Postpartum Hemorrhage

“I had given birth to my first child then. My doctors had mentioned that I might face bleeding for a day or two. After four days of continued bleeding I was in a state of panic. After being rushed to the hospital I found out that I had Secondary Postpartum Hemorrhage and had lost a lot of blood. It was like a nightmare for me. But, I have recovered from it now, at least physically,” says Arundhati Girikar, a mother of two now.

Excessive bleeding or postpartum hemorrhage is the no. 1 cause for the deaths of mothers during or after pregnancy.

Postpartum hemorrhage is a rare but serious condition that causes excessive bleeding following childbirth. The bleeding starts within 24 hours after childbirth and can last up to 12 weeks. This can cause a drop in blood pressure or heart rate and in severe cases, even result in death.

There are two types of postpartum hemorrhage.

1. Primary Postpartum Hemorrhage – bleeding that occurs within the first 24 hours after childbirth.
2. Secondary Postpartum Hemorrhage –bleeding that occurs 24 hours to 12 weeks postpartum.

Causes of Postpartum Hemorrhage

The most common causes of postpartum hemorrhage are called the ‘four Ts’ (tone, trauma, tissue and thrombin) and are as follows:

Uterine Atony

Uterine atony or uterine tone, is responsible for nearly 70% of all postpartum hemorrhage cases. Post birth, the uterus, in response to the release of a hormone called oxytocin shrinks from its expanded state back to its original size.

However, sometimes the uterus fails to respond to oxytocin and its muscles do not contract enough to clamp the placental blood vessels shut, leading to excessive bleeding and a hemorrhage.

Uterine Trauma

Uterine trauma is responsible for almost 20% of all postpartum hemorrhages.

During labor, the pressure of the baby moving though the mother’s birth canal can damage and injure the uterus, cervix (lower end of the uterus/womb), vagina and perineum (the area between the genitals and anus) and cause bleeding.

This can lead to a hematoma, which is a collection of blood, to form in a hidden area and cause bleeding hours or days after delivery.

Retained Placental Tissue

Retained placental tissue is not as common and is responsible for only 10% of all postpartum hemorrhages. This condition is also called ‘invasive placenta’

In this condition, the whole or part of the placenta is too deep or attached to the uterine wall and fails to come out during delivery. If the placenta is not delivered within an expected period of time, it has to be surgically removed.

Blood Clotting Condition

Blood clotting conditions arise when there’s a deficiency of thrombin, a blood clotting protein. This can make even a tiny bleed uncontrollable.

Conditions leading up to a deficiency of thrombin are extremely rare and occur in less than 1% of childbirth.

While bleeding after childbirth is normal, you may have postpartum hemorrhage if:

1. You are soaking through a pad every 1 to 2 hours.
2. You have persisting and worsening pain in your abdominal and pelvic region.
3. You are experiencing symptoms of low blood pressure like dizziness, blurred vision or fainting.
4. You feel nauseous, or feel as if you need to vomit.

Fortunately, diagnosing and treating the cause of postpartum hemorrhage quickly can lead to successful recovery! Contact your doctor or healthcare provider immediately if you are experiencing symptoms of postpartum hemorrhage.

Dealing with hemorrhage right after giving birth can be tough on you. Take care of yourself first, eat well, sleep properly and get as much rest as possible during your recovery time.

If you have any other concerns, leave them in the comments section below and we’ll be happy to address them. 🙂