Written by Medicover Team and Medically Reviewed by Dr Amatul Hafsa, Gynecologist

How to Identify the Signs of Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is a serious condition that can occur after childbirth. It is important to recognize the signs early to ensure timely medical intervention. This guide will help you understand the signs of postpartum hemorrhage, how to identify them and what actions to take if they occur.

What is Postpartum Hemorrhage?

Postpartum hemorrhage is excessive bleeding following the birth of a baby. This condition typically occurs within the first 24 hours after delivery but can also happen up to 12 weeks postpartum. PPH is one of the leading causes of maternal mortality worldwide, making early detection and prompt treatment crucial.

Types of Postpartum Hemorrhage

There are two main types of postpartum hemorrhage:

Both types can be life threatening if not recognized and treated quickly. Primary PPH is more common and usually results from uterine atony (when the uterus fails to contract), trauma or retained placenta. Secondary PPH may be due to infection, leftover placental tissue or subinvolution of the uterus (when the uterus doesn’t return to its normal size).

Recognizing the signs early such as heavy bleeding, large clots, rapid heartbeat, or a drop in blood pressure is essential. Immediate medical attention is critical to manage bleeding and ensure the mother's recovery.

Treatment options can include medications to help the uterus contract, surgical procedures to stop bleeding and blood transfusions if necessary. Proper prenatal care and monitoring during delivery also help reduce the risk of postpartum hemorrhage.

Recognizing the Signs of Postpartum Hemorrhage

Identifying the signs of postpartum hemorrhage early can save lives. Here are the key symptoms to watch for:

Heavy Vaginal Bleeding

One of the most obvious signs of PPH is heavy vaginal bleeding. While some bleeding is normal after childbirth, excessive bleeding is a red flag. If you soak through more than one sanitary pad per hour or notice large clots, seek medical help immediately.

Decreased Blood Pressure

A significant drop in blood pressure can indicate severe blood loss. Symptoms of low blood pressure include dizziness, fainting and a feeling of lightheadedness. If you or someone you know experiences these symptoms after childbirth. It is essential to contact a healthcare provider right away.

Increased Heart Rate

An increased heart rate or tachycardia, can be a response to blood loss. If you notice a rapid heartbeat that does not subside with rest, it could be a sign of postpartum hemorrhage. Monitoring vital signs after delivery is crucial for early detection.

Swelling and Pain

Swelling and pain in the vaginal or perineal area can be signs of internal bleeding. If you experience severe pain or notice unusual swelling, consult your doctor immediately. These symptoms may indicate a hematoma, which requires prompt medical attention.

Pale, Clammy Skin

Pale, clammy skin is another warning sign of PPH. This symptom occurs due to reduced blood flow and can be accompanied by feelings of coldness or chills. If you observe these signs, seek medical help without delay.

Trouble Breathing

Difficulty breathing or shortness of breath can result from significant blood loss. If you find it hard to catch your breath or experience chest pain, it is vital to get medical assistance as soon as possible.

Fatigue and Weakness

While feeling tired is common after childbirth, extreme fatigue and weakness could indicate postpartum hemorrhage. If you feel overwhelmingly weak or unable to perform daily activities, it is essential to inform your healthcare provider.

Additional Danger Signs After Cesarean Delivery

If you have had a C-section, you should be especially alert to the danger signs after cesarean delivery. These include:

Always follow your doctor's post op care instructions closely, and do not delay seeking help if symptoms appear.

Menstrual Blood Loss vs. Postpartum Hemorrhage

It is important to differentiate menstrual blood loss from abnormal postpartum bleeding. While regular menstrual bleeding typically ranges from 30-80 ml per cycle, postpartum hemorrhage involves the loss of over 500 ml after vaginal delivery or 1000 ml after a cesarean section. If your bleeding feels heavier than a normal period, it may be a sign of PPH.

Causes of Postpartum Hemorrhage

Several factors can contribute to postpartum hemorrhage. Understanding these causes can help in prevention and early detection:

Uterine Atony

Uterine atony is the most common cause of PPH. It occurs when the uterus fails to contract properly after delivery, leading to excessive bleeding. Risk factors include prolonged labor, overdistended uterus and multiple births.

Retained Placental Fragments

Retained fragments of the placenta can prevent the uterus from contracting effectively, causing heavy bleeding. A thorough examination of the placenta after delivery can help detect and address this issue.

Uterine Rupture

Uterine rupture is a rare but serious condition where the uterine wall tears during labor. This can lead to severe bleeding and requires immediate surgical intervention.

Coagulation Disorders

Certain blood clotting disorders can increase the risk of PPH. Conditions such as disseminated intravascular coagulation (DIC) can impair the body's ability to stop bleeding, necessitating specialized medical care.

Trauma to the Birth Canal

Injuries to the birth canal including tears and lacerations. It can cause significant bleeding. Bleeding after childbirth may result from such injuries. Proper suturing and medical care can help manage these injuries and prevent excessive blood loss.

Preventing Postpartum Hemorrhage

While not all cases of PPH can be prevented, taking certain precautions can reduce the risk:

Prenatal Care

Regular prenatal check ups can help identify risk factors for PPH. Discussing your medical history and any previous complications with your healthcare provider is essential for tailored care.

Active Management of the Third Stage of Labor

Active management of the third stage of labor involves administering uterotonic drugs, controlled cord traction and uterine massage. These measures can help reduce the risk of uterine atony and excessive bleeding.

Monitoring and Early Detection

Close monitoring of vital signs and bleeding after delivery is crucial for early detection of PPH. Healthcare providers should be vigilant and respond promptly to any signs of excessive bleeding.

What to Do If You Suspect Postpartum Hemorrhage

If you or someone you know shows signs of postpartum hemorrhage, take the following steps:

Conclusion

Postpartum hemorrhage is a serious condition that requires prompt recognition and treatment. By understanding the signs and symptoms, you can take swift action to protect the health and well being of new mothers.

Regular prenatal care, vigilant monitoring, and timely medical intervention are key to managing and preventing PPH. Stay informed, stay prepared and do not hesitate to seek help if you suspect postpartum hemorrhage. Early detection can make all the difference.

Frequently Asked Questions