There are three stages, or "types," of lochia. The duration of each stage can vary from person to person. Characteristics of lochia rubra include:. Characteristics of lochia alba include:. Characteristics of lochia serosa include:. Lochia can present differently in different people, and its duration, heaviness, and other characteristics can be affected by a number of factors or activities.
People who have a cesarean delivery may have less lochia after 24 hours than those who have vaginal deliveries.
You may notice a temporary increase in lochia:. Unless there are complications like infection, lochia does not require treatment. To help manage lochia, try:. To help prevent irritation and infection:. Lochia usually clears up on its own without incident, but there is a risk of infection or hemorrhage too much blood loss. Contact your healthcare provider if any of the following occurs:. Lochia is a normal part of postpartum healing in which the uterus sheds blood and tissue no longer needed to sustain the pregnancy.
While no treatment is usually needed for lochia, it is important to remember that this bleeding is partially because of the wound left behind when the placenta detaches at birth and begins to scab over and heal.
Take it easy and take your time working back up to physical activities. Rest—as much as you can with a newborn—and give your body a chance to heal. For most people, lochia will gradually resolve on its own without any adverse effects. If you notice signs of infection such as a foul odor or fever, or signs of abnormal bleeding such as an increase in blood or large clots, seek medical attention, as this may require treatment.
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Lochia, or postpartum bleeding: what do you need to know? Updated October Lochia: What you need to know about postpartum bleeding. Updated April Cleveland Clinic.
Physical changes after child birth. Updated January 1, March of Dimes. Postpartum hemorrhage. Updated March, University of Michigan. Management of Lochia Lochia does not need any specific management. One thing which should be remembered is that the placental area as well as the sites of sloughing endometrium are raw and open during this time and bacteria can easily spread from the vagina.
So, use of tampons should be avoided - sanitary pads are the best options to be used at this time. Sex should also be avoided during this time due to the same reason - to avoid spread of bacteria. Bathing in public pools are also best avoided until the lochia has completely stopped. Using a Sitz bath may help to clean out the vagina and also soothe the episiotomy stitches , if any. Abnormalities of of Lochia The lochia may be abnormal if infection occurs at this time.
Infection can be suspected when : The Lochia continues to remain bright red even after the first week from childbirth. The lochia becomes bright red again after having become paler over the previous days. There is abnormally heavy bleeding causing a sanitary pad to soak through within 1 hour or less or there is passage of blood clots larger than a golf ball.
This is a sign of secondary postpartum hemorrhage and needs emergency treatment. It has an unpleasant smell. There is fever with chills. There is pain in the lower abdomen which increases over the days.
Lochia after a Cesarian Section Many women believe that the flow of lochia is less after a cesarian section since the uterine cavity is cleaned out after the birth of the baby. This is not true. This Alba stage is the final and longest stage of postpartum discharge.
At this point, it may not even look like bleeding anymore. Lochia will be a yellowish-whitish color, and consists of cervical mucus, white blood cells, and epithelial tissue. The placental site is rapidly creating new skin tissue to heal, which results in more sloughed off tissue. The return to fertility after giving birth is wildly variable depending on a whole host of circumstances. Even for the same woman, the return to fertility can vary after each new baby.
If you are more interested in greater certainty of pregnancy prevention, consider charting with a fertility awareness method while breastfeeding. At Natural Womanhood, we have covered this topic in other articles, which can be found here and here. Working with a certified FAM instructor is always highly encouraged to ensure efficacy rates of pregnancy prevention, and especially so during this transitional phase.
So, as a FAM instructor, I generally tell women not to stress about beginning charting again at any particular time during those first 4 to 6 weeks; you should simply begin charting when you either see cervical fluid after lochia has cleared, or when you find yourself even remotely interested in sex again. Being physically ready for sex is also different than being emotionally ready.
A mom may not feel ready due to how the birth unfolded or the pressures of her new and chaotic life. Everyone has a different journey. Some women are ready to go at six weeks, while others need more time—even months more time. And that is okay. If you experience any of these symptoms, you should immediately contact your OB or midwife.
Some of these symptoms may be indicative of postpartum hemorrhage or infection, conditions that can be deadly if not treated promptly. Your care provider will be able to help you navigate which kind of postpartum bleeding is normal and which is not.
When this article refers to fertility awareness methods FAM , or natural family planning NFP , we are referring to Fertility Awareness-Based Methods, evidence-based methods of cycle charting which can be used as effective forms of natural birth control when learned by a certified instructor.
Can you really use breastfeeding as natural birth control? Fertility Awareness Around the World.
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