Bleeding after giving birth: what does it mean and when can it cause problems?

Posted: 01/04/2022

Following our recent article on APGAR scores, the next article in this series deals with bleeding after giving birth.

Will I bleed after giving birth?

Some bleeding from the vagina after giving birth is normal. It usually starts out heavy and decreases over time. To begin with the blood will be fresh, but it will gradually turn browner over the following weeks before eventually stopping altogether.

When will I need treatment?

If you lose blood in large clots, or very heavily, this could mean that you are suffering from what is known as a ‘postpartum haemorrhage’. Postpartum haemorrhage is a rare complication, but it can be very dangerous. Severe blood loss causes a drop in your blood pressure, and you could go into shock and even die if it is not treated.

Postpartum haemorrhage can be immediate - within 24 hours of you giving birth - or delayed - up to six weeks after birth.

What symptoms should I watch out for?

Some of the more common symptoms of postpartum haemorrhage are heavy bleeding, decreasing blood pressure, increasing heart rate, swelling and pain around your vagina, and a low red blood cell count.

Postpartum haemorrhage can happen to anyone, but it is more common if you are obese, have had lots of births before, your labour was very long, or you have high blood pressure. Some medications to induce labour or stop contractions can make postpartum haemorrhage more likely.

What causes postpartum haemorrhage?

There are a number of causes of postpartum haemorrhage but the most common is called uterine atony. After you give birth to your baby, you will usually continue to have contractions until the placenta is delivered as well. After that, the contractions should compress the blood vessels where the placenta was attached and slow down the bleeding. If the contractions are not strong enough then the vessels will continue to bleed.

Postpartum haemorrhage may also be a sign of the placenta having detached too early from the uterus (placental abruption), or the placenta covering the cervical opening (placenta previa).

It can also occur due to an overdistended uterus, usually caused by having a large baby, or more than one baby at once. Alternatively, you may have suffered a serious tear during labour or an infection, which can also lead to haemorrhage.

What treatment will I need?

The cause of the bleeding needs to be established as quickly as possible so that it can be stopped. Depending on how severe the bleeding is, and what caused it, you could be given medication, manual massage of the uterus, a catheter, or surgery. You may also have intravenous fluids and bloods to replace the blood you have lost.

Postpartum haemorrhage can be very serious if not treated promptly and so it is important to seek medical advice without delay. However, with treatment a complete recovery is likely.

Postpartum haemorrhage does not necessarily mean that your medical care was substandard, but if you do have concerns about the circumstances of your baby’s birth, please do not hesitate to contact our specialist birth injury team for a no-obligation discussion.

Previous articles in this series: