What is the correct sequence of lochia progression after birth?

• A. Rubra then alba then serosa
• B. Alba then rubra then serosa
• C. Rubra then serosa then alba
• D. Serosa then rubra then alba

Answer: (C)

The key idea is how lochia changes as the uterus heals after birth. Right after delivery, lochia is rubra—bright red and often with small clots—as it contains fresh blood and shed decidual tissue. This phase typically lasts about 3 days (often up to day 4). As involution progresses and bleeding decreases, the discharge becomes serosa—pink to brown-tinged fluid composed of serous exudate, blood cells, and debris. This phase usually spans roughly days 4 through 10. Finally, the discharge becomes alba—pale yellow to white, thinner in consistency and mainly mucus, leukocytes, and tissue debris—persisting from about day 10 onward, potentially for several weeks (up to around 6 weeks). Choosing the sequence rubra, then serosa, then alba reflects the natural progression from more blood and tissue to cleaner, healing discharge as the uterus returns to its pre-pregnant size.

If lochia suddenly increases in amount again, has a foul odor, or there is fever, that could signal an infection or other complication and warrants prompt assessment.