Postpartum Discharge: Is It Menstruation or Normal Recovery?

Regarding postpartum lochia and discharge..?

Hello Doctor: I had a natural delivery, and on the 23rd day postpartum, I suddenly experienced a flow similar to the first day of my menstrual period, which then returned to the form of lochia.
During my postpartum check-up at four weeks, I still had lochia (occasionally reddish-brown).
The doctor performed a pelvic examination and confirmed that my uterus was not prolapsed, the wound had healed, and a Pap smear was conducted, which later returned normal results.
In the fifth week postpartum, I experienced bleeding similar to a menstrual period for about a week.
My questions are: (1) Since I am not breastfeeding, did my menstruation return in the fifth week postpartum, or is it still lochia? (2) Now at seven weeks postpartum, I still have discharge with blood streaks or reddish-brown discharge for two to three days each week.
Why is this happening, and is this normal? Thank you for your answers to these two questions.

Xiao You, 30~39 year old female. Ask Date: 2006/06/26

Dr. Xu Junzheng reply Obstetrics and Gynecology

The conditions you described are all normal, thank you!

Reply Date: 2006/06/26

More Info

After giving birth, many women experience a variety of physical changes, including postpartum discharge, which can sometimes be confusing. Your questions regarding whether the discharge you are experiencing is menstruation or a continuation of lochia (the postpartum discharge) are quite common.

1. Is the discharge postpartum bleeding or menstruation?
After a vaginal delivery, women typically experience lochia, which is a combination of blood, mucus, and uterine tissue that is expelled from the body as the uterus heals. This discharge can last for several weeks and usually transitions from bright red to pinkish-brown and eventually to yellowish-white as healing progresses. The fact that you experienced a discharge resembling menstrual blood around the fifth week postpartum could indicate the return of your menstrual cycle, especially since you mentioned that you are not breastfeeding.
In non-breastfeeding women, menstruation can return as early as 4 to 6 weeks postpartum. However, it is also possible that what you experienced was a heavier episode of lochia, particularly if it was around the time your body was adjusting to the hormonal changes after childbirth. Given that you had a normal postpartum check-up and your doctor confirmed that your uterus was healing well, it is likely that your body is transitioning back to its pre-pregnancy state.

2. Why are there still reddish-brown discharges at seven weeks postpartum?
It is not uncommon for women to experience some residual discharge for several weeks after childbirth. The presence of blood-tinged discharge or brownish spotting can occur as the body continues to shed the remaining uterine lining and tissue. This is especially true if you have been physically active or if your body is still adjusting hormonally.
However, if the discharge is accompanied by any unusual symptoms such as a foul odor, significant pain, or fever, it would be advisable to consult your healthcare provider to rule out any potential complications, such as an infection or retained placental tissue.

In summary, based on your description, it seems likely that you are experiencing a combination of postpartum discharge and the return of your menstrual cycle. The variations in color and consistency of the discharge are normal as your body continues to heal. If you have any concerns or if the discharge changes significantly, it is always best to reach out to your healthcare provider for personalized advice and reassurance.
Remember, every woman's postpartum experience is unique, and factors such as hormonal changes, breastfeeding status, and individual health can all influence the recovery process. It’s important to listen to your body and seek medical advice when necessary to ensure a smooth recovery.

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