Lochia: how long does bleeding last after childbirth?

Nobody really told us: after giving birth, you bleed. Not for a few days, but for several weeks. You often discover it in the maternity ward bathroom, looking at a pad that is already full, wondering whether this is normal.

This bleeding has a name: lochia. It is the sign of a uterus closing up again, and it follows a rhythm regular enough for you to know what to expect. Here is what is useful to know, and the few signs that mean you should call.

Lochia: what are we talking about?

Pendant la grossesse, le placenta est attaché à la paroi de l'utérus. Quand il se détache, il laisse une plaie, de la taille d'une soucoupe, qui doit cicatriser. Les lochies, c'est ce que l'utérus évacue pendant ce travail : du sang, des restes de la muqueuse qui tapissait l'utérus, du mucus.

It affects every woman who has just given birth, vaginally or by caesarean. It is not a period. Periods will come back later, in their own time: that is the return of periods, another story altogether.

How long does lochia last?

Lochia most often lasts between four and six weeks. Its appearance changes along the way, and it is this change that is reassuring: it shows that healing is progressing.

Period	Appearance	Flow
The first three to four days	Bright red, small clots possible	Heavy, like a very heavy period
Until roughly the end of the second week	Pinkish, then brown	It eases noticeably
Up to four to six weeks	Yellowish, then whitish	Light, sometimes intermittent

These are guidelines, not a timetable. Some women have almost stopped bleeding after three weeks; others have light discharge until the postnatal check-up. Both are normal.

The small bleed around day 10 to 15

Between roughly the tenth and fifteenth day, many women see the bleeding turn red and heavier again for one to three days. In French it is called the petit retour de couches, the small bleed. It happens when the scab covering the wound in the uterus comes away. Worrying when you are not expecting it. Reassuring once you know about it.

What makes the bleeding vary

Lochia does not flow at a steady rate. Several things make it heavier, without being a sign of a problem.

• Breastfeeding. Feeding releases oxytocin, which makes the uterus contract. Bleeding is often heavier during and after a feed, sometimes with cramps: the afterpains.
• Getting up. When you are lying down, blood pools. It flows out all at once when you stand up, sometimes with a small clot. This is expected.
• Exertion. Standing for a long time, carrying, walking a lot: if the bleeding increases after a day that was too full, it is your body asking you to slow down.
• Caesarean section. Lochia is often a little lighter, but it is very much there, and it lasts about as long.

The signs that mean you should call

The vast majority of lochia runs its course without difficulty. But some signs call for prompt advice, from the maternity unit, your midwife or your doctor. Do not wait for the next appointment.

• A very absorbent pad soaked through in an hour or less
• Clots larger than a golf ball
• A strong, unpleasant smell, different from that of a period
• A fever of 38 °C or higher, or chills
• Lower abdominal pain that gets worse instead of easing
• Bright red bleeding that starts again heavily and does not slow down, beyond the small bleed around day 10 to 15

In case of very heavy bleeding with dizziness, faintness or a racing heart, call 15 (the French emergency number). These situations are rare. They are managed very well when action is taken quickly.

Looking after yourself during lochia

The area is tender, the perineum sometimes stitched, and the mucous membrane more fragile than usual. A few simple steps bring a great deal of comfort.

• External pads only. No tampons or menstrual cups for as long as the lochia lasts: the cervix is still slightly open, and the risk of infection is higher.
• Change often. Every three to four hours, and more often in the first few days.
• Rinse without rubbing. With lukewarm water after each trip to the toilet, using a hand shower or a rinse bottle, then pat dry.
• A gentle, fragrance-free wash. Once a day is enough. Ordinary soaps and scented wipes cause irritation.
• Showers rather than baths. In the first few weeks, most teams advise waiting before taking a bath. Ask your midwife when you can.

And rest, as much as possible. It does not speed up healing. It simply avoids asking too much of your body.

Frequently asked questions

Is it normal for lochia to have a smell?

Yes, a faint smell, similar to that of a period, is normal. A strong, unpleasant smell, or one that changes suddenly, can signal an infection and means you should see someone quickly, especially if it comes with a fever.

Can you use tampons during lochia?

No. Tampons and menstrual cups are not recommended until the lochia has ended, because of the risk of infection. Your midwife will tell you when you can use them again, often at the postnatal check-up.

Can lochia stop, then start again?

Yes. The small bleed between the tenth and fifteenth day is the most common example. Bleeding that starts again heavily and does not ease within a few hours should, however, prompt a call.

Do you have lochia after a caesarean?

Yes. The uterus has to heal in the same way, whatever the mode of delivery. Lochia is sometimes a little lighter after a caesarean, but it lasts about as long.

What is the difference between lochia and the return of periods?

Lochia is what the uterus sheds after the birth. The return of periods is the first period after childbirth. It most often happens six to eight weeks after the birth if you are not breastfeeding, and much later if you are breastfeeding exclusively.

A passage closing up again

Lochia may be the most tangible thing about the weeks after the birth. Day after day, it tells you that a body is working to close up again, quietly, at its own pace. There is nothing you need to hurry.

To follow this work week after week, read Post-partum week by week.