Your baby has grown inside of your uterus and been connected to your blood supply for 40+ weeks. After delivery of your baby and the placenta your uterus is left with an open wound. Your body quickly works to contract your uterus and seal off all of the blood vessels that provided your baby with nutrients and oxygen via the placenta. In addition to the blood that is lost from these vessels closing, your uterine lining, which has cushioned and nourished your baby, will shed and heal over the coming weeks. This is lochia and there are three lochia stages.
Lochia Stages: Listen to this article
What is lochia?
In simple terms, it’s the 9 to 11 periods that you didn’t have while you were pregnant. Each month, under the control of estrogen and progesterone, you have your cycle and the thickness of the lining of the uterus, the endometrium, varies from 1-18mm. When you have your period the endometrium is at the thinnest – the blood you lose is the lining shedding because no embryo implanted. When you are pregnant, there is an embryo implanted and the endometrium thickens throughout pregnancy to supply your embryo and then fetus with nutrients and blood.
So, lochia is the vaginal discharge that women experience after giving birth. It consists of blood, uterine tissue, and mucus. It is the body’s natural way of healing and shedding after delivery.
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How long does it last and what are the different stages of lochia?
Although you will commonly find online that 2 weeks is normal, research shows that actually 4 to 6 weeks is most common. There are three stages: lochia rubra, lochia serosa, and lochia alba. The duration and characteristics of each stage change due to vaginal or cesarean birth, number of previous births, and individual differences.
Lochia Rubra
Bright Red
The color is bright red and the flow is similar to a heavy period. During this phase you may see blood clots up to the size of a golf ball. This stage typically lasts 3-4 days after delivery. Rubra consists of blood, mucus, and uterine tissue.
Lochia Serosa
Pink to Brown
The color is a pink or brownish hue and the flow is less than before. This stage typically lasts 2-3 weeks. You may still have small blood clots, but they should not be bigger than the size of your pinky fingernail. Serosa is composed of serum, leukocytes, and organisms, and blood.
Lochia Alba
Yellow to White
The color is yellow to white and can look like normal vaginal discharge. It is a very light flow or spotting. Depending on how long the other two stages lasted this will complete the 4 to 6 week lochia phase. 1 in 3 women do not experience this stage. Alba consists of mucus, organisms, and white blood cells that healed your uterus after delivery.
I have more questions about the lochia stages and postpartum bleeding
There are blood clots in the lochia, is that normal?
Yes, it’s normal to see small blood clots – even up to the size of a quarter. Blood clots are also more common if you gave birth vaginally.
How do I know if I am bleeding too much?
Bleeding is heavy after delivery, but it can also be a sign of a postpartum hemorrhage (PPH).
Abnormal blood loss is:
- Passing clots that are larger than a golf ball
- Bleeding that soaks through a sanitary pad every hour and does not slow down
- Bright red bleeding beyond the third day after delivery
A postpartum hemorrhage can happen anytime from delivery to 12 weeks and is a medical emergency. It is the most common and dangerous complication of childbirth, occurring in 1-6% of all deliveries.
PPH is the leading cause of morbidity and mortality in childbirth.
- Primary PPH occurs within 24 hours of delivery and affects approximately 2%–5% of all deliveries
- Secondary PPH occurs between 24 hours and 12 weeks after delivery and affects anywhere from 0.8% to 2% of all deliveries
Will my lochia be different if I gave birth vaginally or had a cesarean section?
Yes, if you had a c-section you may have less lochia for a shorter amount of time. As the uterine cavity was not as involved as a vaginal birth the 3 stages of lochia can progress more rapidly and the overall duration may be shorter.
Will my lochia stages be different if I have given birth before?
Yes, after a second or third baby the uterus can take longer to contract and therefore the lochia may last longer overall. Some women also experience two rubra phases, where the lochia changes to pink/brown/yellow and then there it goes back to the bright red lochia rubra a second time before going through the pink/brown/yellow/white color change again and then ending.
Read more on postpartum cramping.
Read more on first pregnancy vs second pregnancy.
Does breastfeeding affect my lochia stages?
Yes, if you are breastfeeding, the oxytocin will contract your uterus more quickly and you may begin bleeding sooner or experience a longer rubra phase.
You may also feel heavy blood flow while you are breastfeeding, again due to oxytocin that is released during suckling which causes those painful postpartum cramps that contract your uterus.
Read more on the advantages of breastfeeding, breastfeeding with a good latch, or our breastfeeding FAQ.
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