Maternal Health

Postpartum Bleeding (Lochia)

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, NIH, ACOG guidelines

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Your health matters just as much as your baby's. If you are dealing with postpartum bleeding (lochia), here is what you need to know.

The short answer

Postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery.

Key takeaways

  • Postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery.
  • Usually normal when: Heavy, bright red bleeding in the first few days that gradually decreases over weeks
  • Call your doctor if: You are soaking through one or more pads per hour for two or more consecutive hours
  • Varies by age — see the age-by-age breakdown below
About 1 in 8 women experience symptoms of postpartum depression. If you have symptoms of depression that last longer than 2 weeks, tell your health care provider.
Depression During and After Pregnancy, Centers for Disease Control and Prevention (CDC)

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What Parents Should Know

According to ACOG, NIH guidelines, postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery. At 0-2 weeks postpartum, in the first few days, lochia is bright red and heavy, similar to a very heavy period. You may pass small blood clots up to the size of a plum, particularly when standing up after lying down. By the end of the first week, the bleeding should be decreasing in volume and turning from bright red to a darker red or brownish color. Soaking more than one pad per hour consistently is not normal and requires immediate medical attention. It is generally considered normal when heavy, bright red bleeding in the first few days that gradually decreases over weeks. However, you should contact your pediatrician promptly if you are soaking through one or more pads per hour for two or more consecutive hours.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Heavy, bright red bleeding in the first few days that gradually decreases over weeks
You are soaking through one or more pads per hour for two or more consecutive hours
Passing small blood clots (up to plum-sized) in the first few days, especially when changing positions
You feel dizzy, lightheaded, or faint, which could indicate excessive blood loss
Discharge transitioning from red to pink to yellowish-white over four to six weeks
You pass very large clots (larger than your fist) or experience a sudden gush of blood after the first day postpartum
A temporary increase in flow with breastfeeding or physical activity that settles with rest
Bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood

By Age

What to expect by age

0-2 weeks postpartum

In the first few days, lochia is bright red and heavy, similar to a very heavy period. You may pass small blood clots up to the size of a plum, particularly when standing up after lying down. By the end of the first week, the bleeding should be decreasing in volume and turning from bright red to a darker red or brownish color. Soaking more than one pad per hour consistently is not normal and requires immediate medical attention.

2-6 weeks postpartum

The discharge gradually transitions from pinkish-brown to a yellowish or creamy white color (lochia alba). The volume should be significantly lighter than the first week. You may notice a temporary increase in bleeding with increased activity or breastfeeding, which stimulates uterine contractions. This is your body's signal to rest more if bleeding picks up.

6-12 weeks postpartum

For most women, lochia has stopped completely by six weeks postpartum. Some women may experience light spotting or occasional discharge for up to eight weeks, which is still within the normal range. If you experience a return of bright red, heavy bleeding after lochia had slowed or stopped, contact your provider, as this could indicate a retained piece of placenta or other complication.

3-6 months postpartum

Lochia should have resolved well before this point. Any vaginal bleeding at this stage may represent the return of your menstrual period, particularly if you are not exclusively breastfeeding. If you experience unexplained heavy bleeding months after delivery, consult your provider to rule out other causes.

What to Tell Your Pediatrician

  • Describe when you first noticed postpartum bleeding (lochia) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood.
  • Mention if the discharge has a foul smell, which could indicate an infection.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Heavy, bright red bleeding in the first few days that gradually decreases over weeks
  • Passing small blood clots (up to plum-sized) in the first few days, especially when changing positions
  • Discharge transitioning from red to pink to yellowish-white over four to six weeks
  • A temporary increase in flow with breastfeeding or physical activity that settles with rest
Mention at your next visit when...
  • Bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood
  • The discharge has a foul smell, which could indicate an infection
  • Lochia has not significantly decreased by three weeks postpartum
  • You are passing clots larger than a golf ball after the first 24 hours
Act now when...
  • You are soaking through one or more pads per hour for two or more consecutive hours
  • You feel dizzy, lightheaded, or faint, which could indicate excessive blood loss
  • You pass very large clots (larger than your fist) or experience a sudden gush of blood after the first day postpartum

What You Can Do at Home

  • Keep track of when you notice postpartum bleeding (lochia) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that heavy, bright red bleeding in the first few days that gradually decreases over weeks — this is generally within the range of normal.
  • At 0-2 weeks postpartum, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
  • While monitoring at home, seek immediate care if you are soaking through one or more pads per hour for two or more consecutive hours.

Frequently asked questions

Is postpartum bleeding (lochia) normal?
Postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery.
When should I call the doctor about postpartum bleeding (lochia)?
You are soaking through one or more pads per hour for two or more consecutive hours You feel dizzy, lightheaded, or faint, which could indicate excessive blood loss You pass very large clots (larger than your fist) or experience a sudden gush of blood after the first day postpartum
When is postpartum bleeding (lochia) normal?
Heavy, bright red bleeding in the first few days that gradually decreases over weeks Passing small blood clots (up to plum-sized) in the first few days, especially when changing positions Discharge transitioning from red to pink to yellowish-white over four to six weeks
What causes postpartum bleeding (lochia)?
Postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery. Common explanations include: Heavy, bright red bleeding in the first few days that gradually decreases over weeks. Passing small blood clots (up to plum-sized) in the first few days, especially when changing positions.
What should I mention to my pediatrician about postpartum bleeding (lochia)?
You should mention postpartum bleeding (lochia) at your next visit if: Bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood. The discharge has a foul smell, which could indicate an infection. Lochia has not significantly decreased by three weeks postpartum.
Is postpartum bleeding (lochia) normal at 0-2 weeks postpartum?
In the first few days, lochia is bright red and heavy, similar to a very heavy period. You may pass small blood clots up to the size of a plum, particularly when standing up after lying down. By the end of the first week, the bleeding should be decreasing in volume and turning from bright red to a darker red or brownish color. Soaking more than one pad per hour consistently is not normal and requires immediate medical attention.
Is postpartum bleeding (lochia) normal at 2-6 weeks postpartum?
The discharge gradually transitions from pinkish-brown to a yellowish or creamy white color (lochia alba). The volume should be significantly lighter than the first week. You may notice a temporary increase in bleeding with increased activity or breastfeeding, which stimulates uterine contractions. This is your body's signal to rest more if bleeding picks up.
Should I go to the ER for postpartum bleeding (lochia)?
Seek emergency care if you are soaking through one or more pads per hour for two or more consecutive hours, or if you feel dizzy, lightheaded, or faint, which could indicate excessive blood loss. When in doubt, call your pediatrician's after-hours line for guidance.
Does postpartum bleeding (lochia) go away on its own?
In many cases, postpartum bleeding (lochia) resolves on its own, especially when heavy, bright red bleeding in the first few days that gradually decreases over weeks. By 3-6 months postpartum, lochia should have resolved well before this point. Any vaginal bleeding at this stage may represent the return of your menstrual period, particularly if you are not exclusively breastfeeding. If you experience unexplained heavy bleeding months after delivery, consult your provider to rule out other causes.

References

  1. [1]American College of Obstetricians and Gynecologists. Postpartum Hemorrhage. ACOG Practice Bulletin, 2017. ACOG
  2. [2]National Library of Medicine. Lochia. StatPearls, 2023. NIH
  3. [3]American College of Obstetricians and Gynecologists. Your Body After Baby. ACOG PostpartumCare, 2022. ACOG

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Postpartum Bleeding (Lochia).

Things to mention

  • Describe when you first noticed postpartum bleeding (lochia) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood.
  • Mention if the discharge has a foul smell, which could indicate an infection.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Bleeding that seemed to be slowing suddenly becomes heavier again with bright red blood
  • The discharge has a foul smell, which could indicate an infection
  • Lochia has not significantly decreased by three weeks postpartum

Urgent signs to report immediately

  • You are soaking through one or more pads per hour for two or more consecutive hours
  • You feel dizzy, lightheaded, or faint, which could indicate excessive blood loss
  • You pass very large clots (larger than your fist) or experience a sudden gush of blood after the first day postpartum

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Bottom line

Most cases of postpartum bleeding (lochia) are normal. Talk to your pediatrician if you are soaking through one or more pads per hour for two or more consecutive hours.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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