Postpartum Hemorrhage

By Medically reviewed by Dr. Duyen Le

Pregnant women are supposed to lose some blood postpartum due to the placental separation. Those who have a C-section often lose more blood than those who have a vaginal birth. Fortunately, the blood in your body increases up to 50% during pregnancy, so your body is well prepared for the blood loss afterward. However, some conditions such as placenta previa or placenta accreta may result in too much blood loss and require special treatments. 6% of pregnant women experience this excessive blood loss called a postpartum hemorrhage.

What are other causes of postpartum hemorrhage

Besides placental separation, many conditions can cause postpartum hemorrhage, including:
−Cervical lacerations
−Deep tears in your vagina or perineum
−A large episiotomy
−A ruptured or inverted uterus
−A systemic blood clotting disorder
(A clotting disorder may be genetic or it may develop during pregnancy due to certain complications such as a placental abruption, severe preeclampsia or HELLP syndrome.)

How to treat postpartum hemorrhage?

Since the most common cause of postpartum hemorrhage is uterine atony (a loss of tone in the uterine musculature), your doctor will massage your uterus to help it contract while you get intravenous oxytocin. You will also be catheterized so that your bladder is empty because an empty bladder makes it easier for your uterus to contract.
If the placenta still remains inside your uterus, your doctor may need to reach inside and remove it manually after giving you pain medication. You will be moved from the birthing room to an operation room for the procedure.
If your uterus still bleeds even after the placenta has been removed, your doctor will continue to massage it while you receive more oxytocin. In most cases, when the uterus contracts, the bleeding will stop. If need be, your doctor will put a hand inside your vagina and the other hand on your belly, compressing your uterus between two hands. This is often enough to stop the bleeding.
If the bleeding does not stop, you will be checked for other sources of bleeding such as lacerations and placental fragments. If your vitals are not stable, you will need a blood transfusion. In more rare cases, abdominal surgery and possibly a hysterectomy is ordered to stop a hemorrhage.

After the bleeding has stopped…

You’ll continue to receive IV fluids and medication to keep your uterus contracted. Also, you’ll be closely monitored for further bleeding. You will need bed rest. How quick your recovery depends on yourself and how much blood you lost.


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