worse general condition. In such cases an infection should be ruled out.
Postnatal warning signs that should be medically assessed are also described by the RCOG. RCOG: Heavy bleeding after birth
Clots and pieces of tissue: when this is normal
Small clots can occur in the first days, especially after lying down for a while. A brief heavier bleed after getting up is also common because blood can collect and then flow out.
What is generally unremarkable
- Small clots in the first days, if the flow decreases afterwards
- A short period of heavier discharge after rest
- Clots without fever, without a foul smell and without increasing pain
What is less consistent with normal lochia
- Large or repeatedly numerous clots, especially if the overall bleeding increases
- Weakness, dizziness, a racing heart or feeling physically unstable
- Clots together with fever or severe new lower abdominal pain
Amount and pace: when bleeding may be too much
In the postnatal period it is normal to need several pads a day, especially at the start. What feels like too much depends on the material and how you feel, so a pragmatic view helps.
Signs you should get checked promptly
- You need to change very frequently because the pad becomes soaked through quickly
- The bleeding becomes noticeably heavier again after clear improvement and remains bright red
- You feel circulatory instability or unusual weakness
- Large clots appear or clots occur repeatedly
If you are unsure, a useful question is: Is it overall getting better or worse? The trend often matters more than a single day.
Hygiene and safety in everyday life
The womb is still healing in the postnatal period. Good hygiene means being clean and gentle, not sterile or excessive.
What is commonly recommended
- Pads rather than tampons or menstrual cups until healing is well advanced
- Change regularly, even if the amount is small
- Wash hands before and after changing
- Lukewarm water is often sufficient; aggressive intimate washes are usually unnecessary
Bathing, swimming, sex
Many people wait with baths, swimming and penetrative sex until the lochia has clearly reduced and there are no warning signs. This is not about a fixed day but about keeping infection risk low and allowing the body time to recover.
Fever and lower abdominal pain in the postnatal period
Fever is not a typical symptom of lochia. If fever occurs, it should always be medically assessed, especially if accompanied by a foul smell, increasing lower abdominal pain or a noticeably worse general condition.
Lower abdominal pain can be caused by afterpains, particularly during breastfeeding. Again, the course is decisive. If pain increases rather than decreases, or if it is constant and worsening rather than intermittent, it should be investigated.
A reference for postnatal warning signs and when to seek help is also available from ACOG. ACOG: Warning signs postpartum
Conclusion
Lochia is a normal part of healing after childbirth. Colour and amount often change over weeks, and a slight smell can be part of that. What matters are the course and accompanying symptoms: if bleeding becomes strongly bright red again, if large clots occur, or if fever, a foul smell and increasing pain develop, you should have it checked.
