What are the Colours of lochia?

In the field of obstetrics, lochia is the vaginal discharge after giving birth, containing blood, mucus, and uterine tissue.[1] Lochia discharge typically continues for four to eight weeks after childbirth,[2] a time known as the postpartum period or puerperium. A 2016 review ties this "lochial period" to worldwide customs of postpartum confinement, a time for the new mother and baby to bond.[3]

Lochia is sterile for the first two days, but not so by the third or fourth day, as the uterus begins to be colonized by vaginal commensals such as non-hemolytic streptococci and E. coli.[4]

It progresses through three stages:[5]

  1. Lochia rubra (or cruenta) is the first discharge, composed of blood, shreds of fetal membranes, decidua, vernix caseosa, lanugo and membranes. It is red in color because of the large amount of blood it contains. It lasts 1 to 4 days after birth, before easing to light "spotting".[6]
  2. Lochia serosa is the term for lochia that has thinned and turned brownish or pink in color. It contains serous exudate, erythrocytes, leukocytes, cervical mucus and microorganisms. This stage continues until around the tenth day after delivery. Lochia serosa which persists to some weeks after birth can indicate late postpartum hemorrhaging, and should be reported to a physician.
  3. Lochia alba (or purulenta) is the name for lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth weeks after delivery. It contains fewer red blood cells and is mainly made up of leukocytes, epithelial cells, cholesterol, fat, mucus and microorganisms. Continuation beyond a few weeks can indicate a genital lesion, which should be reported to a physician.

In general, lochia has an odor similar to that of normal menstrual fluid. Any offensive odor or change to a greenish color indicates contamination by organisms such as chlamydia or staph saprophyticus.[7]

Lochia that is retained within the uterus is known as lochiostasis[8] or lochioschesis, and can result in lochiometra[9] (distention of the uterus - pushing it out of shape). Lochiorrhea describes an excessive flow of lochia and can indicate infection.[10]

  1. ^ Murkoff, Heidi; Eisenberg, Arlene; Hathaway, Sandee (2002). What To Expect When You're Expecting (3rd ed.). New York: Workman. p. 383. ISBN 0-7611-2132-3. This discharge of leftover blood, muscus, and tissue from your uterus, known as lochia, is normally as heavy as (and sometimes even heavier than) a menstrual period for the first three to ten postpartum days.
  2. ^ Oppenheimer, LW; Sherriff, EA; Goodman, JD; Shah, D; James, CE (July 1986). "The duration of lochia". Br J Obstet Gynaecol. 93 (7): 754–757. doi:10.1111/j.1471-0528.1986.tb08063.x. PMID 3755355. S2CID 221487083.
  3. ^ Sharma S, van Teijlingen E, Hundley V, Angell C, Simkhada P. Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal. BMC Pregnancy Childbirth. 2016;16(1):147. Published July 5 2016. doi:10.1186/s12884-016-0938-4
  4. ^ Hanretty, Kevin P. (2009). Obstetrics Illustrated. Illustrated by Ian Ramsden and Robin Callander (7th ed.). Churchill-Livingston. p. 337. ISBN 978-0-7020-3066-6. Retrieved 13 November 2013.
  5. ^ Sherman, D.; Lurie, S.; Frenkel, E.; Kurzweil, Y.; Bukovsky, I.; Arieli, S. (1999). "Characteristics of normal lochia". Am J Perinatol. 16 (8): 399–402. doi:10.1055/s-1999-6818. PMID 10772198.
  6. ^ "Postpartum Bleeding: What To Expect and How To Manage It". Yoppie.com.
  7. ^ "What Is Lochia". Elite Doula.
  8. ^ "lochioschesis - definition of lochioschesis in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia".
  9. ^ "lochiometra - definition of lochiometra at the Free Dictionary by Farlex".
  10. ^ Shevtsova, Maria. "Postpartum Bleeding – The Healing Wound". Mother How. Also, a profuse lochia discharge three weeks after childbirth can be a sing of lochiorrhea. Lochiorrhea may indicate an infectious disease in a woman or a sign of disturbed blood coagulation.

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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 Alba

How 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 Serosa

How 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 Alba

How 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:

  • Bright red bleeding beyond the third day after birth
  • Blood clots bigger than a plum
  • Bleeding that soaks more than one sanitary pad an hour and doesn’t slow down or stop
  • Blurred vision
  • Chills
  • Clammy skin
  • Rapid heartbeat
  • Dizziness
  • Weakness
  • Nausea
  • Faint feeling

Protection to Manage Bleeding After Birth

Bleeding 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.