Understanding Lochia: What to Expect After Birth

Most women leave the hospital knowing they will bleed after birth. Very few are told what that bleeding will actually look like, smell like, or how long it will continue. Lochia is the vaginal discharge that follows delivery, and is one of the least discussed and most misunderstood parts of postpartum recovery.

Here is what it is, what to expect at each stage, and what warrants a call to your doctor.

What Is Lochia

Lochia is not simply postpartum bleeding. It consists of blood, mucus, uterine tissue, and other material from your uterus. It is how your body clears and repairs the uterine lining after the placenta detaches, and it happens whether you delivered vaginally or by C-section.

When you breastfeed, your body produces oxytocin, which causes the uterus to contract and return to its original size, while simultaneously squeezing it to stop blood flow to the placenta. This is why you may notice a temporary increase in flow during or just after a nursing session.

The Three Stages

Lochia rubra — days 1 to 4. Dark or bright red for at least three to four days. The flow is heavy and may include small clots. You can expect to soak one thick maxi pad every two to three hours. The smell is similar to menstrual blood; it should not smell fishy or foul.

Lochia serosa — days 5 to 10. The discharge turns pinkish-brown and more watery, with less blood and more serum. Flow is significantly lighter than the first stage.

Lochia alba — day 10 onwards. After around 10 to 14 days, lochia changes to a creamy, yellowish-white colour. This stage can last several more weeks.

How Long Does It Last

Longer than most women are told. The median duration of lochia is 27 days, and it is common for postpartum bleeding to stop and start again, or to be characterised by intermittent spotting. Lochia lasting more than 40 days is not unusual.

It is also normal for flow to increase temporarily when you move around more than usual. Sometimes you may feel a sudden gush of blood when you stand — this is because blood collects in the vagina while you are sitting or lying down, and releases when you get up.

Signs of Worry

If bleeding continues to look bright red and heavy past the first 3 to 4 days, it may indicate the uterus is not shrinking as it should. Contact your doctor if you notice:

• Soaking through one or more large maxi pads in less than an hour, for two consecutive hours
• Blood clots larger than a golf ball
• A foul or fishy odour, which may indicate a uterine infection
• A sudden return of heavy, bright red bleeding after it had already lightened
• Fever above 38°C, chills, or abdominal pain alongside any of the above

Feeling dizzy or faint, unusual weakness, or cold and clammy skin alongside heavy bleeding are signs of postpartum hemorrhage. This is a serious condition requiring immediate medical attention. We're not trying to scare you — just making sure you're better informed.

Frequently Asked Questions

Is it normal for lochia to stop and start again? Yes. It is common for postpartum bleeding to stop and start again, or to be characterised by intermittent spotting, particularly in the first several weeks. A sudden return to heavy, bright red bleeding after it had lightened is a different matter and needs medical assessment.

Does lochia look different after a C-section? The stages and timeline are broadly the same. The uterus still needs to shed its lining regardless of delivery method, so lochia occurs after both vaginal and cesarean deliveries.

Can I use a menstrual cup during lochia? No. Avoid inserting anything into the vagina for at least six weeks postpartum. This applies to tampons, menstrual cups, and intercourse.

Why does lochia increase when I breastfeed? When your baby nurses, the hormones released cause the uterus to contract, which helps speed up the expulsion of uterine tissue. A temporary gush or heavier flow during or after a feed is a sign the uterus is contracting efficiently.

When does my period return after lochia ends? It is possible to get pregnant again as early as three weeks after birth. If you do not intend to conceive, use contraception, even if your period has not yet returned, as ovulation can occur first. Women who are exclusively breastfeeding may find their period takes longer to return, but this is not a reliable contraceptive method.

How do I recognise a postpartum hemorrhage? Heavy bleeding after birth is called postpartum hemorrhage and is serious, as it can cause a significant drop in blood pressure; if pressure gets too low, organs do not receive adequate blood flow. The key markers are a soaked pad in under an hour, alongside dizziness, weakness, or a rapid heartbeat. Seek immediate medical attention if you notice these signs.

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This article is for general information and does not replace individualised medical advice. Seek immediate medical care for any signs of postpartum hemorrhage.

At Filocia, we believe that expecting mothers and new moms deserve access to the kind of honest, medically sound information that used to only exist behind a clinic door. It's time we started having more open conversations about our health and happiness, rather than behind closed doors.

If you have questions, or if something you read here resonated with your experience, write to us at care@filocia.com.