Have you ever been so wrapped up in caring for your newborn that you forget to pay attention to your own recovery?
It’s completely normal—motherhood takes over everything!
While postpartum bleeding is something all mums experience, there’s a point where it can become too much.
That’s where postpartum haemorrhage comes in.
While it sounds a bit scary, understanding what it is, why it happens, and how to spot the signs can make all the difference.
Let’s break it down in a way that’s easy to understand, so you can feel reassured and ready to handle anything that comes your way.
Understanding Postpartum Bleeding Vs Postpartum Haemorrhage
Before we jump into the details of postpartum haemorrhage, let’s first talk about postpartum bleeding, also known as lochia.
After giving birth, it’s completely normal for mums to experience bleeding as the body begins to shed the lining of the uterus.
This bleeding is part of the natural healing process and can last anywhere from 2 to 6 weeks.
Lochia tends to be heaviest in the first few days after delivery.
It resembles a heavy period, and will gradually lighten over time.
The colour and consistency of lochia change as you heal.
At first, it’s bright red and may include small clots.
Then it transitions to a pinkish-brown colour before eventually becoming yellowish-white.
This progression is a good sign that your body is healing properly.
What Is Postpartum Haemorrhage?
Postpartum haemorrhage refers to excessive bleeding after childbirth.
Normally, mums experience some level of bleeding (known as lochia) following the birth of their baby.
However, when this bleeding exceeds a certain amount, it’s classified as postpartum haemorrhage.
Postpartum haemorrhage occurs when a woman loses more than 500 ml of blood after a vaginal birth or 1000 ml after a C-section.
It can happen right after delivery or even a few hours or days later.
How Common Is Postpartum Haemorrhage?
Many new mums may wonder, ‘How likely am I to experience postpartum haemorrhage?’
The thought can be worrying, but it helps to know how often this condition occurs.
Postpartum haemorrhage, while serious, is not an everyday occurrence for all mums.
According to the World Health Organization (WHO), postpartum haemorrhage affects about 5% of women globally after childbirth.
Although the percentage may sound concerning, healthcare providers are well-trained and equipped to handle these situations swiftly.
It’s more common in cases where there are risk factors like prolonged labour, retained placenta, or multiple births.
However, most cases are managed effectively without long-term consequences for the mother.
Knowing that this condition is rare and manageable can help to ease the anxiety.
Healthcare professionals routinely monitor women closely after childbirth for signs of excessive bleeding.
Therefore, if it does happen, you’re in good hands.
Types of Postpartum Haemorrhage
Postpartum haemorrhage is classified into two types: primary (immediate) and secondary (delayed).
Primary postpartum haemorrhage occurs within the first 24 hours after delivery.
This is the most common type and is often due to uterine atony.
Other reasons include trauma to the birth canal, such as tears in the cervix or vaginal tissue, or placenta abnormalities.
Secondary postpartum haemorrhage occurs between 24 hours and 12 weeks after birth.
This type is less common, but it can still be just as harmful if left untreated.
Retained placental fragments are typically what cause secondary postpartum haemorrhage.
These fragments are pieces of placenta that remain in the uterus after childbirth.
It prevents the uterus from fully healing and contracting, which leads to prolonged or excessive bleeding.
Infections, such as endometritis can also trigger secondary postpartum haemorrhage.
It’s important to note that postpartum haemorrhage is a medical emergency and should be treated right away.
Why Does It Happen?
The body is incredibly smart.
Normally, after the baby is born, the uterus contracts to stop the bleeding by clamping down on the blood vessels where the placenta was attached.
However, if the uterus fails to contract properly after delivery, it can’t close off those vessels, leading to heavy bleeding.
This condition is called uterine atony, which is one of the most common causes of postpartum haemorrhage.
Research shows that uterine atony is the leading cause of postpartum haemorrhage, accounting for about 70% of cases.
Uterine atony is more likely to happen if the uterus has been overstretched.
This can happen in cases of multiple pregnancies, carrying large babies, or when labour is either too prolonged or too rapid.
Who Is More Likely to Experience Postpartum Haemorrhage?
Aside from that, there are other conditions that can contribute to an increased risk of postpartum haemorrhage.
There are a few conditions that increase the risk of why this might happen.
Understanding these risk factors can help both expecting mums and healthcare providers take extra precautions during labour and delivery.
Let’s explore some of the other common causes that can elevate the risk of postpartum haemorrhage.
Retained Placenta
Another cause of postpartum haemorrhage is a retained placenta (the placenta remains in the uterus after delivery).
After birth, the placenta should be expelled from the body.
Though, sometimes fragments remain, preventing the uterus from contracting properly.
This can happen due to conditions such as placenta accreta.
It’s when the placenta grows too deeply into the uterine wall, making it difficult to detach.
In more severe cases, the placenta may penetrate through the entire uterine wall, known as placenta increta or percreta, causing significant bleeding.
Retained placenta is a significant risk factor for postpartum haemorrhage, contributing to about 10% of cases.
Tears or Lacerations
In some cases, postpartum haemorrhage occurs due to tears or lacerations in the cervix, vagina, or perineum.
During a difficult delivery, instruments like forceps or vacuums may be used.
Due to this, the birth canal may experience trauma, resulting in tears that can bleed heavily.
Additionally, episiotomies, which are incisions made to enlarge the vaginal opening during childbirth, can cause excessive bleeding if not managed carefully.
Blood Clotting
Another less common cause of postpartum haemorrhage is related to blood clotting disorders.
Women with pre-existing clotting disorders, like disseminated intravascular coagulation (DIC) or von Willebrand disease, may experience difficulties in stopping the bleeding naturally.
These disorders mean that their blood lacks the proteins needed to form clots.
DIC is a particularly serious condition where the body’s clotting mechanisms become over-activated.
It can lead to both widespread clot formation and severe bleeding.
On the other hand, von Willebrand disease is a genetic disorder that prevents blood from clotting effectively.
In such situations, transfusions of blood products, like plasma or platelets, may be required to help the blood clot.
Multiple Pregnancy
As mentioned earlier, mothers of multiples are at a higher risk for postpartum haemorrhage due to uterine atony.
Having a multiple pregnancy (twins, triplets, or more) puts extra strain on the uterus as it stretches beyond its normal size.
After delivery, this overstretching makes it more difficult for the uterus to contract.
This causes the uterus to struggle to shrink back to its normal size.
Recognising the Symptoms of Postpartum Haemorrhage
So, how can you tell if what you’re experiencing is normal postpartum bleeding or something more serious?
While every woman’s recovery is different, there are some key signs of postpartum haemorrhage to be aware of.
Here’s a breakdown of the key symptoms that can help you identify when it might be time to seek medical help.
Heavy Bleeding
By now you would know that in the first few days, postpartum bleeding is expected.
However, one of the biggest red flags is if you’re soaking through a maternity pad in less than an hour.
Lochia typically starts off heavy, similar to a heavy menstrual period, but it should gradually lighten over time.
If your bleeding remains heavy, this could be a sign of excessive bleeding.
Passing large blood clots, especially clots larger than a golf ball, is also concerning.
Small clots can be normal in the early postpartum period.
On the other hand, larger clots may indicate that the uterus isn’t contracting properly or that there is retained placental tissue.
Dizziness or Fainting
Experiencing dizziness or fainting after childbirth can be a sign that your body is losing more blood than it can handle.
Blood loss can lead to a drop in blood pressure.
It reduces the amount of oxygen getting to your brain, causing light-headedness or fainting spells.
Yes, you may feel fatigued or weak as your body recovers from childbirth.
However, it’s not normal if it is accompanied by fainting or frequent dizziness.
These symptoms are your body’s way of signalling that it’s not getting enough blood to function properly.
Thus, it’s important not to dismiss them.
Rapid Heartbeat
Your body will try to compensate for the sudden loss of blood by increasing your heart rate, a condition known as tachycardia.
You may notice that your heart is racing, even while you’re at rest.
This could be a sign that your body is struggling to circulate enough blood due to the loss of volume.
A rapid heartbeat is a concerning sign especially it’s accompanied by other symptoms like dizziness, shortness of breath, or weakness
A heart rate over 100 beats per minute in a postpartum woman can indicate significant blood loss and should be treated as an emergency.
Pale or Clammy Skin
Blood loss doesn’t just affect how you feel internally, it can also show on your skin.
Pale, ashen, or greyish skin can be a result of low blood volume.
As your body redirects blood away from the skin and extremities to vital organs like your heart and brain.
You may also notice that your skin feels cool and clammy to the touch.
This is your body going into shock—a defence mechanism in response to losing a large amount of blood.
How Do Doctors Treat Postpartum Haemorrhage?
If doctors diagnose you with postpartum haemorrhage, don’t panic—several effective treatments can quickly stop the bleeding.
The treatment depends on the cause of the haemorrhage, but common interventions include:
- Uterine massage: A doctor may massage your uterus to encourage contractions and stop the bleeding.
- Medications: Doctors may use drugs such as oxytocin or misoprostol to help your uterus contract.
- Removing the placenta: If a retained placenta is the cause, doctors will manually remove it.
- Surgical intervention: In severe cases, surgery may be necessary to stop the bleeding, such as tying off the blood vessels.
Fortunately, most postpartum haemorrhage cases can be managed without long-term consequences.
Remember, healthcare providers handle these situations swiftly and effectively.
Recovering from Postpartum Haemorrhage
After you’ve been through the struggles of postpartum haemorrhage, you must want to make sure you recover properly, right?
Well, recovery is different for everyone.
Recovering from postpartum haemorrhage depends on the severity of blood loss and how your healthcare provider treated it.
Though, what you can do for aftercare is to take care of yourself in the days following delivery.
To do so, make sure you are eating healthy, drinking lots of water and resting as much as possible.
You may also take iron supplements if your healthcare provider allows it, to help with anaemia.
You’ve Got This, Mums!
Bringing a new life into the world is nothing short of extraordinary, but it’s not without its ups and downs.
Postpartum haemorrhage may sound daunting. But with the right knowledge and preparation, you can feel empowered to handle any situation that arises.
Always listen to your body and don’t be afraid to seek help if you feel something isn’t quite right.
After all, becoming a mum is a journey, and every part of it helps shape the strong, resilient parent you’re becoming.
With the proper care and attention, most mums who experience postpartum haemorrhage recover quickly.
So, don’t worry, mummies! You’ll bounce back fully and ready to embrace motherhood.
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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