Postpartum hemorrhage: what it is, causes and how to avoid it

Postpartum hemorrhage corresponds to excessive blood loss after childbirth due to the lack of contraction of the uterus after the baby is born. It is considered hemorrhage when a woman loses more than 500 mL of blood after a natural birth or more than 1000 mL after a cesarean section.

Postpartum hemorrhage is the main complication during and after childbirth, which can lead to hypovolemic shock and, consequently, death. Women at greatest risk are those who are older or have a chronic illness. Find out what the main causes of death during childbirth are.

This type of bleeding happens more frequently in women who tried to have a natural birth for several hours but ended up having a cesarean section. However, it can also happen to women who have already scheduled a cesarean section and who have not yet gone into labor.

Causes of postpartum hemorrhage

The main causes of postpartum hemorrhage are:

• Prolonged laborfor more than 12 hours;
• Uterine atonywhich is the loss of the uterus’ ability to contract after the placenta exits;
• Great distension of the uterus during pregnancy with twins or more babies;
• Presence of fibroids in the uterus, which makes it difficult for the uterus to contract during labor;
• Medication useas a muscle relaxant, or large amounts of magnesium during pregnancy;
• Wound in the uterus caused by a spontaneous birth;
• Tissue retentionsuch as the placenta or clots;
• Changes in the blood clotting process, where stopping bleeding is more difficult;

When one or more factors are present, the risk of hemorrhage after childbirth is even greater.

Although it is more common during childbirth, this bleeding can also occur up to the first month after birth, if there are traces of the placenta still attached to the uterus, however, the latter does not put the mother’s life at risk of death. See when to worry about postpartum bleeding.

Warning signs

The main warning sign is the loss of more than 500 mL of blood, which can be perceived through some signs and symptoms such as fainting, paleness, weakness, difficulty standing or holding the baby, in addition to in some cases fever and abdominal pain.

Although it is not possible to predict that there will be hemorrhage during childbirth, it can be avoided by adopting certain measures, such as treating anemia during pregnancy, preparing for natural birth through birth preparation classes and practice. exercise during pregnancy to gain more resistance and make natural birth faster.

Furthermore, it is important to only take the medications recommended by the doctor, in the dosage and for the duration recommended by the obstetrician, also reading the leaflet and observing whether there are signs that something is not right before and during labor.

Classification of postpartum hemorrhage

Postpartum hemorrhage can be classified into:

• Primary postpartum hemorrhagewhen it occurs in the first 24 hours after birth;
• Secondary postpartum hemorrhagewhich happens between 24 hours and 6 weeks after birth.

Postpartum bleeding, known as lochia, lasts a few weeks and is characterized by the release of amounts of blood similar to menstruation, which is considered normal. However, when excessive amounts of blood are lost, it is a sign of hemorrhage, the cause of which must be identified and treatment started immediately.

How the treatment is carried out

Doctors control bleeding after childbirth through direct massage of the uterus and administration of oxytocin directly into the vein, as this hormone promotes contraction of the uterus. In more serious cases, the doctor may choose to cut the arteries that supply the uterus or even remove them, to control the bleeding and save the woman’s life.

In addition, the doctor may recommend blood transfusions to replace the amount of iron and hemoglobin in the body and reestablish the supply of oxygen to the organs. After an episode of postpartum bleeding, it is normal for a woman to have anemia for a few more weeks, requiring an iron supplement for a few months.

What is recovery like?

Due to the large amount of blood loss, the woman may have anemia for a few weeks, making it necessary to carry out the treatment indicated by the doctor, which normally includes increasing iron consumption. Symptoms of anemia include tiredness and excessive drowsiness, which can make it difficult to take care of your baby at home for the first time. Discover the best foods for anemia.

Despite this, breastfeeding should not be compromised and all the mother’s strength should be to feed herself and ensure her safety and that of her baby. Additionally, having someone at home to help with cooking, cleaning the house, and doing laundry can be essential to keeping things calm and under control.