What lochia actually is

Lochia is the vaginal bleeding that follows every birth, whether that birth was vaginal or by caesarean. The HSE describes it plainly as "your body's way of getting rid of the extra blood and tissue that was in your womb during pregnancy." The RCOG adds the anatomical detail that explains the volume: the blood "mainly comes from the area in your womb (uterus) where the placenta was attached, but it may also come from any cuts and tears caused during the birth."

That placental site is a raw wound roughly the size of a saucer, and it is the reason the NHS is firm about internal period products. "You should not use tampons until you've had your 6-week postnatal check," it says, "because you'll still have a wound where the placenta joined with the wall of your womb." The HSE says the same about menstrual cups. Pads only, until you are checked.

What normal looks like

The pattern matters more than any single day. Bleeding should be heaviest at the start and get lighter, not heavier, as the weeks pass.

Volume. The NHS says the bleeding "will be quite heavy at first, and you'll need super-absorbent period pads." The RCOG notes it is "usually heaviest just after birth" and reduces over the next few hours and days.
Colour. The HSE describes the sequence: "bright red at first. This will change to brown and eventually to a yellow or whitish colour as your uterus heals."
How long. The HSE says bleeding "can last for up to 6 weeks." The RCOG puts the outer edge later, saying lochia "will usually have stopped by the time your baby is 12 weeks old." Both are normal ranges, which is why a six-week deadline you have read somewhere is not a rule.
Feeding. The NHS: "You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract."
After activity. The HSE: "It's normal to have an increased amount of blood or a darkening in the colour of the blood if you do something strenuous. This may be a sign that you need to take it easy."

Small clots in the first days are common. The NHS asks you to report the large ones: "If you're losing blood in large clots, tell your midwife. You may need some treatment."

What is not normal

NICE's postnatal care guideline (NG194) tells midwives to give every woman a specific list of bleeding signs to act on. Recommendation 1.2.13 says to seek medical advice if:

the vaginal bleeding is sudden or very heavy
the bleeding increases
you pass clots, placental tissue or membranes
you have symptoms of possible infection, such as abdominal, pelvic or perineal pain, fever, shivering, or vaginal bleeding or discharge that has an unpleasant smell
you have any concerns about bleeding after the birth

ACOG gives a number that is easier to use at 3am: postpartum haemorrhage is "bleeding after birth that's much heavier than usual — meaning you're soaking through two pads an hour for more than 1 to 2 hours."

The trap in this topic is timing. Most people assume the bleeding risk ends when they leave hospital. It does not. The RCOG defines secondary postpartum haemorrhage as "abnormal or heavy vaginal bleeding between 24 hours and 12 weeks after the birth," and says it "is often associated with infection in the womb." Bleeding that was settling and then gets heavier again, weeks later, is exactly the pattern that matters.

When to call

Call your local emergency number (999 in the UK and Ireland, 911 in the US and Canada, 000 in Australia, 111 in New Zealand) or go straight to a maternity unit if: the bleeding suddenly gets much heavier, or you are bleeding and feel faint, dizzy or have a pounding heart. The HSE lists this combination as an emergency, and the NHS names "sudden or very heavy blood loss from your vagina, possibly feeling faint, rapid heartbeat" as a sign of postpartum haemorrhage.

Contact your midwife, health visitor, GP or maternity unit the same day if:

your bleeding is getting heavier rather than lighter
you are passing large clots, or passing tissue
the blood or discharge smells unpleasant or unusual for you
you have a temperature over 38°C, shivering, or tummy, pelvic or perineal pain
you simply feel unwell and are not sure why

The HSE lists smell, clots, dizziness and feeling unwell together for a reason: they point at infection or retained placental tissue, and both are treatable when caught early.

What actually helps

There is not much to do about lochia itself, which is the honest answer. What is worth doing:

Maternity pads, changed often. The NHS asks you to change them regularly and wash your hands before and afterwards.
Take the increase seriously as information. The HSE's framing is useful: a sudden increase after activity is your body telling you to slow down.
Expect iron to matter. After a significant bleed the HSE says a doctor "may advise that you take iron tablets for a few weeks." Persistent exhaustion after heavy bleeding is worth a blood test rather than more coffee.
Let feeding do its job. Breastfeeding makes the womb contract, which is why the cramps and the redder bleeding show up together.

What you can stop worrying about

The colour changing from red to brown to yellowish is healing, not infection. A day that is heavier than the one before, after a day of carrying a toddler or climbing stairs, is common. And bleeding that lasts past six weeks is within the range the RCOG describes, as long as it is getting lighter. It is the direction of travel, the smell, and how you feel in yourself that decide whether this is a phone call.

Postpartum Bleeding (Lochia)