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Lochia is the medical term for postnatal bleeding. This is how to prepare for it

A main perk of being pregnant is not having to deal with your period for nine months. So it seems kind of unfair that as soon as you give birth you basically experience a heavy period that lasts for around six weeks. Like seriously, WTF, Mother Nature?!

Never fear though, we’re on the case. Scroll down for everything you need to know about bleeding after birth (aka lochia) and how to make sure you’re postpartum prepared…

What is lochia?

Lochia (pronounced low-kee-ya) refers to the vaginal discharge that occurs after giving birth. It’s also referred to as postnatal bleeding or postnatal discharge. Lochia is something you will experience regardless of whether you give birth vaginally or via a C-Section.

Lochia consists of blood, mucus, and tissue from the lining of the uterus. It’s a natural process that happens as the uterus contracts and sheds the lining that supported your baby during pregnancy. The discharge of lochia helps the uterus to heal and return to its pre-pregnancy state. In other words, it’s a totally normal part of the birth recovery process.

How long does it last?

On average, postnatal bleeding usually lasts around four to six weeks after giving birth, however it can go on for up to twelve weeks. The amount of bleeding can also vary from person to person, but it is typically heavier in the first few days after delivery.

The length and amount of bleeding can be influenced by various factors such as whether you had a vaginal delivery or a C-section, if you had any tears or an episiotomy during delivery, and whether you have any medical conditions.

Is it painful?

Postnatal bleeding itself is not typically painful. It is more commonly described as a heavy menstrual-like flow. However, it is fairly common to experience some cramping or mild discomfort during the postnatal period as the uterus contracts and returns to its pre-pregnancy size. These cramps, often referred to as after-birth pains, are more common in the first few days after delivery and may be more pronounced during breastfeeding due to the release of oxytocin, which helps the uterus contract.

What are the stages of lochia?

You’ll likely find that the bleeding starts off quite heavy in the first few days. It should then gradually become lighter, changing in colour from bright red to pink or brown. These are the three main stages of lochia to know about:

  1. Lochia rubra: This is the initial stage of lochia and is typically bright red in colour, similar to a heavy menstrual flow. It can contain small to medium blood clots and may last for a few days after childbirth.
  2. Lochia serosa: After the lochia rubra stage, the discharge often transitions to a pinkish or brownish colour. Lochia serosa usually occurs around the second week after delivery and can last for a couple of weeks.
  3. Lochia alba: As your body continues to heal, the discharge becomes lighter in color, similar to a yellowish or whitish discharge. Lochia alba can last for a few weeks or even up to twelve weeks after childbirth.

What’s the best way to manage lochia?

The first thing to do is to get yourself prepared in advance of giving birth. Stock up on disposable pants, big maternity pads and a peri-wash bottle. Make sure you have them packed in your hospital bag and set up a little station in your bathroom too so you can grab them easily after birth.

It’s really important to maintain good hygiene after giving birth, especially after a vaginal delivery. Remember to only use sanitary pads rather than tampons to manage the bleeding and avoid infection. It’s also important to change the pads frequently, preferably every 1-2 hours.

We recommend

Comfortable is key after giving birth. As we said above, there are a couple of key items you will want to help you through those first few days and weeks to manage the lochia.

The first item is comfortable pants. Choose pants that are big, super stretchy and breathable. It’s also advisable to opt for cotton or other breathable fabrics (like bamboo) to help wound healing. Some women prefer to wear disposable underwear in the first few days due to the amount of blood and to then opt for period pants as the bleeding eases. We love this disposable and affordable option from MumBubHub, which come in four different sizes:

The second key item is maternity pads. We recommend wearing pads that are specifically designed for postpartum bleeding, which are often larger and more absorbent than regular pads. Remember to change the pads frequently to avoid infection. We love this FridaMom option because it also doubles as an ice pack to help aid healing…

Prioritise your comfort and hygiene during the first few days and weeks after giving birth in order to speed up recovery and prevent infection. If you have any concerns or questions about what to wear, be sure to talk to your midwife for advice.

Can I make the bleeding end more quickly?

Postnatal bleeding is a natural process that takes as long as it takes. While there is no way to make it speed up, there are some things you can do to help manage it and promote healing:

  • Rest: Getting plenty of rest and avoiding strenuous activity can help your body heal and reduce the risk of heavy bleeding.
  • Stay hydrated: Drinking plenty of fluids can help promote healing and prevent dehydration, which can worsen postpartum bleeding.
  • Eat a healthy diet: Eating a healthy and balanced diet that is rich in nutrients can help your body heal more quickly.
  • Use ice packs: Applying ice packs to your perineal area can help reduce swelling and discomfort, which can help manage postnatal bleeding.
  • Follow advice: Be sure to follow any instructions provided by your midwife, such as taking any prescribed medications, using pads instead of tampons, and attending any follow-up appointments.

When should I be worried?

In some cases, postnatal bleeding can be more severe than just lochia and may require medical attention. This can occur if the uterus does not contract properly or if there is damage to the uterus or other organs during delivery. Seek immediate medical attention if you experience any of the following issues:

  • Heavy bleeding: If you soak through a pad in less than an hour or pass large blood clots, it may indicate excessive bleeding.
  • Prolonged bleeding: If the bleeding persists or continues to be heavy after the first few days, rather than gradually decreasing in volume.
  • Foul smell: If you notice a strong, unpleasant odour from the bleeding, it may indicate an infection.
  • Severe pain: If you experience severe abdominal pain or pelvic pain, it could be a sign of a complication such as a uterine infection or retained placenta.
  • Fever or chills: If you have a fever of 38°C (100.4°F) or higher, or experience chills along with other concerning symptoms, it may indicate an infection.
  • Dizziness or lightheadedness: If you feel lightheaded, dizzy, or faint, it could be a sign of excessive blood loss.

If you experience heavy bleeding (soaking through a pad in less than an hour), pass large blood clots, or have any concerns about the colour, odour, or duration of lochia, you should contact your midwife or GP straightaway.

What should lochia smell like?

Lochia shouldn’t really have a specific smell. It might smell slightly metallic due to the presence of blood but it shouldn’t be offensive or strong-smelling. If you notice that the odour becomes foul, strong, fishy, or unusually unpleasant, it could potentially indicate an infection. If you begin to notice a strong and foul-smelling odour, speak to your GP or midwife to get things checked over in case there is an infection present.

What is the difference between lochia and postnatal haemorrhage?

Postnatal bleeding is the normal vaginal discharge that occurs after giving birth. As described above, it starts off as bright red and gradually transitions to lighter colours over days and weeks.

Postnatal haemorrhage (PNH), on the other hand, refers to excessive bleeding that occurs after child birth. It is a potentially serious complication that can lead to severe problems, and even death, if not treated quickly. There are two types of PNH:

  • Primary PNH: This occurs within the first 24 hours after delivery and is usually associated with uterine atony, which is the failure of the uterus to contract properly after childbirth. Other causes may include retained placental tissue, trauma to the birth canal, or blood clotting disorders.
  • Secondary PNH: This occurs between 24 hours and 6 weeks after delivery. It is often related to retained placental tissue, infection, or abnormal healing of the placental site.

Risk factors for PNH include a previous history of PNH, prolonged labor, multiple pregnancies (e.g., twins or triplets), placenta previa (where the placenta blocks all or part of your baby’s exit from your vagina), uterine abnormalities, and certain medical conditions or medications that affect blood clotting. Immediate medical attention is necessary if PNH is suspected.

What are the symptoms of postnatal haemorrhage?

The symptoms of PNH can vary depending on the severity of the bleeding. These are some key signs and symptoms to be aware of:

  • Excessive or prolonged bleeding: Heavy bleeding that saturates a pad within an hour or the presence of large blood clots is a concerning sign. Keep in mind that some blood loss is normal in the immediate postpartum period, but excessive or ongoing bleeding should be evaluated.
  • Signs of low blood pressure and shock: Symptoms may include feeling lightheaded, dizzy, or faint, rapid or weak pulse, pale or cold skin, and difficulty breathing. These signs can indicate significant blood loss and require immediate medical attention.
  • Abdominal pain or discomfort: Severe or persistent abdominal pain or discomfort, particularly if accompanied by heavy bleeding, could be a sign of PNH.
  • Signs of infection: In some cases, PNH may be associated with an infection. Symptoms may include fever, chills, increased pain, foul-smelling discharge, or redness and warmth at the incision site (in the case of a cesarean section).

If you are experiencing any of these signs or have concerns about postnatal bleeding, it is essential to seek advice straightaway. Like all things during pregnancy and motherhood, remember to trust your instincts and reach out to your midwife or GP if you have any concerns about your recovery. They can evaluate your symptoms and provide appropriate guidance and medical care.

Sources

https://www.uhs.nhs.uk/Media/UHS-website-2019/Patientinformation/Pregnancyandbirth/Blood-loss-what-to-expect-after-the-birth-of-your-baby-743-PIL.pdf

https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/heavy-bleeding-after-birth-postpartum-haemorrhage-patient-information-leaflet/

Birthbabe does not provide medical advice, diagnosis, or treatment. The resources on our website are provided for informational purposes only. You should always consult with a healthcare professional regarding any medical diagnoses or treatment options.

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