How We Treat Postpartum Hemorrhage
Postpartum hemorrhage (PPH) can be a concerning topic for mothers. Understanding how it’s treated can put your mind at ease. Here’s everything you need to know about postpartum hemorrhage, and how we treat it at The Birth Center of New Jersey.
What Is Postpartum Hemorrhage?
PPH is excessive bleeding immediately after birth. Minor PPH is when you lose 500ml or more of blood within the first 24 hours of delivery. Major PPH occurs if the mother loses more than 1000 ml of blood in the same time frame. The chances of PPH are quite low (four percent, to be precise) and most cases occur in cesarean births.
Causes of PPH
The most common cause of PPH is uterine atony. After giving birth, the placenta is expelled within 30-60 minutes due to uterine contractions. These contractions continue for about six weeks, compressing the blood vessels where the placenta was attached to stop the bleeding. If the contractions aren’t strong enough, the blood vessels flow freely and postpartum hemorrhage occurs.
Retained placenta is another common cause of PPH, where the placenta isn’t delivered or pieces of placenta remain in the uterus after birth.
Stages of PPH
There are four stages of PPH:
- The first stage is early (or primary) PPH, which happens within the first 24 hours after delivery. This is often due to issues like uterine atony (when the uterus doesn’t contract well), retained placenta, or lacerations.
- Next is delayed (or secondary) PPH, which can occur anywhere between 24 hours and up to six weeks postpartum and is often caused by retained placental tissue or infections.
- As mentioned above, Minor PPH is blood loss of 500-1000 mL after a vaginal delivery (or over 1000 mL after a cesarean).
- Major PPH is any blood loss beyond those amounts and may cause complications.
Our Approach to Treating PPH
Our first step in managing postpartum hemorrhage is to encourage the uterus to contract via massage techniques. We also have medications to stimulate uterine contractions, supervised by trained medical professionals.
If bleeding continues, we administer IV fluids and may arrange a transfer to the hospital. At the hospital, the staff will continue to monitor the bleeding and assess the need for additional medications or intervention. They may also provide blood products or transfusions necessary for the mother’s safety.
Again, these situations are rare, especially if you are low-risk. Risk factors include multiple pregnancies, giving birth to twins or triplets, or a large baby. For most cases of PPH, we use uterine massage and medication at our birth center. You can learn more about PPH treatments on our YouTube channel.