All you need to know about postpartum bleeding, or Lochia

What is postpartum bleeding, or lochia?

When a woman suffers from heavy bleeding after giving birth to a baby, this is called postpartum bleeding or lochia. Our vagina discharges it, which not only contains blood but also mucus and uterine tissue. This condition typically lasts for four to six weeks but can also persist for up to eight weeks.

It’s normal to have vaginal bleeding in the days after having a baby, but you should know the symptoms indicating it’s abnormal & requires medical attention.

How long does lochia last

In the first few days, the blood flow is heavy, but over time, it gradually decreases. At first, it appears bright red in colour, then it turns pink or brown in color. In the last few days, it usually changes to yellow or white.

Stages of postpartum Bleeding or lochia

Now we will discuss the stages of postpartum bleeding to know further. Postpartum bleeding, or lochia, contains three stages, as follows:

1. Lochia Rubra
2. Lochia serosa
3. Lochia alba

Let's talk about these stages in detail, one by one.

Lochia Rubra

Lochia rubra is the first stage of lochia. In this, the colour of blood will look like dark or bright red. The flow of the blood will be just like a heavy period. In this, the blood contains a small clot. You can also suffer from periods like cramping. If you are breastfeeding your baby or pumping milk from your breasts, then you may also experience mild cramping, just like how it happens during your periods. This stage of lochia rubra will last for at least three to four days after your childbirth.

Lochia Serosa 

The second stage of lochia is lochia serosa. Your blood colour will appear pinkish brown and thin. Moderate blood flow occurs in this stage, which may contain fewer blood clots or no clots at all. This condition can last for four to twelve days.

Lochia alba

The third and last stage is lochia alba. It may appear yellowish or white in colour. There will be no clots present in your blood, and you may only experience spotting. Blood flow will stop eventually. From day twelve to almost six weeks of delivery, this stage will remain.

Related reading: Pregnancy, Labor & Delivery Blog

Signs And Symptoms 

There are different symptoms of lochia that are important to know. You will experience heavy bleeding from your vagina. You will feel weakness in your body because of blood loss. 

Dizziness, increased heart rate, and respiratory rate will also occur.

Causes 

Various causes of postpartum bleeding are contained in the 4 Ts rule, which are as follows:

Tone (Uterine atony)

It is the most common cause of postpartum bleeding. After the delivery, the uterus fails to contract properly. Without contraction of the uterus, the blood vessels keep bleeding at the placental site. There can be different risk factors, such as prolonged or rapid labour, general anaesthesia, and use of oxytocin for long periods. Overdistended uterus (twins, large baby, too much amniotic fluid) and high parity (multiple previous births) factors are also included.

Tissue (Retained Placental Tissue or clots)

In this case, pieces of the placenta or membranes remain inside the uterus. These prevent the uterus from contracting efficiently. Risk factors can be incomplete delivery of the placenta and manual removal in previous pregnancies. Placenta accreta, which means the placenta grows too deeply into the uterine wall, also comes under a risk factor for this cause.

Trauma (Genital Tract Injuries)

During delivery, tears in the cervix, vagina, perineum, or uterus occur. It simply means the birth canal tears because of the instrumental delivery (forceps or vacuum), a big baby, and uterine rupture.

Thrombin (Coagulation Issues)

Problems of blood clotting that prevent the normal control of bleeding. This can happen due to preexisting clotting disorders, massive blood transfusion, and severe preeclampsia or HELLP syndrome.

Other factors can also be involved, like infections, use of anticoagulant medicines, and retained products of conception.

How Lochia Can Be Treated 

The most important thing is the treatment of any illness. You would also be curious to know how it is treated.  After delivery, it is normal for any woman to bleed for a few weeks because her uterus takes time to heal. Lochia can be treated without medical treatment. You just need good care and monitoring.

There are a few things that you can do at home to treat lochia.

• Use maternity pads.
• Don’t use a tampon to prevent the infection.
• Maintain proper hygiene. Use pads frequently
• Doing some light physical activity, such as a simple walk, can also help.
• Get as much rest as possible
• Avoid any heavy lifting tasks 
• Breastfeed if possible, as it helps the uterus to contract.
• Take a healthy diet. A nutrient-rich postpartum diet helps your body rebuild blood, regain strength, and heal faster.

When To Worry About Postpartum Bleeding

Postpartum bleeding is normal because every woman goes through it after childbirth.

It is normal bleeding that contains light to moderate flow and can last for up to 4-6 weeks.

But there is a term called postpartum hemorrhage that people often confuse with the lochia or postpartum bleeding. The word hemorrhage is serious

In contrast to lochia, postpartum hemorrhage is heavy or uncontrolled bleeding after delivery. It is abnormal and dangerous bleeding. In postpartum hemorrhage (PPH), you may experience 500 ml or more blood loss from your body.

You should worry about postpartum bleeding if you are experiencing too much bleeding or heavy bleeding, and it lasts for a long period of time.  

Conclusion

Postpartum bleeding, or lochia, is a natural process for your body to heal after childbirth. It helps your body heal and remove the remaining tissues from your uterus.

By following some simple steps during your postpartum bleeding, you can support your recovery and reduce discomfort. 

However, if the bleeding becomes excessively heavy and lasts unusually long, then you must seek medical attention immediately. Understanding lochia helps new mothers to stay informed and safe during their postpartum journey