Bleeding After Birth: Lochia Stages, Clots and When to Get Help

Bleeding after birth, called lochia, is normal after both vaginal and caesarean births. It is usually heaviest and bright red for the first few days, becomes pink or brown over the following week or two, then turns yellowish or creamy and gradually stops, often by around six weeks. Small clots in the first days are common. Seek urgent help if you soak a pad in an hour or less, pass clots larger than a golf ball, or your bleeding becomes heavy again with a fever or bad smell.

No matter how you gave birth, your uterus needs to heal where the placenta was attached. Lochia is a mix of blood, mucus and tissue from that healing. Knowing what is expected can bring real peace of mind during the early weeks.

The three stages of lochia

Lochia rubra: days 1 to 4

Bleeding is bright or dark red and is often heavier than a period. You may notice small clots, particularly when you stand up after lying down or during feeds, as breastfeeding releases hormones that help your uterus contract. Use maternity pads rather than tampons or menstrual cups.

Lochia serosa: about days 4 to 12

The flow becomes lighter, thinner and pink or brownish. It can briefly increase when you are more active, which is your body's signal to slow down and rest.

Lochia alba: about week 2 to week 6

The discharge turns creamy, yellowish or white and becomes lighter until it stops. Some women find it lasts a little longer than six weeks, which can still be normal if it is light and does not smell.

What about clots?

Clots smaller than a 50-cent coin are common in the first few days. Clots tend to become fewer and smaller over time. Passing a large clot, or several clots after the first week, should be checked by your midwife or doctor.

Why bleeding might increase for a while

• Standing up after lying down for a long time
• Breastfeeding, especially in the first week
• Doing more than usual, such as long walks, lifting or housework
• Around weeks 1 to 2, when the scab over the placenta site comes away

A brief increase that settles with rest is common. Bleeding that becomes persistently heavy again needs to be checked.

Urgent warning signs

Call 000 or go to your nearest emergency department if you:

• Soak through a maternity pad in an hour or less
• Pass a clot larger than a golf ball
• Feel faint, dizzy, short of breath, or notice a racing heart

Contact your maternity unit, midwife or GP promptly if you notice:

• A foul-smelling discharge
• A fever of 38°C or above, or chills
• Increasing tummy pain or tenderness
• Bright red bleeding returning after it had turned pink or brown and not settling with rest

For non-urgent advice at any time, call Pregnancy, Birth and Baby on 1800 882 436.

Looking after yourself while you bleed

• Change pads at least every four hours and wash your hands before and after.
• Avoid tampons and menstrual cups until after your six-week check, to lower infection risk.
• Wee often, as a full bladder can stop your uterus contracting well.
• Eat iron-rich foods and keep taking any supplements recommended by your care team, especially if you lost a lot of blood at birth.
• Rest. Bleeding is a helpful guide; if it increases, your body may be asking you to slow down.

Your first period after birth

If you are not breastfeeding, periods often return within six to ten weeks. With breastfeeding they may not return for months. You can become pregnant before your first period, so talk to your GP about contraception at your six-week check.

Feeling tired and emotional during this time is common. Mention any bleeding concerns to your Maternal Health Nurse at your home or clinic visits; there is no question too small.

This article is general information and does not replace individual advice from your midwife, GP or Maternal Health Nurse.

Is a small pregnancy bump normal at 16 weeks?

Is a small pregnancy bump normal at 16 weeks?

Yes, having a small or barely noticeable bump at 16 weeks can be completely normal. Pregnant bodies change at different rates, and the outside appearance of your abdomen is not a reliable measure of your baby's size or wellbeing.

How early you show may be influenced by your height and body shape, abdominal muscle tone, the position of your uterus and whether you have been pregnant before. People in a first pregnancy often show later because their abdominal muscles have not stretched during a previous pregnancy. Bloating can also make the bump look larger on some days and smaller on others.

How your baby's growth is checked

At antenatal appointments, your midwife or GP may feel your abdomen to assess the uterus. Formal measurement of the uterus, called fundal height, is generally more useful later in pregnancy. Your routine mid-pregnancy ultrasound, usually performed at around 18 to 22 weeks, also checks your baby's growth and development.

Try not to compare your bump with photos, friends or other pregnant people. Two healthy pregnancies at the same stage can look very different. You do not need to eat extra food simply to make your bump grow; aim for a varied diet and follow any individual advice from your care team.

When to seek advice

Contact your midwife, GP or maternal and child health service if you are worried about your bump, have ongoing severe vomiting or weight loss, or feel your abdomen has become noticeably smaller. They can review your dates, symptoms and antenatal checks.

Seek prompt medical advice for vaginal bleeding, leaking fluid, fever or persistent or significant abdominal pain. Call 000 or attend an emergency department for heavy bleeding, severe pain, fainting, difficulty breathing or if you feel seriously unwell. At 16 weeks, movements are often not yet regular, particularly in a first pregnancy, so not feeling movement at this stage is usually not a dependable sign of a problem.