There are three phases to the postpartum bleeding stage.  The length of each phase is completely dependent on each mother, as no one is the same, and no birth is the same. Studies show that the average duration of the entire lochia period is 27 days, but that bleeding for over 40 days is still completely normal and common. 

Lochia: Bleeding After Birth

Phase 1:  Lochia Rubra

• Typically lasts 3-4 days after birth
• It is bright red in color as the liquid contains significant amount of blood
• Bright red in color
• Blood clots are normal

• Typically starts around day 4 and lasts a week
• This is the lochia which is thin in density
• Color turns from red to pink to pinkish-brown
• This discharge contains mucus, exudate, leukocytes, and erythrocytes.
• Flow is much less than Lochia Rubra, with very few to no clots, but the flow is ongoing

Note: Large blood clots or bright red blood during this time may be signs of a problem.  If this phase continues for weeks, it can be a sign of postpartum hemorrhaging.

Phase 3: Lochia Alba

• Typically lasts 2-4 weeks
• The discharge changes from the pinkish-brown to a yellowish-white or whitish liquid
• The liquid contains little amount of red blood cells and mostly contains leukocytes, cholesterol, fat, epithelial cells and mucus.
• There should be no odor and no real flow

Note: The presence of clots, a bad smell, or bright red blood may be signs of a problem. If this condition continues over several weeks, then it may indicate genital lesion.

Generally, there is a progression from lochia rubra through lochia serosa to lochia alba.  If you are overextending yourself, you may experience some red spotting that signals you should stop and rest.   You should call your midwife or doctor immediately at any time after birth if your bleeding does not decrease or if you are filling more than one menstrual pad in one hour.

Caring for Yourself While Bleeding

• Stock up on overnight pads or cloth pads for this period.  Tampons cannot be used and are a source for infection.
• Once flow lessons, you can use lighter pads, but still no tampons.
• Urinate often, keep your bladder clear. After you give birth, during the first few days, your bladder becomes less sensitive. So, sometimes you won’t feel the need to pee even if you are moving with a full bladder. This makes it hard for the uterus to contract and can result in serious postpartum bleeding.
• Take herbal baths with Epsom salt to speed the recovery process.
• Try to get as much rest as you can. Too much work will cause you to bleed even after your lochia condition has passed over.