Postpartum · Bleeding
Lochia / Postpartum Bleeding Tracker
Postpartum bleeding (lochia) lasts 4-6 weeks for most. Three phases: rubra (red), serosa (pink-brown), alba (creamy yellow). Red flags: soaking pad/hour for 2h, large clots, fever, foul smell. RCOG.
Last reviewed 2 June 2026
Postpartum bleeding (lochia)
Is this normal — and when to call?
Current colour
Current flow
Largest clot today
Three phases of normal lochia at a glance
- Lochia rubra (days 1–3): bright/dark red, heavy, small clots OK.
- Lochia serosa (days 4–10): pink-brown, watery, lighter.
- Lochia alba (~day 10 to 6 weeks): cream-yellow, minimal.
Caesarean lochia is sometimes lighter overall and may finish slightly sooner than vaginal delivery, but the phases are the same. Breastfeeding tends to mildly reduce overall bleeding.
Common questions + things parents notice
- Gush of blood when standing up — normal pooling that empties when posture changes. Not haemorrhage if it doesn’t continue at that rate.
- Heavier flow when breastfeeding — oxytocin during feeding causes uterine contractions and brief bursts of bleeding. Normal and a sign the uterus is contracting back to size.
- Sudden activity makes bleeding return — rest and slowing down typically settle it. If it’s soaking pads or doesn’t settle in a few hours, call.
- Period vs lochia at 6 weeks — if not exclusively breastfeeding, periods can return as early as 4–6 weeks. Lochia tapers and stops; periods come in cycles — usually distinguishable.
- Smell that’s different from menstrual blood — mild metallic/earthy smell is normal. Foul, fishy, or rotten-smelling discharge = call (suggests infection).
- Tampons — avoid for 6 weeks postpartum (infection risk). Use maternity pads.
- Sex resumption — generally after the 6-week check and once bleeding has stopped. Resume contraception planning before.
- Discomfort that worsens passing clots — can be normal afterpains, but increasing or severe pain warrants review.
- Caesarean wound vs lochia — lochia comes from the vagina regardless of delivery type. C-section wound itself shouldn’t bleed externally beyond the first 24–48 hours.
- Heavy bleeding on iron deficiency — postpartum anaemia is common. Continue prenatal iron / postnatal iron as advised; report fatigue, breathlessness, palpitations.
- Retained products of conception — persistent heavy bleeding past day 10–14, with passage of fresh tissue or large clots, can suggest retained placental fragments. Needs scan and possibly evacuation.
- Second-time mums — afterpains and lochia bleeding can be heavier with each subsequent baby, especially when breastfeeding.
Educational tool only — not medical advice. If you’re soaking through a maternity pad in an hour, passing golf-ball-sized clots, feeling faint, smell suggests infection, or are running a fever, call your maternity team / GP same-day, or emergency services for severe bleeding.
What does this mean?
Postpartum vaginal bleeding (called lochia) is your body shedding the lining of the uterus after birth, and it goes through three predictable phases over about 4–6 weeks. Lochia rubra (the first 3 days) is bright or dark red, heavy, and may contain small clots — that’s normal as long as you’re not soaking through more than one maternity pad an hour. Lochia serosa (days 4–10) is pinker-brown and much lighter. Lochia alba (from about day 10 up to 6 weeks) is creamy or yellowish and often only stains a panty liner. A few patterns are normal and surprise parents: a gush of blood when you stand up after sitting or lying down (pooled blood emptying); heavier bleeding while breastfeeding (the same oxytocin that releases milk also contracts the uterus, briefly increasing flow); and bleeding that gets heavier with activity but settles with rest. The signs that mean call your team today: soaking more than one maternity pad every hour for 2 hours; passing clots bigger than a golf ball after the first 24 hours; bright red bleeding returning after it had paled; smelly discharge with fever and abdominal pain (signs of postpartum infection); persistent bleeding still going strong at 6 weeks; or feeling dizzy, light-headed, breathless or with palpitations. The first 12 weeks postpartum is the highest-risk time for venous thromboembolism, postpartum pre-eclampsia, and infection — don’t dismiss new symptoms as “just feeling rough after birth”. Maternity pads not tampons for 6 weeks, and book the 6-week postnatal check even if everything feels fine.
Lochia phases
- Rubra (days 1-3): bright/dark red, heavy.
- Serosa (days 4-10): pink-brown, lighter.
- Alba (day 10-6 weeks): creamy yellowish, minimal.
Typically resolves 4-6 weeks. C-section lochia often lighter.
Red flags — same-day call
- Soaking >1 maternity pad/hour for 2+ hours.
- Clots bigger than golf ball after first 24h.
- Sudden return to bright red after lighter.
- Foul smell + fever + abdominal pain.
- Persistent bleeding at 6 weeks.
- Dizziness / lightheaded / breathless.
Severe sudden bleeding = emergency.
Breastfeeding + bleeding
Oxytocin from breastfeeding contracts uterus (afterpains) + briefly increases bleeding but reduces total overall. Sign uterus is contracting back.
Pads vs tampons
Pads / maternity pads ONLY for first 6 weeks. No tampons or cups — infection risk during healing.
Clots
Small (up to coin-size) normal first 24-48h. Larger or sudden increase = midwife / out-of-hours.
When period returns
- Exclusive breastfeeding: amenorrhoea 6-18 months typical.
- Formula / non-BF: 6-10 weeks.
- Mixed: 3-12 months variable.
- Ovulation can occur BEFORE first period — contraception needed.
Self-care
- Watch danger signs.
- Maternity pads only.
- Perineal care: gentle water wash; pat dry.
- Take it easy; elevate legs.
- Hydrate.
- Iron-rich foods; supplement if Hb low.
- Pelvic floor exercises gently from day 1.
- Avoid heavy lifting first 6 weeks.
Different scenarios
Scenario 1: Day 5, light pink discharge, panty liner
Normal serosa phase. Continue care.
Scenario 2: Day 3, soaking pads + golf-ball clots
Maternity unit call same-day. Possible secondary PPH.
Scenario 3: 7 weeks postpartum, still light bleeding
GP review. Investigate retained products / endometritis.
Scenario 4: Foul smell + fever + tender abdomen day 6
Endometritis suspected. Same-day antibiotics.
Scenario 5: Bleeding stopped at 4 wk, restarted bright red at 8 wk
Likely first period back. Confirm with pregnancy test if applicable.
Care guidance
- Track flow + colour through 6 weeks.
- Maternity pads only.
- Red flags = same-day call.
- Iron + hydration support recovery.
- Contraception even before period returns.
- Birth debrief 4-6 weeks if traumatic.
Sources
- RCOG. Postpartum care.
- NHS. Postnatal bleeding.
- NICE NG194. Postnatal care.
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Frequently asked questions
How long does postpartum bleeding last?
Usually 4-6 WEEKS. Three phases: LOCHIA RUBRA (days 1-3) — bright/dark red + heavy; LOCHIA SEROSA (days 4-10) — pink-brown + lighter; LOCHIA ALBA (day 10-6 weeks) — creamy-yellow + minimal. Some women stop at 4 weeks; others edge past 6 — both normal range. PERSISTING beyond 6 weeks deserves a check.
Is it normal to bleed 4 weeks postpartum?
YES. Most women have light bleeding / spotting until 4-6 weeks. By 4 weeks: light, pink-brown to yellowish, often only on panty liner, tapering off. BRIGHT RED flow returning at 4 weeks (especially with clots / pain) is worth calling midwife / GP.
What does lochia look like by week?
(1) WEEK 1: bright red to dark red; heavy days 1-3; small clots up to 50p / £2 coin size normal first 24h. (2) WEEK 2: pinker, watery, mid-flow. (3) WEEKS 3-4: creamy yellowish, very light. (4) WEEKS 5-6: minimal or stopped. CAESAREAN lochia often slightly lighter overall; may finish slightly earlier.
When should I worry?
Call maternity / out-of-hours same-day if: soaking through >1 maternity pad/hour for 2+ hours; passing CLOTS bigger than a golf ball after first 24h; sudden return to bright red bleeding after lighter; FOUL-smelling discharge with fever + abdominal pain (infection); persistent bleeding at 6 weeks; dizziness / lightheaded / breathless / palpitating. SEVERE SUDDEN bleeding — call emergency services.
Why do I bleed more when breastfeeding?
Breastfeeding releases OXYTOCIN — same hormone contracts uterus during labour. Each feed = brief uterine contractions ('afterpains') squeezing out fresh trickle of blood. SIGN your uterus is contracting back to pre-pregnancy size. Briefly increases bleeding but REDUCES total bleeding overall.
Could it be a postpartum haemorrhage?
PRIMARY PPH: within 24 hours of birth. SECONDARY PPH: 24h-12 weeks post-birth. CAUSES of secondary PPH: retained placental products; infection (endometritis); rare AVM. SIGNS: heavy bleeding (soaking pads); large clots; fever; foul-smelling; tender uterus. NEEDS evaluation. ULTRASOUND for retained products; antibiotics if infection. /calculators/pph-qbl.
How much bleeding is normal?
FIRST 24h: heavy maternity pads — up to half full per few hours typical. DAYS 2-4: 4-6 maternity pads / day. WEEK 2: 2-3 pads / day. WEEKS 3-6: panty liner sufficient often. INDIVIDUAL VARIATION. RED FLAG: soaking pad / hour for 2+ hours; large clots; sudden increase.
Should I use pads or tampons?
PADS / MATERNITY pads ONLY for first 6 weeks. NO TAMPONS — increase infection risk during postpartum healing. Cervix slightly open; tissue healing. Switch to regular pads / liners as bleeding lightens. CUPS NOT recommended postpartum until healing complete (typically 6+ weeks).
Why are clots forming?
Small clots (up to 50p / £2 coin) NORMAL especially first 24-48 hours — blood pools when sitting / lying. LARGER CLOTS (golf ball+ after first day) = concerning. LARGE CLOTS or sudden increase = midwife / out-of-hours; possible retained products + need for evacuation.
When does my period come back?
BREASTFEEDING EXCLUSIVELY: amenorrhoea typical for 6-18 MONTHS (lactational). FORMULA FED / non-breastfeeding: usually 6-10 weeks postpartum. MIXED feeding: 3-12 months variable. FIRST PERIOD can be heavy / different from before. OVULATION can occur BEFORE first period — contraception needed if not wanting another pregnancy soon. /calculators/postpartum-contraception.
Lochia vs return of period?
Lochia: continuous flow trailing off; pink/brown/creamy. PERIOD: clearer red flow; comes after lochia has finished + after 4-6 weeks. STOPPED then started again = often first period (especially if 6+ weeks postpartum). DURING lochia phase: sudden bright red increase = possible secondary PPH, infection — call midwife.
Self-care during lochia?
(1) WATCH for danger signs; (2) Maternity pads (not tampons); (3) PERINEAL CARE — gentle washing with water; pat dry; (4) Take it easy; (5) ELEVATE legs when possible (reduces swelling, bleeding); (6) STAY HYDRATED; (7) IRON-rich foods (anaemia common post-birth); (8) IRON SUPPLEMENT if Hb low (NICE Hb <100 postpartum); (9) PELVIC FLOOR exercises (gentle) from day 1; (10) AVOID heavy lifting + strenuous activity first 6 weeks.
C-section vs vaginal lochia?
C-SECTION lochia: often slightly LIGHTER overall + may finish a bit earlier. STILL HAVE lochia (uterus shedding lining post-birth). NOT to be confused with C-section wound bleeding/discharge — different. C-SECTION recovery: extra warnings re wound + infection signs. SAME RED FLAGS for postpartum bleeding apply.
How does this relate to other calculators on BumpBites?
Companion: /calculators/pph-qbl; /calculators/maternal-sepsis; /calculators/postpartum-mood-warning; /calculators/postpartum-contraception; /calculators/postpartum-weight-loss; /calculators/breastfeeding-latch; /calculators/cmqcc-pph-risk.