What lochia is and why it happens
Lochia is the discharge from the uterus after childbirth. It contains blood, wound secretions and tissue remnants as the uterus contracts and the placental site heals.
Many people first think of bleeding. Practically, lochia is more of a process: it changes, usually decreases and shifts in colour. The aim is not to control every single deviation but to know the typical patterns and the warning signs.
A clear, easy-to-understand explanation of why lochia occurs 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 is individual. It is often heaviest in the first days and then gradually decreases. For some people it is barely noticeable after two to three weeks, while for others it takes longer.
More important than the exact week is the trend. If it is generally decreasing and the colour shifts toward brown and then lighter shades, that usually fits 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 much you exert yourself and whether you spend a lot of time standing or lifting
- Breastfeeding, because the uterus contracts more strongly during feeds
- Whether tissue remnants remain in the uterus, which is rare but can be relevant
- Infections, which are more likely to be noticed through smell, fever and increasing pain than by colour alone
Understanding colours: from bright red to pale
Colour is often the first thing noticed. It is only part of the picture. The combination of colour, amount, smell and how you feel overall is decisive.
Bright red
Bright red lochia is common in the first days. It can flare up again briefly later, for example after increased activity or after being inactive for a long time and becoming active again. If bright red bleeding becomes stronger again, lasts longer, or is accompanied by clots, dizziness or weakness, medical assessment is advisable.
Brown, reddish-brown, yellowish, pale
Many people see more brown or reddish-brown tones after a few days. Later the discharge can become more yellowish or paler. This generally fits wound healing as long as smell and overall condition are unremarkable.
What colour alone does not reliably indicate
A lighter or darker tone does not automatically mean everything is fine. Warning signs are more often shown by the course and accompanying symptoms than by a single colour.
Lochia smell: what can be normal and what is not
Lochia usually has its own smell. Many describe it as metallic, slightly sweet or similar to menstrual blood. This can be unpleasant but is not automatically a problem.
It becomes unusual when the lochia smells distinctly foul, putrid or sharp, especially if there is fever, chills, increasing lower abdominal pain or a marked decline in overall condition. In such cases, an infection should be ruled out.
Postpartum warning signs that should be medically assessed are also described by professional bodies such as the RCOG. RCOG: Heavy bleeding after birth
Clots and tissue fragments: when they are normal
Small clots can occur in the first days, especially after lying down for a while. A brief heavier bleed after standing up is also not uncommon because blood that has pooled can then drain.
What is usually unremarkable
- Small clots in the first days, if the bleeding then decreases again
- A short episode of heavier discharge after rest periods
- Clots without fever, without foul smell and without increasing pain
What does not usually fit normal lochia
- Large or repeatedly many clots, especially if the overall bleeding increases
- Weakness, dizziness, a racing heart or feeling unstable
- Clots together with fever or severe new lower abdominal pain
Amount and pace: when bleeding can be too much
In the postpartum period it is normal to need several pads a day, especially at the start. What feels like too much depends a lot on the material and personal sensation, so a pragmatic assessment helps.
Signs that you should get it checked soon
- You need to change pads very frequently because they become soaked through quickly
- The bleeding becomes noticeably heavier again after clear improvement and stays bright red
- You feel circulatory instability or unusual weakness
- Large clots appear or there are repeatedly many clots
If you are unsure, a helpful question is: Is it getting better overall or worse overall? The trend often matters more than a single day.
Hygiene and safety in daily life
The uterus is still healing in the postpartum period. Good hygiene means being clean and gentle rather than sterile or excessive.
What is usually recommended
- Pads instead of tampons or a menstrual cup until healing is complete
- Change regularly, even if the amount is small
- Wash hands before and after changing
- Lukewarm water is usually sufficient; aggressive intimate washes are often unnecessary
Bathing, swimming, sex
Many people wait with full baths, swimming and penetrative sex until the lochia has clearly decreased and there are no warning signs. This is not about a fixed day but about keeping infection risk low and giving the body time to recover.
Fever and lower abdominal pain in the postpartum period
Fever is not a typical symptom of lochia. If fever occurs, medical assessment should always be sought, especially if there is also a foul smell, increasing lower abdominal pain or a marked decline in overall condition.
Lower abdominal pain can come from afterpains, especially during breastfeeding. Again, the course is decisive. If pain gets stronger instead of weaker, or if it is not cramping but constant and increasing, it should be evaluated.
Guidance on postnatal warning signs and when to seek help is also available from organisations such as ACOG. ACOG: Warning signs postpartum
Conclusion
Lochia is a normal part of healing after childbirth. Colour and amount often change over weeks, and a mild smell can be part of that. What matters are the course and accompanying symptoms: if bleeding becomes strongly bright red again, if large clots appear, or if fever, foul smell and increasing pain occur, you should have it checked.
