Which color change indicates late postpartum hemorrhage?

• A. Red after pink or white
• B. Pink discharge only
• C. White discharge only
• D. Green discharge

Answer: (A)

Recognizing lochia color changes helps identify secondary postpartum hemorrhage. After birth, the vaginal discharge (lochia) moves from red (lochia rubra) to pink/brown (lochia serosa) to white/yellow (lochia alba) as healing occurs. When red lochia reappears after a period of pink or white, it signals renewed uterine bleeding from the placental site or endometrium—secondary postpartum hemorrhage. This red return is a warning sign that needs prompt assessment of bleeding, uterine tone, and possible infection. Pink or white discharge alone is part of the normal progression, not a sign of renewed bleeding, and green discharge is not a typical stage and may indicate infection or other issues.