How does lochia typically progress postpartum, and what lochia characteristics may indicate infection?

• A. Lochia progression from rubra to serosa to alba; foul-smelling lochia, heavy bleeding, or color change can indicate infection.
• B. Lochia progression is rubra only; infection is indicated by any fever.
• C. Lochia alba occurs first after birth.
• D. Lochia rubra is the last stage and indicates healing.

Answer: (B)

Lochia follows a normal sequence as the uterus heals: initially a dark red lochia rubra, then it typically shifts to pink-brown lochia serosa, and finally to pale or yellow-white lochia alba over several weeks. This progression reflects decreasing blood loss and clearing of uterine debris as healing occurs.

Infection signs are a change from the expected pattern or smell. Foul-smelling lochia, heavy or increasing vaginal bleeding, or a lochia color change accompanied by fever or uterine tenderness should raise concern for endometritis or another infection and prompt clinical evaluation.