The Stages Of Postpartum Bleeding, Explained By Doctors

You were probably so thrilled that the pressure and pain of labor and delivery was over that you didn’t give much thought to the aftermath of birth: postpartum bleeding. Because, if we’re being honest here, it can look like a bloodbath on that hospital bed. And while you might expect to have a heavier flow right after Baby is born, sometimes bleeding after childbirth can last well past the time you head home from the hospital. If you’re trying to figure out the postpartum bleeding stages (aka “When will I be able to take off this pad already?”), this is what you need to know about how your body is healing.

Here's What You Need To Know About Postpartum Bleeding

It’s a fact that whether you deliver vaginally or via cesarean delivery, your body is bound to bleed. Although it might seem like it’s gushing out of you, it’s a relatively small amount of liquid loss, according to Dr. Daniel Roshan, MD, FACOG, FACS, a leading board-certified OB/GYN and high-risk maternal-fetal specialist in New York City. “In a normal vaginal delivery, the blood loss is about 500 cc, and with a C section, it’s about 1000 cc,” explains Dr. Roshan. To give you an idea of how much that is, 500 cc would be about half a liter of liquid, and 1000 cc would be one liter.

So how much bleeding can you expect, and when? Here’s how long you’ll be wearing those mesh hospital panties for.

Days 1-4: Lochia Rubra

Although the bleeding that happens postpartum might seem to be like a period (but on TK), there’s actually a special name for it. “The bleeding that occurs postpartum is called lochia,” Dr. Cynthia Flynn, MD, a board-certified OB/GYN with JustAnswer tells Romper. “It is a mix of tissue, fluids and blood.” And as much as you might have boohooed them, you’ll never be happier for those mesh hospital panties than in those first few days after delivery, because those are the ones you’ll be using (along with those super-sized pads) to soak up all the blood and bodily fluids. Lochia rubra is the heaviest flow you’ll have postpartum, and it typically lasts 3-4 days.

Days 5 -26: Lochia Serosa

About a week or so after you’ve delivered, you might notice that your bleeding has changed. Not only has it become slightly more normal in flow, but it’s also not really dark reddish brown any longer. Congratulations, because you’re now in the lochia serosa phase. The second part of the postpartum bleeding stage, lochia serosa is described as being more like a regular period in terms of flow and color. Lochia serosa can last up to about three weeks, researchers found, and changes in color from a dark red to a pink, brown (or brownish-pink) shade.

Days 27-42: Lochia Alba

The last stage in postpartum bleeding is lochia alba. It’s much milder than its wicked stepsisters rubra and serosa insofar as it’s got a lighter flow — even its appearance is a yellow/white color. At this stage of postpartum, while you’ll still be bleeding, you’ll be able to get away with using a pantiliner instead of a big ol’ pad. But even if you’re tempted to use a tampon after delivery instead of a pad or pantiliner, it’s best to wait until your 6-week postpartum checkup with your doctor to ensure that your body has healed and it's safe to do so.

Here's Why You Still Might Bleed Beyond 6 Weeks

If you’re counting down the days until your 6-week checkup (when you’ve probably stopped bleeding, and can get the greenlight to exercise or even have sex again), you might want to hold off on the celebrations. Some new mommas might bleed longer than that, says Dr. Flynn. “Some moms who breastfeed may bleed on and off for 12 weeks,” she says. “The first periods after delivery may be lighter for a few months, or they may also just return to normal very quickly.” If you have questions about your blood loss as it relates to breastfeeding, you should speak with your medical doctor or your breastfeeding consultant who will know what’s normal and what’s not.

This Is When You Should Be Concerned About Postpartum Bleeding

Bleeding is all part of the postpartum process as your body heals itself from the inside out. But there are times in which bleeding can become an issue. “Postpartum women can experience blood clots, or a very heavy period that requires them to keep changing pads several times an hour,” explains Dr. Roshan. Blood loss that seems severe can be a result of a retained placenta, another study found. Removal of the leftover placenta via a dilatation and curettage (D&C) will be necessary and can help control bleeding.

There are other signs you should look out for to ensure that your lochia is regular and doesn’t require medical intervention. “If the bleeding lasts past six weeks, becomes heavier, or has a foul odor, you should consult your doctor,” says Dr. Flynn. Or, according to Dr. Roshan: “If you feel lightheaded or can’t stand up — or if you’re soaking your pads — you should seek medical attention.”

While you might not be looking forward to those postpartum bleeding stages, it’s important to remember that lochia doesn’t last forever. Just make sure that your body is healing well after delivery, and all those newborn snuggles will make up for the fact that you’re both basically wearing a diaper for the foreseeable future.

Studies referenced:

Lopez-Gonzalez, D., Kopparapu, A., “Postpartum Care Of The New Mother” 2021.

Oppenheimer, L., Sherriff, E., Goodmna, J., Shah, D., James, C. “The duration of lochia” 1986.

Sherman, D, Lurie, S, Frenkel, E., Kurzweil, Y., Bukovsky, I., Arieli, S. “Characteristics of normal lochia” 1999.

Gallee, M., Lee, S., Spence, A., Czuzoj-Shulman, N., Klam, S. Abenhaim, H. “Association Between First-Trimester Bleeding and Retained Placenta Requiring Dilatation and Curettage” 2021.

Experts:

Dr. Daniel Roshan, MD, FACOG, FACS, a leading board-certified OB/GYN and high-risk maternal-fetal specialist in New York City

Dr. Cynthia Flynn, MD, a board-certified OB/GYN with JustAnswer