While bleeding following delivery is normal some women experience excessive blood loss, or postpartum hemorrhage.
Following delivery, we expect women to experience a fair amount of bleeding. In fact, women typically bleed up to a half-quart of blood following a normal delivery and up to a quart of blood after a cesarean section (C-section). However, about 3 to 5 percent of new moms experience excessive blood loss, or postpartum hemorrhage.
While that percentage is relatively small as it pertains to overall deliveries, postpartum hemorrhage remains a common complication that can occur during delivery; in fact, we see women with this condition on a weekly basis. Because that’s so, we want to make sure women understand the common causes, why they might be considered at higher risk, and potential treatment options.
World wide about half a million women die as results of complications of pregnancy and child birth childbirth.
Overwhelming proportions of these deaths occur in developing countries of the world where facilities are poorly developed and due to lack of trained attendants at delivery. Majority of these deaths occur within few hours of delivery and in most cases are due to postpartum haemorrage.Postpartum haemorrhage is a major cause of maternal morbidity and mortality worldwide with the highest incidence in developing countries. According to the World Health Organization obstetrics haemorrhage causes 127,000 deaths annually world wide and is the leading cause of maternal mortality.
While in Africa, due to increased prevalence risk factors such as grand-multiparity, no routine use of prophylaxis against obstetrics haemorrhage coupled with poorly developed obstetrics services, obstetrics haemorrhage is responsible for 30% of the total maternal deaths.
Who is this information for?"Postpartum hemorrhage remains a common complication that can occur during delivery; in fact, we see women with this condition on a weekly basis. Because that’s so, we want to make sure women understand the common causes, why they might be considered at higher risk, and potential treatment options."
– Jamie Morgan, M.D.
This information is for you if you wish to know about heavy bleeding after
the birth of your baby. It may also be helpful if you are a partner, relative
or friend of someone who is or who has been in this situation.
What bleeding can I expect after my baby is born?
It is normal to bleed from your vagina after you have a baby. This blood
mainly comes from the area in your womb (uterus) where the
placenta was attached, but it may also come from any cuts
and tears caused during the birth.
Bleeding is usually heaviest just after birth and gradually
becomes less over the next few hours. The bleeding will reduce further over the next few days. The colour of the blood should change from bright red to brown over a few weeks. This vaginal bleeding is called the lochia and it will usually have stopped by the time your baby is 12 weeks old. Sometimes bleeding during or after birth is heavier than normal.
What is a postpartum haemorrhage (PPH)?
Postpartum haemorrhage (PPH) is heavy bleeding after birth. PPH can be primary or secondary:
•Primary PPH is when you lose 500 ml (a pint) or more of blood within the first 24 hours after the birth of your baby. Primary PPH can be minor, where you lose 500–1000 ml (one or two pints), or major, where you lose more than 1000 ml (more than two pints).
•Secondary PPH occurs when you have abnormal or heavy vaginal bleeding between 24 hours and 12 weeks after the birth.
How could a PPH affect me?
If you lose a lot of blood, it can make you anaemic and worsen the normal tiredness that all women feel after having a baby.
If heavy bleeding does occur, it is important that it is treated very quickly so that a minor haemorrhage doesn’t become a major haemorrhage, which can be life-threatening.
Who is at risk of primary PPH?
The risk factors below is associated with primary PPH. Even if some apply to you, it is important to remember that most women with these risks factors will not experience a haemorrhage after giving birth.
In fact, most women who have a primary PPH have no identifiable risk factors. However, if you do have any of these risk factors you may be advised to have your baby in a hospital setting where there is access to blood transfusion if you need it.