by Krisha McCoy, MS
Postpartum hemorrhage is excessive blood loss in a woman after childbirth. It is called primary when it is within the first 24 hours after childbirth. Secondary (or delayed) postpartum hemorrhage occurs between 24 hours to six weeks after childbirth.
Some blood loss is normal. However, postpartum hemorrhage is a potentially serious condition that often goes unrecognized. Any excessive blood loss can put a woman at considerable risk. Talk with your doctor if you have any concerns about blood loss after giving birth.
The following are potential causes of postpartum hemorrhage:
Risk Factors TOP
The following factors are thought to increase the risk of postpartum hemorrhage:
Signs and Symptoms TOP
The most obvious sign of postpartum hemorrhage is heavy vaginal bleeding. If the bleeding is not obvious, other signs may include:
Your doctor will ask about your symptoms. A physical exam will be done. The doctor will check your perineum, vagina, cervix, and uterus for bleeding. Other tests may include:
Talk with your doctor about the best plan for you. Treatment options include:
Fluids, Oxygen, and/or Resuscitation
You may need:
Bimanual Uterine Massage
A massage technique called bimanual uterine massage can control bleeding. A doctor or nurse will place one hand in your vagina to push on your uterus, while the other hand pushes down on your abdomen. This action will cause a relaxed uterus to contract, thus slowing bleeding.
Bleeding can be caused by a tear in your genital tract or other trauma. The tear will be sutured. In addition, tissue from a retained placenta may need to be removed.
Your doctor may prescribe medicines to contract the uterus. Examples include:
In some cases, surgery may be needed, such as:
These methods may reduce the risk of postpartum hemorrhage:
American Congress of Obstetricians and Gynecologists
American Pregnancy Association
Women's Health Matters
American College of Obstetricians and Gynecologists. Clinical management guidelines for obstetrician-gynecologists. Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol . 2006 Oct;108(4):1039-47.
Postpartum hemorrhage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated July 17, 2012. Accessed October 9, 2012.
Last reviewed September 2012 by Andrea Chisholm
Last Updated: 09/30/2012