What should lochia look like?
26 Jan 2012 Leave a Comment
In a recent post, I discussed a training simulation that I and a fellow midwifery student did to increase our skill at assessing postpartum hemorrhage. Obviously all women are assessed for PPH before leaving the hospital or as part of the midwife’s postpartum visits, but secondary hemorrhage can develop unnoticed in the weeks following birth. If you are reading this, your chance of developing hemorrhage after your baby is 24 hours old is something around 1%, meaning that, in the developed world, approximately 1 in 100 women will experience non-normal lochia due to inefficient uterine contractions, unrepaired trauma, or other causes. Because this can occur well after many moms are home from the hospital and still 6 weeks away from seeing their OB/GYN, (and while they are probably too absorbed in the wonderful experience of caring for their new baby to think about much else) knowing what is/is not normal can help moms seek help when needed, and avoid unnecessary trips to the dr’s office.
I’ve put together the following information arranged by days postpartum. Notice that there is some overlap in the ranges suggested, because every mom is unique. This is only a representation of what might be typical – use it as a guide, but if you have any questions or concerns about your own health, it’s best to call your midwife or OB just to be sure.
Birth – 10 days
Normal: in appearance and volume, similar to a heavy period. Bright red in color, contains clots of blood and tissue, no more than 8 saturated pads in 24 hours. (it is normal to have larger gushes of flow when standing up, walking, or breastfeeding.)
Abnormal: foul smell, clots larger than a golf ball, consistently soaking a large pad in under an hour, feeling dizzy or lightheaded (not to be confused with having low blood sugar – make sure you are eating good-quality food and drinking lots of water to prevent this.) fever/chills.
8 -14 days postpartum
Normal: flow begins to lessen. The color changes to brown, pink, or a fainter red.
Abnormal: flow that continues to be heavy and dark red with large clots, foul odor, fever and chills.
2 – 6 weeks postpartum
Normal: color is white, yellow, or faintly brown. Bleeding may stop and restart during this time, a phenomenon known as “6-week bleed”. This is usually a very light flow. Anything heavier than you normally would have on the last day of your period may in fact be the return of your menses – this is most common in moms who are not breastfeeding or in those who strictly schedule their infant’s feeding times, but can happen to anyone. Check with your dr or midwife if unsure.
Abnormal: foul odor.
It should go without saying, but this blog is not meant to replace advice from your medical practitioner. If you are worried about your health or are experiencing a medical emergency, don’t just sit there on the Internet, go call a real doctor.
