North American Registry of Midwives (NARM) Practice Exam

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What describes the appearance of lochia alba?

Bright red and bloody
Dark brown and thick
Creamy white and diminishing over time
Clear with a yellow tint

The correct answer is: Creamy white and diminishing over time

Lochia alba is the final stage of the lochia discharge that occurs after childbirth. It typically appears as a creamy white or yellowish-white fluid and consists mainly of white blood cells, mucus, and various cells from the uterus as it heals. The discharge diminishes over time, reflecting the body’s process of returning to its pre-pregnant state. This description aligns with the normal progression of lochia following delivery, which transitions from bright red (lochia rubra) to pinkish-brown (lochia serosa), and finally to the lighter, creamy white appearance of lochia alba. Understanding this progression is crucial for midwives and healthcare providers in monitoring postpartum recovery and identifying any potential issues, such as infection, if the discharge deviates from expected characteristics.