Postpartum Hemorrhage (PPH) – Causes, Symptoms, and Treatment
All women experience some vaginal bleeding after giving birth. You will bleed when your placenta separates from your uterus. Because your blood levels have increased dramatically during pregnancy, the bleeding does not pose any risk. But if the bleeding is heavy or ongoing, you could be experiencing a postpartum hemorrhage. Around 6% of women suffer from this condition after birth. If you are bleeding heavily – DO NOT TAKE THE TIME TO READ THE REST OF THIS ARTICLE. You need to alert your medical team immediately. A postpartum hemorrhage can be life threatening.
What are the Causes of Postpartum Hemorrhage?
We’re not trying to be alarmist. You don’t need to panic about all bleeding during or after childbirth. Bleeding is normal and your body is well-equipped to cope with it. Your body should work hard to stem the bleeding fairly quickly. After a normal delivery, your uterus continues to contract. These contractions clot the blood vessels and slow the bleeding.
But heavy bleeding during or after labor is dangerous. It may be that your uterus is not contracting properly. Your doctor, nurse, or midwife will use massage and hormone treatment to try and stabilize the condition. But your hemorrhage may be caused by another factor. There are several possible causes for the condition. They include:
In this condition, your placenta is low in your uterus instead of at the top of the uterine wall. If it has been detected early, doctors will often opt for a caesarean delivery, rather than risk postpartum hemorrhaging. Placenta Previa is the most common cause of postpartum hemorrhaging.
Uterine, Cervical or Vaginal Tears and Damage:
Hemorrhages are sometimes caused by damage to your uterus, cervix, or vagina. It may be that existing scars have been opened or new tears or trauma have been caused during the birth process.
A Blood-Clotting Disorder:
You may have an existing blood-clotting disorder (such as Von Willebrand’s Disease). Or you may have developed one during your pregnancy (such as preeclampsia). These conditions prevent the blood from thickening (clotting) and can lead to profuse bleeding. This is why it’s important to include any genetic disorders in your birth plan and to have regular checkups for pregnancy-related conditions. If your team knows you’re at risk of hemorrhage, they can make timely interventions and have the right expertise and equipment on hand in case things go wrong.
During the final stages of delivery, a surgical incision is sometimes made in your perineum. The vaginal opening is enlarged to ease the baby’s delivery. Because the cut is muscular, a large episiotomy can sometimes be the cause of a postpartum hemorrhage.
What are the Signs of Postpartum Hemorrhage?
There are two types of postpartum hemorrhage and, in both cases, the major symptom is heavy vaginal bleeding. The two types of hemorrhage are:
Early Postpartum Hemorrhage
A hemorrhage which occurs before, during, or directly after delivering the placenta. Because it happens as part of the birth process, women are generally under close observation from a medical team and receive treatment before the hemorrhage becomes life-threatening. In less medically enlightened times, postpartum hemorrhage was the leading cause of death in childbed.
Delayed Postpartum Hemorrhage
(Also called secondary postpartum hemorrhage or late postpartum hemorrhage)
A hemorrhage which occurs days, or even weeks, after giving birth. In some ways, a late postpartum hemorrhage is riskier than one suffered at the time of delivery. The main reason is that you may have left medical care by the time she suffers the hemorrhage. Another risk is that you will mistake the bleeding for the return of her normal menstrual cycle. It is essential that any heavy bleeding in the postpartum period is immediately reported to medical emergency services.
Postpartum Hemorrhage Risk Factors
The most dangerous risk of suffering a hemorrhage is that you will lose too much blood and your systems will begin to fail. If it is not treated quickly enough, it can be a fatal condition. This is why you need immediate medical attention. There are a number of different medical interventions that your team will use to control the bleeding and, if treated quickly, the outcome is usually good. Depending on how much blood is lost, recovery can be slow and women who have suffered a hemorrhage often need a prolonged stay in the hospital and extra support when they return home. You are also likely to develop anemia (red blood cell deficiency). You will need to take vitamins, iron supplements and eat a special diet, especially if you are breastfeeding.
Postpartum Hemorrhage Treatment
Depending on how severe the hemorrhage is, your medical team will probably work through the following process. They will stop at the point where they successfully stop the bleeding.
- Uterine massage and hormone treatment: your nurse, doctor, or midwife will massage your uterus to try and encourage stronger contractions. An oxytocin hormone is often given through IV as well. Other blood-clotting agents and breastfeeding and can also help to induce contractions.
- Manual Contractions: If step one is unsuccessful, the doctor may put his or her hand inside your vagina and the other hand on top of the belly and try to contract the uterus manually.
- Surgery and Blood Transfusions: In rare cases, medical professionals are unable to stem the blood flow and the vital signs begin to slip. In this case, you would need surgery and, possibly, a blood transfusion.
Summary: Postpartum Bleeding can be Life-Threatening
Although we do stress that hemorrhages are serious, they very rarely prove fatal these days. Most hemorrhages happen when you are still under close medical observation. A diagnosis can be quickly made and treatment administered. But occasionally it can go unnoticed and the results are fatal. If you experience any heavy bleeding in the postpartum period, you need to seek immediate medical help. We are lucky that we live in a time when expert medical services are available. There was a time when hemorrhages were the leading cause of death in childbirth, But, in these days of medical enlightenment, it can be treated quickly and effectively and less than 6% of women suffer from it.
More Articles on the Postpartum Period:
Are you feeling down? Many women experience what’s called the “Baby Blues” in the first few weeks of being a Mom. But perhaps your low is lasting longer than that? Or you’re afraid you may harm yourself or your baby? It is likely you are suffering from postpartum (or postnatal) depression. Click here to read more about the symptoms, causes, and treatment of postpartum depression.
Your low moods and tiredness may not be caused by depression. Another condition which some women suffer after giving birth is postpartum thyroiditis. Find out more about the causes, symptoms, risk factors, and treatment of the condition here.
Being a new Mom is hard. Sometimes you just need a little extra help while you learn the ropes. A postpartum doula offers women practical and emotional support in the first weeks of Baby’s life. Find out more about what doulas do and how to find the right person for you here.