A nurse notes lochia is bright red with small clots in the immediate postpartum period. Which interpretation is most appropriate?

• A. The client is hemorrhaging.
• B. The client needs to increase oral fluids.
• C. The client is experiencing normal lochia discharge.
• D. The client's PHCP needs to be notified of the finding.

Answer: (C)

In the immediate postpartum period, the uterus is shedding the placental site and tightening to control bleeding, so a bright red discharge with small clots can be normal. This is lochia rubra, the first stage of vaginal discharge after birth, and small clots are commonly seen as the uterus contracts and heals. The key is the amount: if the bleeding becomes heavy enough to soak through a pad in an hour, or if there are large clots or the uterus feels boggy, that would signal a problem. Abnormal signs would prompt further assessment, but a bright red discharge with small clots by itself fits the expected postpartum healing process.