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Lochia is the musty-smelling vaginal discharge you have after giving birth. It is a mix of blood, uterine lining and mucus, it is completely normal and healthy, and it is your body clearing out what it no longer needs. It passes through several stages over about six to eight weeks.1
You will still have lochia after a caesarean, though it is often a little lighter. Most of the time lochia needs nothing more than pads and patience – but there are a few warning signs worth knowing, and we will get to those.
What is lochia made of?
Lochia is a collection of blood, uterine lining, amniotic fluid, microbes, leftover tissue from the pregnancy and cervical mucus. The distinctive musty smell comes from that mix, and on its own it is nothing to worry about.
Anything that adds a bit of gravity can bring more of it out at once – standing up after lying down for a while, or a burst of activity. Breastfeeding can also bring on a gush, because it releases oxytocin, which makes the uterus contract.
The three stages of lochia
Lochia varies from person to person, but it tends to follow a pattern, moving from heavy and red to light and pale over several weeks.1
Lochia rubra – the first, heaviest stage
For the first three to four days lochia is heavy, bright red and bloody, with some small clots, much like a heavy period. Use maxi pads and change them every couple of hours or as needed. Avoid tampons and menstrual cups for at least the first six weeks, since they can introduce bacteria while everything is still healing.
Lochia serosa – the second, lighter stage
Once the heaviest days pass, lochia thins to a watery, pinky-brown discharge and you will need fewer pad changes. Fewer clots come through at this point.
Lochia alba – the third, lightest stage
After about two weeks lochia becomes creamy yellow-white and usually only needs a light pad or liner. There should be no clots at this stage, and it gradually fades away.
When to get help
Lochia is usually straightforward, but postpartum bleeding can occasionally become serious, and an infection is possible while things heal. Contact your midwife or doctor, or seek urgent care, if you have any of these:
- You soak through a maxi pad in an hour or less, or the bleeding suddenly gets heavier again.2
- You pass clots the size of an egg or larger.2
- The discharge smells foul or fishy rather than musty, especially with a fever (38°C/100.4°F or higher), chills, or lower tummy pain – this can signal an infection of the uterus (endometritis) or bacterial vaginosis (BV).3
- You feel dizzy, faint, breathless, or your heart is racing.
- You have severe or worsening pain in your lower tummy or pelvis.
- Bright red bleeding is still heavy after the first week, or lochia stops and then returns bright red.
Heavy bleeding after birth, called postpartum haemorrhage, is uncommon but needs prompt attention, so it is always better to ring and check than to wait.2
Frequently asked questions
How long does lochia last?
Usually around six to eight weeks, moving from heavy red to watery pink-brown to creamy pale before it stops. There is a fair range between people, so a bit shorter or longer can still be normal.1
Is lochia different after a caesarean?
You still get lochia after a caesarean, as the uterus still needs to shed its lining. It is often a bit lighter, but the same stages and the same warning signs apply.
Can I use tampons for lochia?
No – stick to pads for at least the first six weeks. Tampons and cups can carry bacteria up into a uterus that is still healing, which raises the risk of infection.
When should I worry about postpartum bleeding?
Soaking a pad an hour or less, egg-sized or larger clots, a sudden increase in bleeding, a foul smell with fever, or feeling faint all warrant prompt medical attention. When in doubt, contact your midwife or doctor.2
This article is general information and not a substitute for personalised medical advice. If you are worried about bleeding or symptoms after birth, please contact your midwife, doctor, or urgent care service.
References
- Fletcher S, Grotegut CA, James AH. Lochia patterns among normal women: a systematic review. J Womens Health (Larchmt). 2012;21(12):1290–1294. https://www.liebertpub.com/doi/10.1089/jwh.2012.3668
- Wormer KC, Jamil RT, Bryant SB. Postpartum hemorrhage. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK499988/
- Taylor M, Jenkins SM, Pillarisetty LS. Endometritis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK553124/
