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Postpartum Bleeding: Lochia is not just a Heavy Period

Updated: Mar 15, 2022

If you are giving birth soon, there are crucial things to know about postpartum recovery.

One of the most important topics to address is postpartum bleeding. It is critical to understand what is normal and what is not, as postpartum hemorrhage is still the number one postpartum complication in the United States.

It is imperative that you, and those who will be supporting you in the early weeks after you've given birth, understand what to watch for.

Let’s start with what is expected.

You should know that every person who gives birth has vaginal bleeding, regardless of whether you gave birth vaginally or via cesarean section.

This bleeding comes from the 8.5-inch diameter placental wound inside your body. This is the area along the uterine wall where the placenta was previously connected to your body. Once your baby is delivered, the placenta detaches from the uterus. It is either expelled from your body vaginally or removed by the surgeon during a c-section. Blood from this area, as well as mucous and tissue, are shed through the vagina for several weeks after birth.

The medical term for postpartum bleeding is lochia. It’s NOT like a regular period.

It's heavier, especially for the first 3-4 days, and lasts longer than a typical period. It can be helpful to have heavy flow pads, adult diapers, or period panties to help deal with the blood flow. Remember not to use tampons or cups or anything internal until after your 6-week check-up, as your body is open to infection at this time (you have that placental wound we talked about).

There may be some clots and gushes. This is especially true if you've been resting for a bit and then get up.

How long the bleeding lasts is different for everyone, but typically it's in the range of 3-10 weeks.

Your flow will not be so heavy the entire time. Gradually it tapers in amount, and it will go from bright red in the early days to brownish later on as it subsides.

These are the things to look out for that might be of concern:

Passing clots that are bigger than an egg.

Passing many clots.

While the bleeding will be heavier than your average period, be sure to monitor the amount.

If you soak through a heavy flow pad each hour for more than 2 hours, bring this to the attention of your health care provider immediately.

Watch for bleeding that gets heavier after being lighter or bleeding that turns brighter red than it was previously. If the discharge had transitioned to a brownish color and then returned to brilliant red, you need to pay attention. These signs could indicate you are physically doing too much, causing more bleeding from the placental wound, and you need to rest immediately. If the bleeding doesn't slow with rest, call your health care provider for advice on how to proceed.

Signs of an emergency are heavy bleeding that does not slow or stop, chills, blurry vision, weakness, or feeling like you might faint. If you experience any of these signs, call your doctor or 911 immediately.

Postpartum hemorrhage is a serious problem not to be ignored.

Although relatively rare (affects about 5% of people who have given birth), and typically occurring in the first 24 hours after delivery, postpartum hemorrhage can happen any time within the first 12 weeks after childbirth.

If ever you feel concerned about the amount or duration of bleeding or feel a bit off, don't hesitate to reach out for medical advice.

It's always better to err on the side of caution!

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