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Postpartum Hemorrhage

  • Cynthia M. Johnson, MA
Publication Type:


Postpartum Hemorrhage

(Obstetric Hemorrhage)


Postpartum hemorrhage is when a pregnant person loses too much blood after giving birth. It is called primary when it happens in the first 24 hours after giving birth. It is called secondary (or delayed) when it happens between 24 hours to 6 weeks after giving birth.

Postpartum Hemorrhage.

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Causes may be:

  • A loss of muscle tone in the womb after birth
  • Wounds in the birth canal
  • Not fully delivering the placenta
  • Bleeding problems in the pregnant person that make the blood unable to clot (rare)

In some people, uterine inversion or uterine rupture may also be a cause.

Risk Factors

Things that may raise the risk are:

  • Problems with the placenta
  • Multiple babies in current pregnancy
  • A past postpartum hemorrhage
  • A fetus that is larger than average
  • The use of medicine to speed up labor
  • Rapid or lengthy labor
  • Pre-eclampsia


The main symptom is heavy blood loss after having a child. There may also be swelling and pain in the pelvic area.


The doctor will ask about symptoms and health history. An exam will be done to check for bleeding.

Your blood will be tested to check for problems with clotting.

Pictures will be taken to view the pelvic area. This can be done with an ultrasound.


Treatment is based on how much bleeding a person has. Options are:

  • Replacing lost fluids, such as with a blood transfusion
  • Oxygen therapy
  • Medicines to make the uterus contract
  • Manual massage of the uterus

Some people may need surgery when other methods do not help. The type of surgery done depends on the source of the bleeding.


There are no known ways to prevent this health problem.





  • Postpartum hemorrhage. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/postpartum-hemorrhage.
  • Royal College of Obstetricians and Gynecologists. Prevention and Management of Postpartum Haemorrhage: Green-top Guideline No. 52. BJOG. 2017 Apr;124(5):e106-e149.


  • Elizabeth Margaret Prusak, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.