S. Marchant et al., A survey of women's experiences of vaginal loss from 24 hours to three months after childbirth (the BLiPP study), MIDWIFERY, 15(2), 1999, pp. 72-81
Objective: to describe the range of normal vaginal loss as reported by wome
n from 24 hours after delivery until three months postnatally.
Setting: two health districts in the south of England.
Methods: a prospective survey of women's experiences and expectations of th
e duration, amount and colour of vaginal loss after childbirth. The term va
ginal loss includes all types of fluid loss from the vagina following child
birth.
Findings: five hundred and twenty-four women were recruited to the survey i
n 1995. Vaginal loss, as reported by the women, was considerably more varie
d in duration, amount and colour than descriptions in current midwifery tex
tbooks,The median number of days reported for the duration of vaginal loss
was 21 days and the interdecile range (10th to 90th percentile) was 10-42 d
ays. For colour of lochia, women overall reported their vaginal loss to be
more predominantly red/brown in colour and the traditional descriptions of
the timing and colour phases of lochia rubra, serosa and alba are not suppo
rted by the majority of the women's experiences. Primiparous women were sig
nificantly more likely to report feelings of surprise or shock about their
experiences of vaginal blood loss after the birth (odds ratio 4 [95% Confid
ence Interval 2-9]), Seven primiparous women (2%) were unaware that they wo
uld have a blood loss at all after the birth.
Implications for practice: the findings from this survey have been used to
develop information leaflets for women and health professionals about vagin
al loss following childbirth. These leaf lets include descriptions of norma
l ranges for the colour, amount and duration of vaginal loss in the first t
hree months after childbirth.