Postpartum bleeding or lochia: what they are and when to go to the doctor

The first days after childbirth, either vaginally or by C-section, there is considerable bleeding known as lochia (or discharge, grandmothers would say). “They resemble a very abundant period and they will change color as the days go by”, says Dr. Mercedes Álvarez Goris (Lucina Gynecologist), specialist in Gynecology and Obstetrics

What are lochia or postpartum bleeding?

For many women, it is surprising, and even worrying, the amount of blood that can appear after having a baby. However, lochia is completely normal, it is the way in which your body recovers from pregnancy. In fact, the blood that comes out is the lining of the uterus.

When you were pregnant, your uterus was covered with blood and tissue, once you deliver your baby, the body eliminates lochia much like the menstrual cycle. On the first or second day, this bleeding can seem alarming, particularly because of the coagulated blood, “At first it is like a very abundant period and it changes color as the days go by, from red or brown, then yellow and white, until they disappear”, explains the gynecologist.

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When should I go to the doctor?

According to Dr. Álvarez, there are some tips that can help you identify if they are “abnormal”:

1. The lochia must not be fetid, they must not have an unpleasant odor. “They have a sui generis smell, like iron and blood, but they shouldn’t have a bad smell”.
2. The vaginal cavity should not feel hot.
3. There should be no a 38°C or higher fever.
4. The clots should not be very large (the size of a fist or an orange, for example).
5. Watch out for bleeding. The amount of lochia is more abundant than a period, but not so much more than you have to change the soaked sanitary pad in less than two hours. If you are changing the pad in less than two hours and you notice that the bleeding is extreme, you have to go to the emergency room immediately because it could be a postpartum hemorrhage”, explains the expert.

You can read: Recovery after childbirth, how long does it take?

How long do lochia last?

Lochia discharge varies greatly from woman to woman. “They usually last about 15 days and appear regardless of whether it was a C-section or vaginal delivery”, says Álvarez. Although there are women, especially if they had a multiple pregnancy, who may have these bleeding for longer.

Types of lochia

According to their color and approximate duration (remember that we are all different), they can be classified into the following:

Lochia rubra (dark red blood): It is the first bleeding after childbirth. It can flow continuously or by intervals. They last up to four days after you have the baby.

Lochia serosa (pinkish-brownish discharge): They become less intense. There is increased exudation and the secretion is more watery. It lasts between five and seven days.

Lochia alba (yellowish-white): The mucous secretion increases. It lasts about ten days.

Lochia is usually not painful, but frightening. Considering these data you should see a doctor. Even if you have large clots and are in doubt, don’t wait to measure it or see if it’s bigger than your fist, see your doctor, especially if you suddenly start bleeding heavily again, moreover if the blood is bright red.

Translated by: Ligia M. Oliver Manrique de Lara

Spanish version: Here

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