What lochia is and why it happens
Lochia is the discharge from the uterus after birth. It consists of blood, wound fluid, and tissue remnants as the uterus contracts and the area where the placenta was heals.
Many people first think of bleeding. Practically, lochia is more of a process: it changes, usually becomes less, and the color shifts. The goal is not to monitor every single deviation but to recognize patterns and warning signs.
You can also find a clear explanation of why lochia occurs and how it can change on the NHS website. 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 there is hardly anything left after two to three weeks; for others it lasts longer.
More important than the exact week is the trend. If it overall becomes less and the color moves toward brown and then lighter shades, that is more in line with normal healing. If it becomes clearly heavier again after a period of improvement, that is a signal to take a closer look.
What can influence the course
- How much physical strain you have and whether you stand or carry a lot
- Breastfeeding, because the uterus contracts more strongly
- Whether tissue remnants remain in the uterus, which is rare but can be relevant
- Infections, which are more likely to be noticed by smell, fever, and increasing pain than by color alone
Understanding colors: from bright red to light
Color is often the first thing noticed. It is only part of the puzzle. The crucial factor is the combination of color, amount, smell, and how you feel overall.
Bright red
Bright red lochia is common in the first days. It can also briefly flare up later, for example after significantly increased activity or after being more active following a longer rest. If bright red bleeding becomes stronger again, lasts longer, or is combined with clots, dizziness, or weakness, a medical evaluation is reasonable.
Brown, reddish-brown, yellowish, light
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 color alone does not reliably indicate
A lighter or darker shade does not automatically mean everything is fine. Warning signs are more often shown by the course and accompanying symptoms than by a single color.
Lochia smell: what can be normal and what isn't
Lochia usually has its own smell. Many describe it as metallic, slightly sweet, or similar to menstrual blood. That can be unpleasant but is not automatically a problem.
It becomes concerning when the lochia smells distinctly foul, putrid, or strong, especially if fever, chills, increasing lower abdominal pain, or a markedly worse general condition occur at the same time. In these cases, an infection should be ruled out.
Postpartum warning signs that should be medically evaluated are also described by the RCOG. RCOG: Heavy bleeding after birth
Clots and tissue fragments: when it's normal
Small clots can occur in the first days, especially after lying down for a while. A brief increase in bleeding after getting up is also not uncommon because blood can collect and then drain.
What is usually unremarkable
- Small clots in the first days if the bleeding then decreases again
- A brief stronger discharge after periods of rest
- Clots without fever, without a 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, rapid heartbeat, or the feeling of being unstable
- Clots together with fever or severe, new lower abdominal pain
Amount and rate: when bleeding might be too much
In the postpartum period it is normal to need several pads a day, especially at first. What feels like too much depends heavily on the product and how the body feels, so a pragmatic assessment helps.
Signs that you should get checked soon
- You have to change very frequently because the pad becomes completely soaked quickly
- The bleeding becomes clearly heavier after a period of obvious improvement and stays bright red
- You feel circulatory instability or unusually weak
- Large clots appear or many clots appear repeatedly
If you're unsure, a helpful 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 uterus is still healing in the postpartum period. Good hygiene means mainly clean and gentle, not sterile or excessive.
Common recommendations
- Use pads instead of tampons or a menstrual cup until everything has healed well
- Change regularly, even if the amount is small
- Wash hands before and after changing
- Lukewarm water is often sufficient; aggressive intimate washes are usually not necessary
Bathing, swimming, sex
Many people wait with full baths, swimming, and penetrative sex until the lochia has declined significantly and there are no warning signs. It's not about a fixed day but about keeping the infection risk low and giving the body time to heal.
Fever and lower abdominal pain in the postpartum period
Fever is not a typical symptom of lochia. If fever occurs, a medical assessment should always be done, especially if a foul smell, increasing lower abdominal pain, or a markedly worse general condition appear.
Lower abdominal pain can be caused by afterpains, especially during breastfeeding. Here too, the course is decisive. If pain becomes stronger instead of weaker or if it is not wave-like but constant and increasing, it should be evaluated.
ACOG also provides guidance on postpartum warning signs and when to seek care. ACOG: Warning signs postpartum
Conclusion
Lochia is a normal part of healing after childbirth. Color and amount often change over weeks, and a slight smell can be part of it. The important aspects are the course and accompanying symptoms: if the bleeding becomes strong and bright red again, if large clots occur, or if fever, a foul smell, and increasing pain appear, you should have it checked.
