What is lochia?

Lochia is the vaginal discharge new mothers experience after the delivery, whether the birth was vaginal or by caesarean section.

Lochia has a stale, musty odor like menstrual discharge and for the first three days after the birth, it is dark red in color.  It’s normal if you notice a few small blood clots smaller than a plum. From day 4 to day 10 after delivery, the lochia has more watery texture and its color ranges from pinkish to brownish. From day 7 to day 10  through day 14 after the delivery, the lochia appears creamy or yellowish in color.

Lochia tends to increase when you get up in the morning, when you are physically active, or while breastfeeding. After 24 hours, lochia produced by women who undergo cesarean sections is less than by those who had vaginal deliveries.

Gradually, the flow become less. However, if you start to involve in physical activities too soon, it may come back. If the bleeding becomes heavier or changes in colour, you have to slow down. Normally, lochia will stop within four to six weeks after delivery.

Where does lachia come from?

The bleeding mainly comes from the place where the placenta coming away from the wall of the uterus. Lachia may also come from cuts and tears you happen to get when giving birth to your baby.

Do I need to do anything about the bleeding?

You just need to use maternity pads.  Change the pads regularly (every hour or two at first, then  every three hours or four). Wash your hands before and after changing the pad to reduce chances of infection.

Tampons should not be used. This is because in this stage, the vagina and womb are in the healing process, using tampons (or menstrual cups) could increase the chances of getting an infection.

When should I call my midwife or doctor?

Lochia is normal until you:

  • Notice heavy bleeding
  • Think you may have an infection

Sometimes, extremely heavy bleeding happens. This is called postpartum haemorrhage (PPH). There are two kinds of PPH:

Primary PPH: happens within 24 hours of giving birth. This condition develops when the placenta does not properly come away from the uterus; when you’ve got an injury during birth; when your uterus fails to contract down properly after the placenta is delivered.

Secondary PPH: happens between 24 hours and 12 weeks after the delivery. This condition is usually results from an infection.

In secondary PPH, one can lose 500ml or more of blood rapidly, thus urgent treatment is required.

You may have PPH if:

  • The lochia gets very heavy in all of a sudden, soaking more than one pad within an hour.
  • The lochia comes in bright red and gets heavier days after your baby’s birth even when you have rest
  • You pass lots of large blood clots that are bigger than  a golf ball
  • You  feel faint or dizzy
  • Your heart beats faster or irregularly

Treatment for postpartum haemorrhage

Treatment is given depending on the cause of PPH. Treatments include:

  • The doctor massaging your belly to stimulate a contraction of the uterus.
  • An injection is given to you to help your uterus to contract.
  • Medicines are given to help bleeding stop.
  • You will receive a blood transfusion and fluids
  • You may need an operation to stop the bleeding. It aims to get rid of the remaining piece of placenta in your womb

You reach out for medical help if you notice symptoms of an infection. The main symptoms may include:

  • Pain in the lower part of your abdomen and your groin
  • Your lachia has an unpleasant smell
  • You develop a high temperature or chills and generally feeling unwell
  • Headache

Hello Health Group does not provide medical advice, diagnosis or treatment.

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