Lochia — The Complete Postpartum Guide

Lochia is the wound discharge your uterus releases through the vagina after birth. It contains blood, placental tissue, shed uterine lining, and wound secretion from the area where the placenta was attached to the uterine wall. After birth, this area is roughly the size of a palm — and it must heal, just like any other wound.

Lochia is not a sign that something is wrong — quite the opposite. It's part of an astonishing biological healing process during which your uterus shrinks from the size of a melon back to the size of a pear. Midwives call this process involution. Lochia is the visible sign of this healing.

Because lochia is potentially infectious, special hygiene rules apply during the postpartum weeks: no tampons, no menstrual cups, no full baths and no intercourse until lochia has ended. We'll cover this in detail later.

Lochia progresses through three phases. They're not sharply separated — color and consistency blend smoothly from one phase to the next. The time ranges are guidelines. For some women each phase lasts longer, for others shorter. That's normal.

The most common postpartum question: how long will this actually last? The honest answer is: it varies. On average, lochia lasts 4 to 6 weeks. Some women finish after 3 weeks, others take up to 8. After a C-section, lochia is often slightly shorter and lighter than after vaginal birth — because some of the uterine lining is already removed during surgery.

One key rule: lochia gets lighter day by day, not heavier. If bleeding suddenly increases after a period of improvement, it's a warning sign — either you did too much too soon (real rest usually helps), or something in the uterus has become inflamed. Calling your midwife or doctor is always the right move.

In the postpartum period your body has a large internal wound. The goal of all hygiene measures is to protect this wound from germs and support healing. The most important rule: pads, not tampons — and above all, rest.

The postpartum period is a sensitive time. Most courses are normal, but there are situations where you should not wait. Take the following warning signs seriously and, without delay, contact your midwife, gynaecologist, or — if in doubt — emergency services:

One of the most important postpartum complications is endometritis — inflammation of the uterine lining. It often arises when lochia is blocked or germs ascend. Typical signs: fever, foul-smelling lochia, lower abdominal pain. Endometritis is treatable if caught early — usually with antibiotics. Don't delay.

The postpartum is not a marathon but a healing process. The classic rule: one week in bed, one week around the bed, one week around the home. It doesn't mean you can't get up — but in the first 10 days your body really needs rest. The more you rest, the faster involution happens and the fewer complications arise.

The official medical recommendation is clear: no sexual intercourse until lochia has completely ended — usually after 4 to 6 weeks, ideally after the postnatal check-up with your gynaecologist. Until then, the internal wound is not yet closed and intercourse would significantly increase the infection risk.

Even after the waiting period, sex is often different at first. Hormones make the vagina drier (especially when breastfeeding), the pelvic floor feels unfamiliar, and a perineal stitch may still be sensitive. Lube helps. Time helps. Honest conversation with your partner helps. And: sexual desire is often simply absent in postpartum — that's normal, not a sign something is broken.

Postpartum isn't only about the physical lochia. Your psyche goes through its own flushing process. Between days 3 and 5 after birth, 60-80% of mothers experience the so-called baby blues: tears without reason, thin emotional skin, the feeling of feeling everything at once. That's a hormonal reaction and passes within a few days.

But if sadness, emptiness or anxiety lasts longer than two weeks — if you feel no joy, feel distant from your baby, or have thoughts of harming yourself or your child — this may be postpartum depression. It is a serious illness affecting 10-15% of mothers. It's treatable. The earlier you accept help, the better.