Lochia: what postpartum bleeding is normal and when to call your midwife

Postnatal recovery · Updated July 2026 · All articles

After giving birth, your body sheds the lining of the uterus in a process called lochia. This postpartum bleeding is completely normal and is a sign that your uterus is healing. Most new mothers have questions about what is expected, how long it lasts, and when the bleeding might signal something that needs attention. This guide walks through everything you need to know.

What is lochia and why does it happen?

Lochia is the vaginal discharge that occurs after birth as the uterus sheds the decidua, the specialised lining that built up during pregnancy to support the placenta and baby. It contains blood, mucus, and uterine tissue. The process starts immediately after birth and continues for several weeks, gradually decreasing as the uterus returns to its pre-pregnancy size and the inner surface heals.

It is sometimes described as a very heavy period, but it is distinct from menstruation. Lochia occurs regardless of whether you gave birth vaginally or by caesarean section, because it is the uterine lining shedding rather than anything specific to how the baby was born. The volume is typically heavier than a period in the first days, then reduces significantly over the following weeks.

The three stages of lochia

Lochia progresses through three recognisable stages, each with a different colour and consistency.

The first stage is lochia rubra, meaning red lochia. This begins immediately after birth and typically lasts for the first 2 to 4 days. It is bright red and may contain small clots and fragments of tissue. This is the heaviest stage: you may need to change a maternity pad every couple of hours. Small clots up to roughly the size of a 50p coin are considered normal in these early days.

The second stage is lochia serosa, meaning watery or serous lochia. This begins around days 4 to 7 and lasts until approximately day 10 to 14. The colour transitions from red to pink, brown, or a pinkish-brown. The flow becomes lighter and the consistency thinner. You may be able to switch from maternity pads to lighter sanitary pads during this stage, though every person is different.

The third stage is lochia alba, meaning white or pale lochia. This begins around weeks 2 to 3 and continues until the lochia stops entirely, which is typically somewhere between weeks 4 and 6, though it can continue a little longer. The discharge becomes pale yellow, cream, or white in colour and is quite light. It may be barely noticeable on a pad.

What makes lochia heavier

Several factors can temporarily increase the flow of lochia, and understanding these helps avoid unnecessary alarm.

Physical activity and spending a long time on your feet are common triggers. You may notice that after a busy morning, the lochia is heavier for the rest of the day. This is generally normal and a useful reminder that rest is still important even if you are feeling better.

Breastfeeding causes the release of oxytocin, the same hormone that drives uterine contractions. When you feed your baby, you may notice the lochia becoming heavier or feeling cramping in your abdomen, particularly in the first week. This is a normal sign that the uterus is contracting as it should.

First thing in the morning, after lying down overnight, you may notice a rush of lochia when you stand up. This is simply blood that has pooled while you were lying still and is not a sign of increased bleeding overall.

What is not normal: warning signs to know

While lochia is normal, certain changes in the bleeding are warning signs that need prompt assessment.

Soaking more than one maternity pad per hour for two or more hours is considered heavy postpartum bleeding and needs urgent attention. Do not wait to see if it settles: contact your maternity unit or call 999 if you cannot get through. This level of blood loss can escalate quickly.

Passing large clots bigger than a golf ball, especially with heavy bleeding, should also be assessed urgently. While small clots are common in the first days, large clots can be a sign that the uterus is not contracting effectively.

An offensive or foul smell to the discharge, particularly if accompanied by a fever above 38 degrees C or increased pain in the lower abdomen, may indicate a uterine infection. This needs treatment with antibiotics and should not be left. Contact your GP, midwife, or maternity triage depending on how unwell you feel.

Lochia that suddenly becomes much heavier again after it has clearly been reducing, rather than just a brief increase after activity, should also be investigated. This can be a sign of retained placental tissue.

Retained placenta: what it means and how it is treated

Occasionally, small fragments of placental tissue remain in the uterus after birth. This is known as retained products of conception. The presence of retained tissue prevents the uterus from contracting down properly and can cause persistent or recurrent heavy bleeding, fever, and foul-smelling discharge in the weeks after birth.

Retained placenta is diagnosed by ultrasound scan. Treatment depends on the amount of tissue present and how you are feeling: in some cases, the tissue passes on its own with the help of medication to stimulate uterine contractions; in others, a surgical procedure under anaesthetic is needed to remove it. If you have ongoing heavy bleeding, fever, or offensive discharge in the weeks after birth, this possibility should always be assessed.

Secondary postpartum haemorrhage: what it is and when to act

A secondary postpartum haemorrhage (PPH) is defined as significant bleeding occurring between 24 hours and 12 weeks after birth. It is less common than the primary PPH that can occur immediately after delivery, but it does happen and can be serious. The causes include retained placental tissue, infection, or a combination of both.

If you experience a sudden return of heavy bright red bleeding at any point in the weeks after birth, particularly if you are passing large clots or soaking pads rapidly, call 999 or your maternity unit immediately. While waiting for help, lie down, keep warm, and if possible have someone with you.

Using tampons and other products during the lochia period

During the lochia period, maternity pads are strongly recommended over tampons, menstrual cups, or period underwear in the early weeks. This is because tampons and internal products introduced into a healing vagina and uterus carry a risk of infection. Most healthcare providers suggest waiting until the lochia has stopped entirely and the six-week check has been completed before using internal menstrual products again. If you are unsure, ask your GP or midwife.

When to call triage, your GP, or wait

To help you decide who to contact, here is a practical guide. Call 999 or go to an emergency department immediately if you are soaking more than a pad an hour for two consecutive hours, if you feel faint or very unwell, or if you are passing large clots alongside heavy flow. Call your maternity triage line if you have heavy bleeding that is not quite at that level but is worrying you, or if you have a fever with worsening abdominal pain. Contact your GP if you have persistent offensive-smelling discharge, low-grade fever, or lochia that has stopped and then restarted days later. If your lochia is progressing normally through the three stages and reducing as expected, simply continue to monitor and attend your scheduled postnatal appointments.

Frequently asked questions

How long does lochia last?

Lochia typically lasts between 2 and 6 weeks after birth. It starts heavy and red, gradually lightening to pink and then to a pale yellow or white discharge. The exact duration varies between people.

Is it normal for lochia to get heavier after it has been lighter?

A small increase in bleeding when you first get out of bed or after breastfeeding is common and normal. However, if bleeding becomes suddenly very heavy again after it had clearly reduced, contact your midwife as this can be a sign of retained placenta or infection.

What clots in lochia are normal?

Small clots up to the size of a 50p coin are common in the first few days. Larger clots, or clots accompanied by very heavy bleeding, should be assessed by a midwife or doctor.

Does breastfeeding affect lochia?

Yes. Breastfeeding causes the release of oxytocin, which helps the uterus contract. You may notice lochia becomes heavier or you feel cramping during feeds. This is normal and is a sign that the uterus is contracting as it should.

What is a postpartum haemorrhage?

A primary postpartum haemorrhage (PPH) is defined as blood loss of 500 ml or more within 24 hours of birth. A secondary PPH occurs between 24 hours and 12 weeks after birth. If you are soaking more than one maternity pad per hour, seek emergency help immediately.

What are the signs of retained placenta after birth?

Signs that part of the placenta may have been retained include persistent heavy bleeding, an offensive smell to the discharge, fever, and a uterus that feels larger than expected on examination. This needs prompt medical assessment.

This article is for general information only. Always speak to your midwife, GP, or health visitor if you have concerns about your physical recovery after birth.