Postpartum bleeding (lochia)

Bleeding after birth — called lochia — is normal and expected, whether you had a vaginal birth or a caesarean. It’s how your body sheds the lining that supported your pregnancy, and it carries on for several weeks. Knowing the normal pattern (and the warning signs) means you can tell healthy healing from something that needs checking.

What’s normal. For the first few days, lochia is like a heavy period — bright to dark red, possibly with some small clots. Over the following weeks it gradually lessens and changes colour: from red, to pinkish-brown, to a creamy yellow-white, before stopping. It has a mild, period-like smell. This whole process commonly takes around four to six weeks, though it varies from person to person.

Clots. Passing some small clots, especially in the early days or first thing in the morning (when blood has pooled overnight), is normal. It’s the size and frequency that matter: small clots are usually fine, but large clots (bigger than a 50-cent coin, or repeatedly) with heavy bleeding need checking.

Afterpains. Alongside the bleeding you’ll likely feel “afterpains” — period-like cramping as your uterus contracts back to its pre-pregnancy size. These are often stronger during breastfeeding (which releases the hormone that drives the contractions) and with second and later babies. Simple pain relief helps, and they ease over the first week or so.

Looking after yourself. Use maternity pads, not tampons, throughout — tampons can introduce infection while you’re healing. Change pads regularly, wash your hands before and after, and keep the area clean to reduce infection risk. Rest matters too: overdoing it, especially early on, can make bleeding heavier again, which is your body’s signal to slow down.

A useful sign to watch. If your bleeding had settled and then becomes heavier or redder again, it’s often a nudge that you’re doing too much — take it as a cue to rest more. A short increase after a burst of activity is common, but it shouldn’t be dramatic.

When to seek help — promptly. Contact your midwife, GP or maternity unit if you’re soaking a maternity pad in an hour or less, passing large clots, your bleeding suddenly becomes much heavier, or it smells offensive or comes with a fever, chills, or tummy pain — these can signal a haemorrhage or infection. Don’t wait to see if it settles.

Call 000 or go to emergency if you have very heavy, uncontrolled bleeding, feel faint, dizzy or short of breath, or have a racing heart — these are signs of significant blood loss and need emergency care. This is rare, but it’s vital to act fast if it happens.

When it doesn’t stop. If bleeding is dragging on well beyond six weeks, stops and restarts oddly, or you’re just not sure what’s normal, get it checked — it’s an easy thing to ask your GP or child health nurse about. Note that your first proper period can return while you’re recovering (and earlier than you might expect if you’re not exclusively breastfeeding), which can be confusing to tell apart from lochia.

A few practical tips. Stock up on maternity pads before the birth — you’ll get through a lot, and you’ll want the long, absorbent kind rather than skinny liners. Dark, comfortable underwear (or disposable maternity briefs) saves your favourites, and keeping a stash of pads and clean underwear by the loo and the change table makes life easier in the early days. Change pads regularly both for hygiene and so you can keep an eye on how much you’re bleeding.

Postpartum bleeding is a normal, if messy, part of healing that winds down over several weeks. Stock up on maternity pads, rest when it flares, and keep the “call promptly” and “call 000” signs above in mind — when in doubt, a quick call to your midwife or GP is always the right move.