There’s no sugarcoating it—giving birth is a major medical event. And while rare, there are some serious conditions that can make it even more intense. One of these conditions is postpartum hemorrhage. And while it certainly sounds a bit scary, Women & Babies Hospital has established standardized interventions to identify and treat complications for all patients—not just those with a higher risk factor. You’re in good hands, mama!
What is Postpartum Hemorrhage?
Postpartum hemorrhage (sometimes abbreviated as PPH) is when a person has heavy bleeding after giving birth. While it’s normal to lose blood during and after the process of any type of birth (roughly half a quart for vaginal deliveries and one quart for C-sections), mamas who experience PPH lose a significant amount more. As a result, this can cause a severe drop in blood pressure and can lead your body to go into shock.
Most times postpartum hemorrhage happens within a day of giving birth, but in some cases it can happen up to 12 weeks after having a baby. PPH affects roughly one to five percent of women who give birth.
What Causes Postpartum Hemorrhage?
After delivering your baby, your uterus continues having contractions in order to help push out your placenta. The contractions also help put pressure on the blood vessels where the placenta attached to the uterus, which in turn helps stop the bleeding that occurs. If the contractions aren’t strong enough, or pieces of the placenta stay attached and aren’t delivered properly, this can actually cause bleeding to increase.
Though not a comprehensive list, factors that can cause an elevated risk of experiencing PPH include:
- Blood clotting disorders
- Conditions that affect the uterus (such as uterine atony, inversion or rupture)
- Conditions that affect the placenta (such as placental abruption, placenta accreta, or retained placenta)
- C-section births
- Augmented labor (where medications such as oxytocin are used to make the uterus contract during labor)
- Lacerations during birth
- Previous experiences with PPH
- Black women have a higher risk of experiencing PPH
What Are the Warning Signs or Symptoms of Postpartum Hemorrhage?
If you experience any of the following signs or symptoms (whether in the hospital or once you return home after birth), seek immediate medical attention from the hospital staff or call 911 right away:
- Heavy bleeding from the vagina that doesn’t slow
- Sudden drop in blood pressure
- Signs of shock (blurry vision, chills, clammy skin, fast heartbeat, feeling like you might faint)
- Nausea or throwing up
- Pale skin
- Swelling and pain around the vagina or perineum (the area between the vagina and rectum)
How is Postpartum Hemorrhage Treated?
While this might all sound scary, there are a lot of different ways to address postpartum hemorrhage depending on the severity of the condition. And your provider will keep a close eye on things in the hours and days following labor and delivery:
- Fluids or medicine through an IV (could include oxytocin to cause the uterus to contract)
- Blood transfusion to replenish lost blood if needed
- Uterine massage to help the uterus contract and pass clots
- Removal of any remaining pieces of the placenta
- Insertion of special balloons or sponges into the uterus to help stop bleeding from blood vessels
- In severe cases, postpartum hemorrhage may be addressed surgically
What Is Women & Babies Hospital Doing to Address Postpartum Hemorrhage Among Black Women?
Lancaster General Health and Penn Medicine have been working system-wide to reduce complications among Black women who deliver in our hospitals, including postpartum hemorrhage. Here are a few of the ways in which we’ve been working to improve:
- We formed the Black Maternal Mortality and Morbidity Committee, which is comprised of all of our major providers and groups, nursing leaders, social workers and IT
- We have established standardized interventions to identify and treat complications most commonly affecting Black women (such as preeclampsia and postpartum hemorrhage). These interventions are applied to all women who deliver at Women & Babies Hospital, regardless of race
- Our providers have been trained to treat a person’s diagnosis only, which eliminates any assumptions based on the race of the patient
We are proud to say that we have already seen improvement due to these efforts. In 2019, 10.1% of Black women experienced complications at Women & Babies Hospital compared to 6% of White women. This disparity has been eliminated as of 2021.
Of these efforts, Dr. Robert Faizon, Chair of the Black Maternal Mortality and Morbidity Committee says: “All women who deliver their newborns at Women & Babies Hospital benefit from standardized practices to identify and treat potential complications like preeclampsia and postpartum hemorrhage…we take pride in “zero gap” complication rates between our Black and White patients and constantly work to assure equity among all we serve.”