A Postpartum Haemorrhage occurs when you have a cumulative blood loss greater than or equal to 500mL for a vaginal delivery and greater than or equal to 1000mL for a c-section. Symptoms generally include vaginal bleeding that doesn’t slow or stop. This can lead to a drop in blood pressure.
Why does a Postpartum Haemorrhage happen?
Trauma: Sometimes, a Postpartum Haemorrhage is a result of uterine, cervical, vaginal, or perineal trauma that causes more significant bleeding.
Tone: This is the most common cause of a Postpartum Haemorrhage! Your uterus is a muscle with a large blood supply, and if it’s not contracting effectively after birth (called atony), you can lose a good amount of blood fairly quickly.
Thrombin: This is a blood-clotting protein in your body. When there’s a blood clotting disorder in play – a Postpartum Haemorrhage is more likely to occur! Keep in mind, thrombin-related disorders are pretty rare.
Retained Tissue: Usually, your placenta comes out shortly after the baby, but when it takes too long, you may need surgery to remove it. Retained pieces of tissue can cause excess bleeding, pain, and even infection!
Signs and symptoms of a Postpartum Haemorrhage
- Heavy bleeding & clotting from the vagina
- Pallor (paleness)
- Excessive sweating
- Increase in heart rate & decrease in BP
How do we monitor for this? We apply fundal pressure to your uterus, while simultaneously checking your pads! This is done to assess how your bleeding is, and if your uterus is firm and acting the way it should after delivery. If it’s not – interventions are necessary!
Postpartum Haemorrhage Treatment Options
- IV fluids
- Extra fundal massage
- Medications to promote contracting
- Pelvic exams (to check for clotting)
- Tamponade devices
- Blood transfusions
If the Postpartum Haemorrhage is severe, your provider may recommend Dilation and Curettage (D&C), embolization of the blood vessels that supply the uterus, or even a hysterectomy or laparotomy (this is rare)!
This USED TO BE the leading cause of maternal death during childbirth. Luckily we’ve made tons of advancements, but there is still work to be done to improve outcomes of Postpartum Haemorrhage.
Most women with Postpartum Haemorrhage improve with routine bedside interventions.
Did you have a Postpartum Haemorrhage? They are scary, but they happen! 😬
Originally posted 2021-03-09 10:25:15.
23 CommentsLeave a Reply
Why didn’t you mention bimanual compression?
I had one 2.5 weeks postpartum from retained placenta. The doctor gave my cytotek to take at home, but I ended up losing consciousness, seizing, and needing to be rushed in ambulance for an emergency d+c. So scary + still processing it. Thank you for sharing these posts because I wish I would have known these risks and signs to advocate for myself more. ♥️
Yes, after the birth of my twins. Got 2 blood transfusions but otherwise was ok.
I am anemic and had a PPH while they’re were trying to stitch me up. Almost went to the ICU. Is there a way to help prevent it happening again? It was my first full term delivery and I’m nervous for it to happen again
Does having this once increase your risk for having it again? I had a PPH after my daughter’s birth in 2018, not severe but required a shot in my leg to help stop the bleeding. I’m due next month with baby #2 and it’s definitely been a worry of mine!
I did, 4.5 WEEKS after delivery. Had retained placenta that decided to really be a problem. My increased bleeding a week earlier was dismissed as my first period when I called the office. Ended up with an urgent D&C.
Well this isn’t terrifying or anything 😬
I had a perfect storm with an amazing outcome. They did a vacuum and episiotomy to get my daughter out and I am guessing that caused the uterine atony and pph it was immediately but my body was in dic with no ability to clot and I lost over 3.5 liters of blood. I bleed out the 1st transfusion and then they realized I couldn’t clot and used clothing agent and induction drugs to keep me contracted and did a bigger transfusion.
This post came at the right time! I still have post partum bleeding at 4 weeks. It faded then came back, heavier than it was before. Like maybe back to day 3 post partum. Can It happen even after 4 weeks?
If I was given pitocin after vaginal delivery… would this be an intervention for an actively occurring hemmorrage?or is this something that is done routinely? No one ever told me they were giving it or why. My nurse friend that came to visit noticed it hanging and asked me why it was there.
I lost 2.2 litres, which was caused by trauma of forceps/ episiotomy and no pain meds (ouch) and then retained placenta which I was taken for surgery for. I had a transfusion following but 8 months later I am i
I just had this for the first time 3 weeks ago when I delivered my baby girl this is baby #4 I was given 8 pills of cytotec rectal 😳 but ever since then I’ve only been spotting so 🤷🏻♀️
I lost 2L of blood after I birthed naturally from a midwife tugging on the cord so much it completely snapped from the placenta still inside of me 😥
I did 🙋🏽♀️Hemorrhaged 4L after vaginal delivery of twins. Had a bakri balloon placed and was on mag for 24 hours after birth- ugh!
I had placental tissue remaining for a couple of months after. I was so confused why I was STILL bleeding for so long. Luckily I had awesome doctors and we did a D&C to get everything out.
Yes PPH after a 37 hour induction. It’s really an out of body experience. I was very dazed and confused. So appreciative of awesome doctors and nurses who are so skilled in catching these early and intervening 🧡
I lost 2 litters of my blood. I was knocked out during the c section and did not know what was going on. Thanks God I am ok and was unaware or it would be very traumatized
Mine was due to placenta being retained. I’m so thankful I had an incredible team of Drs and nurses. The first thing my OB said to me was “thank you for not dying on us.” I bawled like a baby. Extremely scary. I needed a blood transfusion and was rushed into the OR.
Had retained tissue. Went to the ER twice. First time was 10 days after delivery second time was 30 days after delivery. Second time I was on the brink of a blood transfusion. Got a D&C. Scary and was in pretty bad shape for the following 2.5-3 weeks. Eek.
Immediately after my first (and so far only) delivery. My uterus wouldn’t firm back up. Every time I would get a fundas massage, it just felt like a big flood between my legs. Very scary. Luckily peeing and breastfeeding helped it to pass in the next 12 hours but I felt freaked.
Do you recommend a prophylactic dose of oxytocin/pitocin after deliver?
I had HELLP and right after delivering my son I had PPH. I lost so much I need about 5 blood transfusions and 2 bags of platelets. They ended up doing uterine artery embolization. Very scary! 6 days in ICU.
Yes I had this almost two weeks after. I went to the hospital and was sent home saying some heavy bleeding is normal. Ended up passing out in the shower and needing an ambulance. I was in very bad condition. I had a D&C following. This terrifying experience along with being in the middle of a pandemic has made my mental recovery a difficult journey.