Pregnancy health centre

Introduction

Doctors say you have heavy bleeding after childbirth if you lose half a litre (about a pint) or more of blood. Most women in the UK don't bleed heavily after childbirth, but it can occasionally happen. There are treatments that can help prevent heavy bleeding during labour or straight after your baby is born.

We've brought together the best research on preventing heavy bleeding after childbirth. You can use our information to talk to your doctor and decide which treatments are best for you.

It's normal to have some bleeding when you give birth. But if you lose half a litre (about a pint) or more of blood, it means your bleeding is heavy.

Doctors call heavy bleeding after childbirth postpartum haemorrhage. If you lose about one litre (about two pints) or more of blood after childbirth, then you have severe postpartum haemorrhage.^[1]

It can be difficult for doctors to tell exactly how much blood you lose after you have a baby. But your doctor or midwife will monitor you carefully after your baby is born to check that you're not losing too much blood. They will look at how much you are bleeding, and check your blood pressure, pulse, and general health. These things will help them decide if you're losing too much blood and need treatment.

Heavy bleeding (haemorrhage) can happen during the first 24 hours after you give birth or up to six weeks later.

• If you get heavy bleeding within 24 hours of giving birth, it's called primary postpartum haemorrhage.

• If you get heavy bleeding after the first 24 hours and up to six weeks later, it's called secondary postpartum haemorrhage. If you are at home and think you're bleeding heavily and you feel dizzy and weak, call your doctor straight away. You may need treatment.

Bleeding heavily after having a baby is a problem because:

• It can lead to anaemia (when you have a low number of red blood cells in your body)

• You may need a blood transfusion

• You can die. But this is rare.

Most women who bleed heavily after they've had a baby do so because their womb (uterus) doesn't shrink (contract) properly. Doctors call this uterine atony. As your womb contracts and separates from your placenta (afterbirth), the blood vessels in your womb close up. If some of the placenta doesn’t come away completely, the womb can’t contract properly and the blood vessels will continue bleeding. The treatments we talk about here are given to help the womb shrink after childbirth. (See What treatments work to prevent heavy bleeding after childbirth?)

Other problems that also can cause heavy bleeding after childbirth are:^[2]

• Bits of the placenta getting stuck in your womb after delivery, instead of coming out

• Cuts or tears around your vagina or cervix (the opening of the womb) during delivery

• A hole or tear in your womb

• Your blood not clotting normally.