• Postpartum Hemorrhage

    Some postpartum bleeding is to be expected after every delivery. After all, giving birth is a challenging (though rewarding) endeavor. However, in some rare cases, this bleeding can become more significant and more severe than is considered safe or normal. This is known as a postpartum hemorrhage.

    A postpartum hemorrhage is a serious and possibly life-threatening condition. However, a positive outcome is very often achieved–especially when your OBGYN or Midwife is able to make a quick diagnosis and offer prompt management and treatment. 

    Only about 1% to 5% of women will ever experience a postpartum hemorrhage (or PPH), making this a rare complication of childbirth. Still, because the condition can be so serious, your OBGYN or Midwife will be watchful for any symptoms, especially if some specific risk factors are present. 

    What is a Postpartum Hemorrhage?

    Birthing a child can be physically taxing–as those expecting a baby likely already know! Your OBGYN or Midwife will counsel you to expect a certain amount of bleeding, both during labor, birth and after your child has been born. 

    Usually, this postpartum bleeding will stop on its own. After all, the human body is pretty good at birthing a baby! That means you have some natural ways to minimize damage, control bleeding, and promote healing after childbirth. But sometimes those mechanisms don’t work quite right or birth causes more damage than your body can handle. In those cases, you may start to bleed more than what is considered “normal” or uncontrollably.

    This uncontrolled bleeding, which doctors call a postpartum hemorrhage, most commonly occurs within 24 hours of childbirth. Less often, a postpartum hemorrhage can present up to 12 weeks after you deliver your baby. 

    A postpartum hemorrhage can cause a dangerous drop in your blood pressure. If left untreated, this condition can become life threatening. If you think you’re having a postpartum hemorrhage after discharge from the hospital, it’s essential to dial 911 or contact your healthcare provider immediately.

    What Causes a PPH?

    There is no single cause of postpartum hemorrhage. However, your OBGYN or Midwife will be able to point you towards behaviors, conditions, and other criteria which may increase your overall risk profile. The higher your risk profile, the more watchful your OBGYN or Midwife will be for signs of a PPH. 

    Some of the most common causes and risk factors include the following:

    Chorioamnionitis

    One significant risk factor associated with postpartum hemorrhaging is something called chorioamnionitis. This is a condition in which the amniotic fluids and the membranes surrounding the fetus (called the chorion and amnion) become infected with bacteria. 

    Chorioamnionitis is itself a fairly serious condition, for both the mother and the baby. In some cases, the infection can lead to an increased heart rate in the baby, necessitating your baby be born immediately.

    Among other symptoms, chorioamnionitis can cause a buildup of fluid in the uterus, which can then increase the risk of postpartum hemorrhage.

    What Are the Symptoms of Postpartum Hemorrhage?

    Symptoms of PPH may vary from individual to individual, as every person’s labor and birth experience is different and unique. However, the most common presentations of a postpartum hemorrhage include the following:

    To diagnose a postpartum hemorrhage, your OBGYN or Midwife will attempt to assess how much blood you have lost (losing about 1000ml after a vaginal birth or C-Section is about normal). Your Midwife or OBGYN may also check for blood clots, take your blood pressure, or do some fast blood work to help gather information quickly and make an effective diagnosis. 

    How is Postpartum Hemorrhage Treated?

    There are several treatment options available for PPH, and your OBGYN and Midwife will work with you to determine the best course of action for your condition. The optimal treatment will depend on your family history, your overall health, and your symptoms. Additionally, your OBGYN or Midwife will attempt to gauge the severity of the bleeding as it is happening and treat accordingly.

    Possible treatments include:

    In some cases, more severe postpartum hemorrhaging may require more invasive and serious treatment. Those treatments could include:

    Can You Minimize Your Risk for PPH?

    There are multiple known risk factors for postpartum hemorrhaging. If you have high blood pressure or develop gestational diabetes, for example, your OBGYN or Midwife may want to monitor you more closely for postpartum hemorrhaging. 

    If your OBGYN or Midwife believes that you have a high risk of PPH, they may describe preventative actions and prescribe certain medications, such as oxytocin or misoprostol. These medications have been shown to help prevent hemorrhaging for many women. Having an IV placed on admission to the hospital and available to use for administering medications after birth can allow for quick decision-making to help reduce the bleeding if identified early on. 

    You can also talk to your OBGYN or Midwife about lifestyle choices or activities that may increase or decrease your risk of developing a PPH. 

    Rare and Treatable

    It’s important to remember that a postpartum hemorrhage is both relatively rare and quite treatable. Though this is a serious and possibly life-threatening condition, prompt intervention can mean a positive outcome.  

    If you’re worried about a postpartum hemorrhage, talk to your OBGYN or Midwife about what your risk factors may be and what treatment may include. Our midwives track their patients’ rates related to postpartum hemorrhage. If you’d like to learn more about those rates or have questions, please contact us at our Wilmette or Glenview locations.

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