Bringing a new life into the world is exciting and rewarding. However, your body goes through significant physical changes and stressors, sometimes leading to complications. One of the complications some women face due to the birthing process is postpartum hemorrhage (PPH).
It’s normal to lose blood during childbirth, but PPH occurs when you lose too much within 24 hours after delivery. PPH can happen to any woman, but some factors put you at a higher risk, including the following.
History of Postpartum Hemorrhage
The factors that led to your previous hemorrhaging put you at a higher risk of postpartum hemorrhage during delivery. For example, a uterine scar from a previous C-section may still be present, making it more likely for PPH again. Your care team should be aware of your history and take steps to prepare for or prevent PPH.
Having a Cesarean Section
Several factors contribute to postpartum hemorrhage after a C-section, including:
- the incision through the uterine muscle (a low-transverse incision)- This disrupts the uterine blood vessels and leads to bleeding.
- the incision in the lower uterine segment (classical C-section)- This carries a higher risk of PPH because it cuts through more blood vessels.
- use of instruments- Forceps or vacuum used during the delivery or a scalpel used to make the incision cause bleeding by injuring blood vessels.
- retained placental fragments- If part of the placenta or membranes are left in the uterus after delivery, they continue to bleed, causing PPH.
- uterine atony- This is when the uterus doesn’t contract properly after delivery, causing it to bleed. The uterine muscles normally contract to help stop the bleeding by clamping down on blood vessels. If they don’t work properly, the blood vessels stay open, increasing potential for PPH.
Giving Birth to Multiples
Carrying more than one baby puts you at a higher risk for PPH as you have more than one placenta. Having more than one placenta puts you at a higher risk for placental abruption, which is when the placenta separates from the uterine wall before delivery.
The more times you give birth, the more likely you are to have uterine atony or placental abruption, which causes PPH. Uterus muscles stretch each time you give birth, making them less able to contract and clamp down on blood vessels. This causes the bleeding to continue after delivery.
Placenta Previa
Placenta previa causes PPH if the placenta partially or completely covers the cervix as the baby descends during labor. This can cause the placenta to tear away from the uterine wall, causing heavy bleeding. Placenta previa is more common in women who have had a C-section, are carrying multiples, or have had placenta previa in a previous pregnancy.
Induction of Labor
The drugs used to induce labor, such as Pitocin, cause the uterus to contract too strongly, leading to uterine atony and PPH. When the contractions are too strong, they can cause the uterine blood vessels to tear. This is more likely to happen if your labor is induced before 39 weeks.
Obesity
Being obese increases your risk of PPH as it is more difficult to control bleeding. As the uterus stretches during pregnancy, the fatty tissue layer between the skin and muscle gets thinner. This makes it harder to control bleeding after delivery.
Pre-eclampsia or Eclampsia
Pregnancy complications, such as pre-eclampsia and eclampsia, cause high blood pressure and bleeding. Pre-eclampsia is when you have high blood pressure and protein in your urine after 20 weeks of pregnancy. Eclampsia is when you have pre-eclampsia and also experience seizures. These conditions must be treated as soon as possible to prevent PPH.
Seek Medical Attention Early If You Experience Postpartum Hemorrhage
While postpartum hemorrhage is a life-threatening condition, it is treatable. If you experience PPH, seek medical attention immediately to get the treatment you need. Early intervention prevents PPH from becoming fatal. There are many risk factors for postpartum hemorrhage, and you should be aware of them. If you have any risk factors, seek medical attention immediately to know what you can do to reduce your risk.
