Patient education: Postpartum hemorrhage (The Basics)

What is postpartum hemorrhage? — Postpartum hemorrhage is a condition in which a person loses a very large amount of blood after childbirth. This can happen after giving birth through the vagina (called a "vaginal birth") or after having surgery to get the baby out (called a "c-section" or "cesarean delivery").

What causes postpartum hemorrhage? — Most of the time, postpartum hemorrhage happens because the uterus does not contract (tighten) well after birth.

Others causes of postpartum hemorrhage are:

●Tears of the vagina, cervix, or uterus

●Small pieces of the placenta or membranes that stay stuck to the uterus after the baby is born. The placenta is the organ that forms between the mother and her baby. It brings the baby nutrients and oxygen and carries away waste (figure 1).

What are the symptoms of postpartum hemorrhage? — The main symptom is bleeding from the vagina. If a person loses a lot of blood, they might feel weak and lightheaded.

How is postpartum hemorrhage treated? — If the hemorrhage happens because your uterus has not contracted well, treatments include:

●Massaging the uterus – A nurse, doctor, or midwife will use their hands to press down on your lower belly and massage the uterus. This helps the uterus contract.

●Medicines that help the uterus contract and slow down bleeding

●Checking to see if there are bits of the placenta and membranes stuck in the uterus. If so, the doctor or midwife will remove them. They might use tools to remove the tissue.

If the hemorrhage happens because of injuries or tears, the doctor or midwife will stitch up any tears. If the bleeding is very severe, you might need a blood transfusion. For a transfusion, blood donated by someone else is given through a thin tube that goes into a vein, called an "IV."

If these treatments don't stop the bleeding, there are other treatments the doctor can try. If none of the treatments work, the doctor might have to take out your uterus (called a "hysterectomy"). But that is rarely needed.

What if I want to get pregnant again? — Most of the time, a postpartum hemorrhage does not happen again in future pregnancies. But make sure your doctor or midwife knows about your past postpartum hemorrhage. Compared with people who have not had a postpartum hemorrhage, you have a higher chance of having the problem again.

More on this topic

Patient education: Labor and delivery (childbirth) (The Basics)
Patient education: C-section (cesarean birth) (The Basics)
Patient education: Blood donation (giving blood) (The Basics)
Patient education: Hysterectomy (The Basics)

Patient education: C-section (cesarean delivery) (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)