Vaginal Discharge After Birth: Changes, Colors & Meaning

Key takeaways:

• After the birth of a baby, the uterus decreases in size, loosening and expelling any remaining tissues from pregnancy.
• The discarded tissue and bleeding associated with this are called “lochia.” This discharge is normal and lasts for around four to six weeks.
• While vaginal discharge after birth changes over time, some changes in color and consistency may indicate a problem.

After giving birth, during the postpartum period, the uterus gradually returns to its pre-pregnancy size and function. The linings of the uterus react both mechanically and hormonally to achieve this. The muscular fibers of the uterus contract to expel leftover pregnancy materials—this is seen as a vaginal discharge made up of blood, mucus, and uterine tissue. Eventually, the ovaries restart the menstrual cycle.

During your period, your endometrial lining sheds and regrows in preparation for pregnancy, whether that happens or not. After pregnancy, these internal processes are similar but more dramatic. That means that experiencing vaginal discharge after birth is typical. However, some types of vaginal discharge can still be abnormal, particularly if they come with symptoms like itching, burning, or strong odors.

How vaginal discharge changes after giving birth

Postpartum bleeding and discharge are called lochia. You might notice that lochia looks similar to what you see during your menstrual period. There are some differences, however.

Changes in vaginal discharge after birth are a matter of volume, hormones (or the lack thereof), and size. During this time, your uterus contracts to shrink from about the size of a watermelon to that of a pear! As a result, there are three stages of lochia that can affect discharge after birth:

1. Lochia rubra: three to four days after delivery, discharge consists of blood, mucus, and tissue from the placenta and the uterine lining.
2. Lochia serosa: four to 12 days after birth, discharge appears pinkish-brown, thin, and watery.
3. Lochia alba: The third and final stage, from 12 days to six weeks after birth. The discharge appears yellowish-white with possible spotting,

Abnormal vs. normal vaginal discharge after giving birth

The postpartum period typically lasts between four to six weeks. During that time, vaginal discharge should have the characteristics of normal lochia:

• Initially made up of blood, mucus, and tissue from the uterus.
• Heaviest immediately following birth and subsides over time, but can last up to 6-8 weeks.
• Can sometimes increase in volume while breastfeeding during the early postpartum period due to uterine contractions.

However, it is also possible to experience abnormal lochia or discharge that might indicate an infection or complication. Here are some things to look out for:

• Any discharge accompanied by pain in the pelvis, abdomen, bladder, or rectum.
• Yellow or green discharge and an unpleasant smell.
• Fever.
• Heavy bleeding—this may be a sign of a hemorrhage. You shouldn’t need more than one pad per hour to manage discharge and bleeding.
• Passing tissue after being medically cleared or longer than four days—this is a sign that there are still pregnancy tissues left in your uterus, which can lead to a serious infection.

Common causes of vaginal discharge after birth

In most cases, vaginal discharge after birth is a natural result of postpartum bodily changes. The clearance of pregnancy tissue, membranes, and thinning endometrium is normal after birth and can last about six weeks.

Normal lochia

Lochia is the normal blood, mucus, and tissue shed through your cervix into your vagina. Over six weeks, it trails off in volume, blood concentration, and frequency. There may be momentary surges with breastfeeding.

Uterine atony

Atonus means there is a failure to contract. If the uterus does not contract after giving birth, this prevents the compression of blood vessels and leads to heavier, prolonged postpartum bleeding and discharge. Postpartum atony is a cause of anemia and even potential hemorrhaging after delivery.

Hormone imbalance

The return to your normal physiology is complicated but usually happens naturally. However, breastfeeding can delay a return to normal hormonal cycles.

The synchronizing of your hormonal function may be complex, though. For example, after giving birth, you might experience a delay in ovulation, which can cause irregular bleeding that lasts longer than you would normally expect.

Uterine infection

Infection in your uterus interferes with muscle contractions, leading to an abnormal volume of lochia or other complications.

Uterine fibroids

Swirls of fibrous tissue in the uterus can prevent a complete contraction of the muscle fibers of your myometrium that surround them. These are benign growths, called leiomyomata, that normally shrink after delivery, but may put you at risk for hysterectomy or needing hormonal therapy later in life.

Common post-birth vaginal discharge colors and consistencies

Normal lochia is bloody. Therefore, its color is usually pink, red, or brown, and its consistency ranges from liquid to clots. Here are some other common types of discharge you may experience after giving birth:

• Red and heavy: Normal lochia, which should be heaviest immediately after delivery and taper off.
• Red, liquidy: Normal bleeding that’s usually experienced during the first 48 hours after birth.
• Red with clots: Normal lochia.
• Brown, with flecks: This can be normal with an incomplete expelling of tissue or breaking down of blood clots.
• Red, brown, or black with tissue: This indicates retained pregnancy material, and possibly an infection.
• Clear: This may be plasma that has separated from blood clots that have not been expelled yet. It may also point to the last stage of lochia.
• Yellow or green of any consistency: Likely indicates an infection.
• Bad-smelling of any color or consistency: Likely indicates an infection.

Read our guides on vaginal discharge colors and odors for more.

How to maintain healthy vaginal discharge after giving birth

After something as taxing as birth, patience is your best bet. Let your body do the healing work for you. In the meantime, here are some ways to guard against infection and injury.

Don’t douche

Douching may lead to an infection and encourage yeast growth.

Don’t use tampons

Tampons may cause infections, as the cervix can serve as an inroad for bacteria. Use pads instead to manage discharge and bleeding.

Don’t have intercourse until cleared by your physician

Not only can this damage vaginal tissues, but it can introduce infection. Your provider will clear you after 4-6 weeks if appropriate.

When you should see a doctor about vaginal discharge after giving birth

It’s important to pay attention to your body, as it can raise red flags if there’s a problem. The following are some symptoms to look out for, as they may point to infections or complications.

You should see a doctor if:

Contact your healthcare provider if you:

• Have lochia that becomes heavy again after a reduction in volume.
• Pass tissue.
• Experience itching, burning, or a discolored discharge.
• Have lochia that lasts longer than eight weeks.

You should go to the emergency room if:

Any of the above symptoms are accompanied by:

• Fever
• Severe pain
• Painful urination
• Pus or green discharge
• Bad-smelling discharge

Questions to ask your doctor about vaginal discharge after giving birth

• Am I healing normally after giving birth?
• When will I be cleared for normal activity and intercourse?
• When should I expect my menstrual cycle to return to normal?
• (If breastfeeding) How will breastfeeding affect me in the postpartum period?

How a doctor may help treat abnormal vaginal discharge after giving birth

When your vaginal discharge is anything other than normal postpartum lochia, medical intervention may be necessary. Here’s how a doctor may help:

Treatment of postpartum bleeding

If bleeding causes anemia or weakness, or if the volume of bleeding is excessive, it’s important to rule out infection or retained products of pregnancy. Your doctor can also recommend appropriate treatments – such as prescription medications – to manage symptoms or their underlying causes.

Treatment of retained tissue

Postpartum contractions and the release of tissue and blood are normal after delivery. Sometimes, due to remaining placental tissue, membranes, or an infection, some tissue can stay behind. These must be removed for proper healing.

Some medications can stimulate continual contractions to make that happen. Still, in the worst case, this requires mechanical removal via gentle scraping in a procedure called dilation and curettage (D&C).

Retained pregnancy tissues (products of conception) are dangerous because they make an excellent site for colonization by bacteria. Thus, if heavy bleeding continues longer than expected, it is a time-urgent matter.

Treatment of postpartum infection

Infection of your uterus and pelvis is a medical emergency that requires intravenous antibiotics. It can be life-threatening, so it’s important to seek medical care right away

Frequently asked questions: vaginal discharge after giving birth

Healing after birth takes some time, and the process can look different for everyone. Here are some of the most common questions people often have about their discharge postpartum:

How long can changes in vaginal discharge after giving birth last?

Usually, it will gradually return to normal over six weeks. Many people’s lochia tapers off until it blends right in with their next period.

What if you’re experiencing vaginal discharge with a foul odor after giving birth?

An unpleasant smell indicates an infection or tissue that has died from circulation problems or other issues. This is an urgent matter and requires immediate medical intervention.

Final thoughts: lochia, then back to normal

As your uterus resumes its restoration process during the four to six weeks after delivery, you should expect a tapering-off process of normal lochia without any heavy re-starts, fever, pain, discoloration, itching, burning, or loss of tissue. Your normal periods should begin again after six to eight weeks once your lochia has tapered to nothing or as it is ending. As always, reach out to your medical provider if you experience any concerning symptoms or have questions about what the healing process will look like for you.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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