Along with the joys and challenges of motherhood, certain physiological changes happen after childbirth, and one of the most significant is postpartum bleeding, also known as lochia. This natural process involves the discharge of blood and tissue from the uterus as it heals and returns to how it was before you became pregnant. For new moms and others who provide assistance to them during the postpartum period, it is essential to understand the lochia stages and causes, as well as all the available treatments to alleviate the symptoms. 

If you are in the area and are looking for postpartum bleeding relief, our skilled staff at University Park OBGYN is here to guide you through all the lochia stages and support you along the way. Whether you’re seeking routine check-ups, prenatal care, family planning services, or advanced gynecological treatments, our clinic offers a comprehensive range of services to address your specific concerns. In this blog post, we will delve deeper into the causes behind postpartum bleeding, explore the different stages of lochia, and discuss potential treatment options for any concerns that may arise during this critical period. 

What is Lochia?

Serious Doctor Listening to a Patient in Modern Medical Office.

Immediately after the wonderful experience of birth, a woman’s body undergoes a number of physiological changes that help it repair and recover. The presence of lochia, or postpartum bleeding, is a significant aspect of this postpartum journey. This term describes the vaginal discharge that occurs during childbirth and is made up of blood, tissue, and mucus as the uterus goes through an amazing process of enlargement to return to its pre-pregnancy form. It’s essential for women to learn about the different lochia-related factors, including its origins, phases, and especially the early stage known as lochia rubra, throughout the postpartum time.

Postpartum bleeding is the body’s way of shedding the excess blood and tissue that supports the growing fetus while in the womb. Lochia typically begins within a few hours of delivery and can last for several weeks, gradually decreasing in intensity and changing in color as the healing progresses. The initial stage of lochia is known as lochia rubra, characterized by bright red bleeding. This stage usually lasts for about three to four days after delivery. It is crucial to understand that lochia is not the same as menstruation and should not be confused as such. While the flow may be heavy initially, it gradually decreases in intensity and changes in color over time as the healing process advances.

Women are empowered throughout the postpartum period when they have a better understanding of lochia, especially in the first stage of this condition. They can better focus on their recovery, form bonds with their babies, and seek medical advice if necessary by being informed about what to anticipate and how to handle this normal vaginal discharge. 

Understanding lochia ensures that every woman’s childbirth experience is secure and healthy. 

Lochia Stages

As mentioned, postpartum bleeding can be divided into three stages, each with its characteristics and duration. Those are the following:

  1. Lochia Rubra – Also known as the first stage, typically begins immediately after childbirth and lasts for about three to four days. It is characterized by bright red bleeding, similar to a heavy menstrual flow. The vaginal discharge consists of a mixture of blood, uterine tissue, and mucus as the uterus sheds the remains of the pregnancy. It is normal to experience significant bleeding during this stage as the body clears out the excess blood, so don’t be alarmed if you see this happening.
  2. Lochia Serosa – After the initial stage of lochia rubra, the discharge transitions into lochia serosa. This stage usually starts around the fourth or fifth day after delivery and lasts for approximately one to two weeks. Lochia serosa has a pinkish or brownish color and may appear thinner and more watery compared to lochia rubra. During this stage, the body continues to discharge residual blood and old red blood cells. The amount of discharge gradually decreases as the healing goes on.
  3. Lochia Alba – The final part of the three lochia stages is called lochia alba. It can be seen during the third postpartum week and lasts at least six weeks. A characteristic of lochia alba is a yellowish or white discharge resembling typical vaginal discharge. The uterus is still healing at this point, and the discharge is mostly made up of white blood cells, bacteria, and epithelial cells. As the healing process is finished, the discharge gradually lessens until it stops entirely.

It is important to remember that the duration and characteristics of each stage may vary from woman to woman. However, if the bleeding becomes excessively heavy, persists longer than expected, or is accompanied by severe pain, foul odor, or other concerning symptoms, it is essential to consult a healthcare provider for additional evaluation and appropriate treatment. 


Doctor and Patient Sitting and Talking in Hospital or Clinic

Women can better understand the significance of this postpartum process and distinguish it from other forms of bleeding by being aware of the underlying reasons for lochia. The primary cause of lochia is the shedding of the uterine lining and the elimination of excess blood and tissue that supported the growing fetus during pregnancy. The walls of the uterus thicken during the gestational period in preparation for implantation and feeding the growing fetus. The womb starts to contract and discharge this thicker lining once a woman delivers a baby since the body no longer requires it. 

After childbirth, postpartum bleeding is caused by the uterine lining shedding. The blood veins that once nourished the placenta and developing fetus tighten and burst as the uterus contracts, causing bleeding. The uterus also experiences involution, which is the process of returning to how it was before pregnancy. The leftover blood and tissue are lost as a result of this process. Each woman has different amounts of bleeding during lochia. The amount of postpartum bleeding can vary depending on several factors, including the delivery technique (vaginal or cesarean), if there were any issues or interventions made during labor and frictions in uterine involution. 

It is important to note that lochia is not the same as menstruation. Menstruation is the shedding of the uterine lining during the menstrual cycle, whereas lochia happens specifically after childbirth. It typically lasts longer than a standard menstrual period and has distinct stages, including the initial phase of lochia rubra, as mentioned earlier. 


Understanding the causes of lochia allows women to appreciate the natural healing process their bodies undergo after giving birth. It also helps distinguish lochia from abnormal bleeding or complications. While lochia is a normal part of the postpartum period, it is crucial for women to monitor their bleeding, follow proper hygiene practices, and seek medical advice if they have concerns or notice any unusual symptoms. By being aware of the causes of lochia, women can confidently navigate the postpartum period and focus on their recovery and well-being.