What every pregnant woman should know about Lochia (aka Postpartum Bleeding) to guard your life.

I’ve been to pre-natal seminars and bought books upon books on what to expect when you’re expecting. I went with an OB-GYN for my first child and a midwife for my second child for regular checkups and appointments. I thought I had it all covered and was prepared for everything.

What I realized, as with many other mothers out there, is that no one really explains and prepares you for the heavy menstrual period that you experience after childbirth. Yes, you think it is just the regular Aunt Flow, Mother Nature, your monthly companion going on steroids but it is not.

All I recall from my midwife is to watch out for the amount of blood on the pad after the first day of postpartum. She said “If it fills up the pad from end to end, every 45 mins to an hour or so, please give me a ring”. To be honest, I was too busy thinking about getting my breastfeeding technique right that I didn’t really probe to understand why it was important and what it all meant. In fact, my OB-GYN never mentioned anything about this when I had my first child and I hadn’t had much trouble with it so it was a non-issue for me.

I’m so thankful that I didn’t have much trouble with it during my 2 childbirth. I didn’t understand how serious and deadly of an issue it can be.

If you observe very large clots or experience very heavy flow - to soak with a maxi pad every hour - please notify your practitioner immediately. This is not normal - it is a sign of infection.

Lochia Explained

Lochia is a vaginal discharge after giving birth. It contains blood mucus and tissue from the uterus that was used to help with the growth of the baby. After delivery, your body knows it no longer needs all this extra amount which was mostly where the placenta was attached and it discharges out.

Usually the discharge should last around less than four weeks after delivery, so as long as you are within that timeframe and the amount of lochia is gradually diminishing, it is normal.

What are the stages of Lochia (Postpartum Bleeding)?

Just like the telltale signs of the color and texture of a newborn baby’s poop, lochia has its telltale sign to let you know that everything is on track.

Normal Signs:

Lochia Rubra: Roughly 1st to 3rd day after delivery

• Lochia is dark red in color with few small blood clots, no larger than an apricot.

• Similar to one of those heavier menstrual period days

Lochia Serosa: Roughly 4th to 10th day after delivery

• Lochia turns pinkish and eventually brownish in color with more of a watery texture than the first 3 days or so.

• Flow is moderate to small amounts

Lochia Alba: Roughly 10th day to 3 weeks after delivery

• Lochia is yellowish-white and gradually disappearing. Little to no blood clots.

Abnormal Signs at Any Stage:

• Your maxi pad is soaked from front to back, left to right every hour

• Lochia contains large blood clots, bigger than a golf ball

• Light-headedness with fever or flu-like symptoms

• Abdominal pain that is more than usual of a menstrual cramp

You might think that you will be able to tough it out. So many people depend on you. And so you go for your tylenol to help with the fever, cramps, headache and think that these symptoms may just go away on their own. Unfortunately, this may mask the signs of something that is happening. So don’t discount the signs because it can save your life. It is worth your while to call your practitioner, telehealth, midwife to check on it.

Ringing Alarm Bells

When these red flags show up, it is an indication of potential infections that should not be taken lightly. This can be an infection such as endometritis (infection of the uterine lining), myometritis (infection of uterine muscle), parametritis (infection of the areas surrounding the uterus), postpartum hemorrhage (excessive bleeding), Group A Streptococcus (invasive infection in the form of endometritis, necrotizing fasciitis, or streptococcal toxic shock syndrome). Infections, if associated with sepsis, can link to mortality rates of 30-50%, depending on how quickly you catch it and treat it.

Self-Care

Using peri-bottles to spray clean the area after each change of your pad, taking herbal stiz baths, placing cool compresses in the area are all good things to prevent infections. The best advice is to be aware of what is normal and be attune to what your body is telling you. Keep track of your progress in your book or on your phone. Record and monitor your lochia. Be informed and when in doubt, call your doctor. Remember, to keep calm and stay healthy!

(Create a helpful print out of POOP and LOCHIA - all in one.)