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What to do if you experience postpartum hemorrhage

Postpartum hemorrhage (PPH) is a serious but rare condition when a woman has heavy bleeding after giving birth. You’re more likely to have PPH if you’ve had it in the past or if you have certain medical conditions – especially conditions that affect the uterus (womb) or the placenta or conditions that affect how your blood clots.

It’s normal to lose some blood after giving birth. Women typically lose about half a quart during vaginal birth or about 1 quart after a Cesarean birth. With PPH you can lose much more blood, which is what makes it a dangerous condition. PPH can cause a severe drop in blood pressure that must be treated immediately.

The labor and delivery teams at Huntsville Hospital for Women & Children and Madison Hospital have special PPH training. As with any emergency, we are here for you.

When should you contact your provider?

  • When your bleeding increases or if you have heavy bleeding that soaks a pad in 1 hour for 2 hours in a row.
  • You pass large blood clots (larger than a quarter) from the vagina.
  • You feel dizzy.
  • You have a lower back ache, abdominal pain or tenderness, or loss of appetite.
  • You are urinating less than usual or not at all.
  • You have questions or concerns about your condition.

Call 911 right away if you experience any of the following symptoms:

  • Heavy bleeding from the vagina
  • Soaking through 1 pad in 15 minutes that doesn’t slow or stop
  • Blurred vision
  • Clammy or pale skin
  • Feel weak or feel like you’re going to faint
  • You faint or lose consciousness
  • You have trouble breathing

What causes PPH?

After your baby is delivered, the uterus normally contracts to push out the placenta. The contractions help put pressure on bleeding vessels where the placenta was attached in your uterus. If the contractions are not strong enough, the vessels bleed more. It can also happen if small pieces of the placenta stay attached.

How is PPH treated?

Treatment depends on what’s causing your bleeding. Options may include:

  • Getting fluids, taking medicine (like Pitocin) or having a blood transfusion
  • Massaging the uterus by hand. Your provider can massage the uterus to help it contract, lessen bleeding and help the body pass blood clots. Your provider may also give you medications like oxytocin to make the uterus contract and reduce bleeding.
  • Getting oxygen by wearing an oxygen mask
  • Removing any remaining pieces of the placenta from the uterus
  • Packing the uterus with gauze, a special balloon or sponges
  • Using medical tools or stitches to help stop bleeding from the blood vessels
  • Taking extra iron supplements along with a prenatal vitamin. Your provider may recommend this depending on how much blood was lost.
 

Samantha Wall, BSN, RNC-OB
OB Simulation Coordinator at Huntsville Hospital for Women & Children

 

Tammy Baer, RN
Clinical Education Specialist for Labor & Delivery, Antepartum and OB Emergency Department at Huntsville Hospital for Women & Children