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Postpartum Bleeding Stages

Woman with her newborn baby postpartum

You’ve welcomed a beautiful bundle of joy into the world—congrats! Having a baby comes with a lot of physical changes to your body. Some of them can be quite surprising, like heavy vaginal bleeding after giving birth.

Bleeding after delivery is perfectly normal. In fact, there’s even a name for post-pregnancy bleeding. It’s called lochia. Use this guide to understand what lochia is, what causes postpartum bleeding, and what to expect with normal (or not normal) blood loss the weeks after childbirth.

What is Lochia?

Lochia, also known as postpartum bleeding, is vaginal bleeding after giving birth that includes bloody fluid made up of blood, placental tissue, sloughed off endometrial lining and mucous. Normal postpartum bleeding continues for 3 to 6 weeks as your uterus heals and returns to its usual shape and size.

What Causes Lochia and Postpartum Bleeding?

Postpartum bleeding is your body’s way of getting rid of the extra blood and tissue in your uterus that helped your baby grow. The blood in lochia comes mostly from the area where the placenta detached itself from the uterine wall during birth, leaving a wound that needs to heal. The endometrial lining, which thickens during pregnancy, also sloughs off, similar to when you have your period.

Postpartum Bleeding Stages: Rubra, Serosa and Alba

Stage 1: Lochia Rubra

How long it lasts: 3-4 days postpartum

What color: Bright or dark red

The first stage of postpartum bleeding is rubra and can last up to four days postpartum.

Postpartum bleeding is heaviest the first few days after baby is born. Blood will be a dark or bright red and will be very heavy. It is normal to see clots in your lochia during this stage. Normal blood clots are smaller than a quarter or a small plum. You may feel cramping and uterine contractions as your uterus returns to its usual size. If you have large clots—larger than a quarter—you should consult your doctor.

Stage 2: Lochia Serosa

How long it lasts: 4-10 days postpartum

What color: Pinkish brown

The second stage of postpartum bleeding is serosa and can last about two weeks after delivery.

Your blood flow will lighten. Its color will change from light red to a watery pink or pinkish brown. Your placenta will likely still be bleeding, but it will be significantly lighter than the initial few days after you give birth. You can still see blood clots during this stage, though clots should be smaller.

Stage 3: Lochia Alba

How long it lasts: 10-28 days postpartum

What color: Whitish yellow

The third stage of postpartum bleeding is called alba and can last two to six weeks after giving birth.

Lochia changes from pink to a light brown to yellowish white color. You may still experience occasional spotting of blood. This stage of postpartum bleeding is mostly white blood cells leaving the body after they helped heal your uterus after birth. Amazing what a woman’s body can do, right?

How Much Bleeding is Too Much Postpartum and When Should You Call Your Doctor?

Bleeding is heavy for the first few days after delivery. However, if you experience heavier blood loss after that, call your doctor.

In some cases, heavy bleeding after childbirth is a sign of postpartum hemorrhage. While it is most likely to happen in the first 24 hours after delivery, postpartum hemorrhage can take place anytime during the first 12 weeks after delivery. Postpartum hemorrhaging is very serious and needs immediate attention. It can make your blood pressure drop so much that your organs don’t get enough blood. This can cause death if left untreated. If you think you have postpartum hemorrhage, contact your doctor or head to the emergency room right away.

Signs of Postpartum Hemorrhage:

  • Bright red bleeding beyond the third day after birth
  • Blood clots bigger than a plum
  • Bleeding that soaks more than one sanitary pad an hour and doesn’t slow down or stop
  • Blurred vision
  • Chills
  • Clammy skin
  • Rapid heartbeat
  • Dizziness
  • Weakness
  • Nausea
  • Faint feeling

Protection to Manage Bleeding After Birth

Bleeding after delivering a baby can leave a new mom in quite a quandary. While changing diapers and caring for your little one, you may be wondering how to provide protection and comfort for yourself as well. Regular menstrual pads just don’t cut it. You may even find yourself soaking through one every three hours or so. Definitely do not use tampons. This can be very dangerous after giving birth.

Instead, a product like Always Discreet underwear are great for postpartum bleeding, especially during the first stage when blood flow is heaviest. Postpartum underwear can come in different sizes with different levels of absorbency—use this guide for choosing which postpartum underwear is best for you. Always Discreet postpartum underwear are super thin and flexible, which means they are super comfortable. They use special gel technology that locks in moisture and fluid, keeping your skin dry. You may even forget you have one on.