For nine months, pregnant women are growing their sweet little babies. The baby is wrapped into their bags of water, and then the bag of water is surrounded by blood. Once the water is broken and the baby comes out then you will start bleeding. The after-birth bleeding is called Lochia. Lochia is not menstruation but it is similar. However, Lochia is much heavier and lasts much longer than a normal period. Women may have a lot of questions about Lochi and hopefully, this article can help answer many of those questions.
What is Lochia?
According to Always Discreet, Lochia is made up of a number of things:
- Placental tissue that got left behind
- Thickened endometrium no longer needed post-pregnancy
- Blood from the wound site where the placenta detached from the uterine wall
- Cervical mucous
"When you're pregnant, hormones cause the uterine lining to thicken to support the placenta," says OB-GYN Christine Masterson, M.D., chief of the women and children's service line at Summit Medical Group in New Jersey. "After delivery, the uterus begins to contract and shrink back down to its usual size, and the uterine lining sheds."
Will every woman have Lochia?
Yes, every woman who has given birth will have Lochia. However, women who have had c-sections will not have as much. "Typically women who have had a cesarean section will have less lochia because we manually clean the uterus out with a swab to make sure we removed all of the placenta and membranes," says Amy Magneson, M.D., an OB-GYN with CareMount Medical in New York. "That doesn't occur during a vaginal delivery, so [those] women will likely notice more bleeding for longer."
How long with Lochia last?
Lochia can last anywhere from two weeks to six weeks after delivering. The duration of the bleeding is based on a few factors:
- The size of the baby/tearing: Women who did not tear or have any significant damage to their vagina will likely recover quicker than women who had major injuries or tears. For instance, a woman who gave birth to a larger baby and had a fourth-degree tear might be bleeding longer than other women.
- Not resting: Women who are more active and do not give themselves time to recover they are likely to bleed. If you notice an increased amount of blood flow then it is important to take it easy and slow down.
If you are noticing that your bleeding as picked up or you feeling like you are bleeding longer than normal then you should call your doctor.
What does it look like at first?
In the first three days after birth, your blood will be very heavy. Many women share that they have to go through heavy flow pads every hour (or more often). It is very normal to have a thick and heavy flow in the first days. Your blood will look bright red and will be very thick. You will also notice small, medium, and large clots. For the first couple of days, medical staff will "massage" your stomach to push out the blood to prevent large clots from forming. While they are massaging you will feel gushes of blood. This is all normal and expected.
What normally happens with Lochia?
After a few days, Lochia will turn from bright red to light pink. It will become very think and more watery. If you are breastfeeding you will notice that your bleeding becomes more severe with nursing sessions, but that is normal and okay. Actually, breastfeeding will help heal your uterus and help with the bleeding. According to New Parent Support, "Breastfeeding makes your body release oxytocin. This makes your womb contract and produce more (and redder) lochia blood. Any sort of gentle exercise – even a quick vacuum of the lounge – could also make bleeding heavier. This is especially true in the first two weeks."
After about two weeks of bleeding the blood might start turning into a dark red, or brown blood. Dark brown blood indicates old blood and is the sign that the blood is slowing down. You will also start bleeding inconsistently and will possibly bleed in waves. It is advised to not stop wearing a bad (even if you think you are done bleeding) for at least six weeks.
You will have cramps, much like a normal menstruation cycle. However, in Lochia isn't necessarily the cause for the cramps. The cramping and/or contractions are the uterus contracting and shrinking. These cramps are more apparent to women who are breastfeeding. Breastfeeding women will notice that they have more intense cramps and bleeding during their nursing sessions.
What is not normal?
If it has been more than three days since you have given birth than you should not be soaking through more than a pad an hour. If your bleeding has not slowed down from the first couple of days postpartum then you need to make sure you call your doctor right away. According to Discreet Always, "Excessive bleeding after birth can be a sign of postpartum hemorrhage, a very serious condition. The highest risk period for postpartum hemorrhage is within 24 hours of giving birth. This type of severe postnatal blood loss is known as primary postpartum hemorrhage, and it affects 5 out of every 100 women who give birth. However, although much rarer, postpartum hemorrhage can occur anywhere within 12 weeks of birth. This is called secondary postpartum hemorrhage."
Let's talk clots: In the first couple of days after delivering it is completely normal to have blood clots. Some clots may be large, however, after the third day of postpartum clots become concerning. If you notice that you have stopped bleeding after only a few days of giving birth then you might have a clot and should see your doctor right away. Women should talk to their doctor if they are continually getting blood clots (even if they are small) and should call their doctor if they notice a large blood clot (larger than a quarter). According to Healthline Parenthood, "Blood that doesn’t immediately pass through your vagina and out of your body may form clots. Sometimes these clots can be especially large immediately after giving birth." Healthline continues, "While blood clots are normal after pregnancy, too many blood clots or very large blood clots can be cause for concern." Having a blood clot can cause more serious issues and should be reviewed by a doctor.
It is so important to call your doctor if you are feeling like something is not normal. If you are feeling light-headed, dizzy, or are feeling nauseous these might be abnormal symptoms and should be brought up to your doctor in case they are signs of something more detrimental.
Sources: WebMD, Always Discreet, New Parent Support, Parents, Healthline Parenthood, Medical News Today