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Postpartum bleeding

Les lochies, les saignements de l'après-accouchement

That's it: the child we've been waiting for for nine months is finally here! After three trimesters of pregnancy , during which the embryo then the fetus gradually developed in the maternal womb , the newborn arrived. Parents and baby discover each other. Then comes the time of the afterbirth . It's a big upheaval for the whole family , especially for the mother . This phase which directly follows giving birth is called “ postpartum ”, or “ postpartum ”. A total discovery for those giving birth for the very first time; an experience always unique in its kind for those who are already mothers . Many phenomena, both physical and psychological, mark this postnatal period . This is the case with “ lochia ”. This bleeding which occurs just after childbirth , and generally lasts a few weeks, is typical of postpartum. But what is it exactly? And how best to manage them before the menstrual cycle resumes and the return of diapers ?

What is lochia?

Lochia: definition

Lochia refers to vaginal discharge that women have following childbirth. They correspond to the evacuation, through the vagina, of internal residues of pregnancy. They mainly consist of:

of blood ;
placenta debris and uterine lining, also called endometrium;
and lymphatic fluid.

Indeed, during childbirth, once the baby is born and the umbilical cord is cut, the placenta is naturally expelled from the maternal body. This is called deliverance. The placenta is a temporary organ ensuring exchanges (of water, nutrients, oxygen, waste, hormones, antibodies) between the mother and the fetus throughout gestation. It is a sort of flat pocket very rich in blood vessels. It is attached to the uterus at a precise point from which it grows during pregnancy: where the fertilized egg has merged with the endometrium during implantation. At the time of delivery, within 30 minutes or less of birth, the placenta detaches from the uterus. At the point of rupture, the blood vessels break and a wound opens in the uterine wall. Lochia results from the formation and then healing over time of this wound. This is why they are a mixture of blood – liquid or coagulated in the form of clots –, placental and uterine waste and substances with healing properties.

These postnatal discharges occur in both vaginal and cesarean deliveries.

How long does bleeding last after childbirth?

Lochia differs greatly from one woman to another. In the general case and in the absence of complications, they begin after childbirth, immediately after delivery or within a few hours following delivery. They then last until the uterine wall heals completely, which takes more or less time depending on the case. It takes on average 3 to 4 weeks for lochia to end. But it is quite common for them to continue until the return of diapers, i.e. 6 to 8 weeks after birth (without breastfeeding).

Do not confuse lochia and return of diapers

Lochia is not a period. These are indeed blood losses, but they are not linked to the menstrual cycle. This does not resume immediately after birth. The reappearance of menstruation occurs on average 6 weeks after delivery (when there is no breastfeeding). This is called changing diapers. Between birth and the return of childbirth, it is the postpartum period, also known as “afterbirth”. This transition phase ultimately corresponds to the average time required for the female body to return to its initial state before pregnancy. Lochia is therefore usually present during the first half of the postpartum period .

What does lochia look like?

The quantity and appearance of lochia vary throughout their manifestation. In general, during the first 3 to 4 days, they are very abundant and called “bloody”, i.e. bright red, often accompanied by rather large clots. Then their flow decreases and their coloring gradually changes. Between 5 days and 2 weeks after giving birth, the discharge lightens: it becomes light brown. After about 2 weeks, they turn yellowish white. ¹

Are lochia painful?

In the first days after childbirth, lochia is accompanied by what we call “trenches”. These are contractions of the uterus, different from labor contractions. They are normally less intense, but some women may suffer from the cramps and pain caused.
The trenches have a triple purpose. First of all, they limit the risk of hemorrhage by compressing the blood vessels broken during placental abruption. Then, they accelerate the flow and expulsion of lochia, facilitating internal cleaning. Finally, they allow the uterus to gradually return to its original size and position.
Often, it is during feeding that the trenches are felt. Indeed, the hormone allowing the ejection of milk, oxytocin, stimulates their release. Thus, breastfeeding your baby generally shortens the duration of lochia.

How to best manage lochia?

Talking about postpartum to medical staff and those around you

In several ways, pregnancy and then birth are large-scale, particularly significant events. Post-partum is just as important. Managing this period is not always easy for mothers, busy with their baby, troubled by the many physical and psychological changes taking place within them, tired by all this. In addition, they are sometimes embarrassed to share their feelings and their intimate troubles, or even ashamed to ask questions that seem stupid to them. However, that’s what health professionals are there for; they are used to it. Likewise, loved ones, especially those who have already experienced motherhood, can be of invaluable help in experiencing this period more peacefully. Do not hesitate to talk about postpartum symptoms, including lochia, during your stay in the maternity ward and once you return home.

Wear protection adapted to postpartum bleeding

During this very special period that is post-partum, feeling good, both in your body and in your mind, is essential. To do this, it is important to choose the hygienic protection adapted to the situation. A healthy, reassuring and pretty option: Perdième menstrual underwear . To be used as a replacement or in addition to periodic pads and mesh panties given in the maternity ward, which are often uncomfortable and unsightly. Made from GOTS certified cotton, they are gentle on the skin and limit the risk of infection. Capable of absorbing the equivalent of several tampons – 2 to 3 for menstrual panties and 3 to 4 for menstrual shorties , they ensure efficiency and practicality, for a postpartum without overflow!

Take care of yourself

After nine months of waiting, the baby's arrival is most often eagerly awaited. The excitement of discovering the newborn as well as all the activities linked to his arrival mean that many mothers tend to forget themselves. However, it is essential to take care of yourself to recover after childbirth and gradually regain your feminine balance. With Miyé, we have imagined a postpartum box to reduce the not very glamorous symptoms linked to postpartum: lochia, hair loss, breast tension or even vaginal dryness... It is not only baby who should receive gifts, mom deserves to be spoiled too!

Consult if in doubt

Uterine bleeding related to childbirth should be monitored carefully. Postpartum hemorrhage can occur immediately after delivery or within 24 hours. Then, excessive blood loss can occur up to a month after delivery . ² It is imperative to consult a doctor or midwife in the event of worrying symptoms such as:

persistent and increasingly heavy bleeding;
a fever of 38°C or more;
severe abdominal pain;
lochia which smells very strongly;
severe headache, dizziness, or a sudden change in vision.

Menstrual underwear Perdième pattern Taipei

Understand what “lochia” means and implies: a good point for a future birth or a relief to finally understand the conversations of friends with child(ren)!

To extend reading:

Written by cd

Sources:

Moldenhauer, J. S. (2022, April 5). Presentation of postpartum . MSD Manuals for the general public.
Moldenhauer, J. S. (2022, April 5). Excessive bleeding from the uterus during childbirth . MSD Manuals for the general public.