Childbirth Post-Delivery Bleeding

Heavy bleeding after giving birth is called postpartum haemorrhage. According to WebMD It affects up to 5% of women who give birth. It’s most likely to happen within the first 24 hours after delivery but it can happen anytime within the first 12 weeks after your baby is born.

Postpartum haemorrhage can be primary or secondary:

1. Primary PPH is when you lose 500 ml or more of blood within the first 24 hours after the birth of your baby. Primary PPH can be minor, where you lose 500–1000 ml, or major, where you lose more than 1000 ml.
2. Secondary PPH occurs when you have abnormal or heavy vaginal bleeding between 24 hours and 12 weeks after the birth.

Risk factors for postpartum haemorrhage include the following:

• Placental abruption - the early detachment of the placenta from the uterus
• Placenta previa - the placenta covers or is near the cervical opening
• Overdistended uterus - excessive enlargement of the uterus due to too much amniotic fluid or a large baby, especially with birthweight over 4,000 grams (8.8 pounds)
• Multiple pregnancy - more than one placenta and overdistention of the uterus
• Pregnancy-induced hypertension
• Prolonged labour
• Medications to induce labour
• Medications to stop contractions (for preterm labour)
• Use of forceps or vacuum-assisted delivery

What are the symptoms of postpartum haemorrhage

• Uncontrolled bleeding
• Decreased blood pressure
• Increased heart rate
• Decrease in the red blood cell count
• Swelling and pain in tissues in the vaginal and perineal area

What happens if I continue to bleed very heavily?

• Medications may be given as an injection or via the back passage to help stop the bleeding. You will be given oxygen via a facemask and a second drip for extra intravenous fluids. You may be given a blood transfusion or medication to help your blood to clot.
• If the bleeding continues, you may be taken to the operating theatre to find the cause of the haemorrhage. You will need an anaesthetic for this. Your partner will be kept informed about how you are and what is happening, and your baby will be cared for.

There are several procedures your doctors might use to control the bleeding:

1. A ‘balloon’ may be inserted into your womb to put pressure on the bleeding blood vessels. This is usually removed the following day.
2. An abdominal operation may be performed to stop the bleeding.
3. Very occasionally, a hysterectomy is necessary to control the heavy bleeding.