What does it mean if lochia is black?

Lochia appearing black may be caused by the early postpartum lochia stage, poor lochia discharge, endometritis, incomplete uterine involution, or intrauterine residue. It can be improved through observation and care, appropriate activity, and medical intervention. If black lochia persists for more than a week or is accompanied by abdominal pain or foul odor, prompt medical attention is necessary.

1. Early Postpartum Lochia Stage: During the first 1–3 days after childbirth, lochia contains a large amount of blood. When it remains in the body for a prolonged period, oxidation turns it black, and the volume gradually decreases. It is recommended to closely monitor the amount and duration of lochia, maintain external genital hygiene, and avoid excessive fatigue.

2. Poor Lochia Discharge: Limited physical activity after delivery can cause lochia to remain in the uterine cavity for extended periods, leading to oxidation and darkening of the blood, with fluctuating discharge volume. It is advised to engage in gentle ambulation and perform mild abdominal massage to promote lochia expulsion.

3. Endometritis: Infection of the endometrium by pathogens after childbirth causes inflammation, resulting in black-colored lochia accompanied by lower abdominal pain and foul-smelling discharge. It is recommended to take medications such as cefixime dispersible tablets, metronidazole tablets, and Gynecological Qianjin tablets under medical guidance to alleviate symptoms.

4. Incomplete Uterine Involution: Weak uterine contractions after delivery lead to delayed uterine recovery, causing delayed and blackish lochia discharge, along with uterine enlargement and a sensation of heaviness in the lower abdomen. It is recommended to use oxytocin injection, Yimucao granules, or Xinshenghua granules under medical supervision to improve symptoms.

5. Intrauterine Residue: Retained placental or fetal membrane tissue in the uterine cavity after childbirth obstructs lochia discharge, causing it to appear black, along with persistent bleeding and abdominal pain. It is recommended to use misoprostol tablets, Chanfu'an granules, or Shaofu Zhuyu granules under medical guidance to manage symptoms.

Maintain good external genital hygiene, frequently change sanitary products, moderately supplement nutrition to strengthen physical health, avoid sitz baths and sexual intercourse, and adjust care methods promptly based on changes in lochia.